Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
J Natl Med Assoc. 2009 Dec;101(12):1274-82. doi: 10.1016/s0027-9684(15)31139-1.
To examine the association between physician race/ ethnicity, workplace discrimination, and physician job turnover.
Cross-sectional, national survey conducted in 2006-2007 of practicing physicians (n = 529) randomly identified via the American Medical Association Masterfile and the National Medical Association membership roster. We assessed the relationships between career racial/ethnic discrimination at work and several career-related dependent variables, including 2 measures of physician turnover, career satisfaction, and contemplation of career change. We used standard frequency analyses, odds ratios and chi2 statistics, and multivariate logistic regression modeling to evaluate these associations.
Physicians who self-identified as nonmajority were significantly more likely to have left at least 1 job because of workplace discrimination (black, 29%; Asian, 24%; other race, 21%; Hispanic/Latino, 20%; white, 9%). In multivariate models, having experienced racial/ethnic discrimination at work was associated with high job turnover (adjusted odds ratio, 2.7; 95% CI, 1.4-4.9). Among physicians who experienced workplace discrimination, only 45% of physicians were satisfied with their careers (vs 88% among those who had not experienced workplace discrimination, p value < .01), and 40% were contemplating a career change (vs 10% among those who had not experienced workplace discrimination, p value < .001).
Workplace discrimination is associated with physician job turnover, career dissatisfaction, and contemplation of career change. These findings underscore the importance of monitoring for workplace discrimination and responding when opportunities for intervention and retention still exist.
考察医生种族/民族、工作场所歧视与医生离职之间的关系。
2006-2007 年采用横断面、全国性调查,通过美国医学协会主文件和全国医学协会成员名单随机抽取执业医师(n=529)。我们评估了工作场所职业种族/民族歧视与几种职业相关的因变量之间的关系,包括 2 种医生离职衡量指标、职业满意度和职业变更考虑。我们使用标准频率分析、比值比和卡方统计以及多变量逻辑回归模型来评估这些关联。
自认为不属于多数族裔的医生因工作场所歧视而离职的可能性明显更高(黑人 29%;亚裔 24%;其他种族 21%;西班牙裔/拉丁裔 20%;白人 9%)。在多变量模型中,工作场所经历种族/民族歧视与高离职率相关(调整比值比,2.7;95%置信区间,1.4-4.9)。在经历工作场所歧视的医生中,只有 45%的医生对自己的职业满意(而未经历工作场所歧视的医生中则有 88%,p 值<.01),40%的医生在考虑职业变更(而未经历工作场所歧视的医生中则有 10%,p 值<.001)。
工作场所歧视与医生离职、职业不满和考虑职业变更相关。这些发现强调了监测工作场所歧视和在仍然存在干预和保留机会时做出反应的重要性。