COVID-19 exposed the nation’s lack of health equity as, early in the epidemic, a disproportionate negative impact was found among Black, American Indian and Native Alaskan, Hispanic, Asian and Pacific Islander communities. It has now also become clear that the physicians who practice in and belong to those same communities often bear a larger portion of the pandemic’s toll as well.
An AMA-sponsored study, “Experiences of Racially and Ethnically Minoritized and Marginalized Physicians in the U.S. During the COVID-19 Pandemic” (PDF) details the results of a web-based, 12-question survey conducted in the summer of 2020 that nearly 750 physicians took part in.
Physicians who are from demographic groups that have been historically underrepresented in or excluded from the field of medicine are referred to in the study as “marginalized” physicians. “Minoritized,” meanwhile, refers to the process of historically minoritizing others based on a dominant category intended to oppress groups based on a given social standing. For example, this study centers on the experiences of those from racially and ethnically minoritized or marginalized identities, specifically those identities described above.
Black and Hispanic physicians were among the most likely to have treated a patient with a confirmed case of COVID-19 (78.5%; 74.5%), according to the study. This finding aligns with evidence showing Black and Hispanic populations have been disproportionately affected by COVID-19. Members of these groups were infected and hospitalized at higher rates than others, with Black and Hispanic people under 65 dying in greater numbers than white people in this age group.
Also, while telehealth offered a lifeline to many patients who remained in their homes, access wasn’t equal. Three out of five physicians surveyed said they experienced connectivity issues with audiovisual communications.
The pandemic “has been an eye-opening experience, exposing breaks in the system and a lack of technology available to patients” that in turn led to unequal telehealth capabilities, said a Black physician in a nephrology practice who, like other doctors, was quoted anonymously in the study.
“This pandemic is exacerbating deeply seated inequities rampant throughout our health care system and bearing witness to such, day in and day out, inflicts moral injury on health care workers every day,” said an Asian American family physician practicing at a federally qualified health center who was quoted in the study.
A large majority (82.3%) of physicians surveyed agreed that COVID-19 highlighted deep inequities, with 93.3% of Black physicians in agreement.
Learn more with the AMA about the experiences of minoritized and marginalized physicians in the U.S. during COVID-19.
Worsening work environment
At work, the majority (85.3%) of physicians reported they were never or rarely treated with less dignity and respect by colleagues due to their race or ethnicity. Black physicians were the most likely to report that they were sometimes treated with less dignity and respect due to their race or ethnicity (20%), according to the study.
One in five (20.5%) across all groups reported that they were sometimes or more frequently treated with less dignity and respect by their patients because of their race or ethnicity. Black physicians were among the most likely to report this experience (28.2%).
More than 9% of all physicians from historically marginalized or minoritized racial or ethnic groups indicated that they were sometimes or more frequently called insulting names related to their race, ethnicity or skin color at work.
Conditions, however, appeared to be worsening in the workplace, according to the study.
Since the onset of pandemic, some physicians reported they were being treated with less dignity and respect by their colleagues more frequently because of their race or ethnicity. Black physicians were the most likely to report an increase in this experience (22.9%).
Almost one in five physicians from historically marginalized or minoritized racial or ethnic groups reported an increase in experiences of being treated with less dignity and respect by their patients due to their race since the onset of COVID-19 (18.1%).
It is important to note these data were uncovered during the early stages of the pandemic, however, they illustrate the toll on an already marginalized and minoritized physician community.
Learn about the AMA Center for Health Equity and the AMA’s strategic plan to embed racial justice and advance health equity.
Essential Tools & Resources
Read AMA policies on health equity
Explore health equity on JAMA Network™️
Read the latest on health equity from AMA Journal of Ethics®️
Learn more about health disparities on AMA Ed Hub™️
COVID-19 Q&A: health equity in pandemic
Release the Pressure: Heart health equity with Essence