How Social Identity Impacts Clinical Leadership in Emergency Medicine
RACISM AS A PUBLIC HEALTH CRISIS
By Anita Chary MD, PhD and Melanie Molina MD
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As emergency physicians, we are leaders. We lead traumas, codes, and the resuscitation of the critically ill; however, we often receive differential recognition of our leadership based on our social identities. In the United States, the societal vision of a doctor remains White and male, and this has been reflected in the demographic composition of emergency medicine physicians. As two female resident physicians of color, we have noticed the ways in which social identity has impacted perceptions of leadership, both for us and for our colleagues. We have witnessed Black physicians being mistaken for non-clinicians such as transportation staff or patient sitters. We have experienced senior female residents being silenced during traumas in favor of male junior residents. We have had patients refuse the care of our Black and Brown colleagues. In light of these realities, we held a panel with a few of our experienced mentors to discuss how social identity impacts clinical leadership in emergency medicine. Here are some excerpts from our conversation.
How do your social identities influence your clinical leadership style?
Dr. Adaira Landry: I have various social identities. I think the leading one for me is being a Black person. That’s number one, two, and three. When I walk into a room, I am being observed as a Black person before I am being observed as a woman. I think that has carried over into my experience as a physician as well. I have been in the room with women
who are not of color. I have seen them questioned less about their credentials compared to me and doubted less as to who’s going to be doing the procedure. I’m also aware of when I want to bring in a different identifier, such as being a mother. There are some situations where that is the part of me that I’m bringing forward. Sometimes it’s being a woman. It can transition a bit depending on the topic at hand or the situation at hand. Dr. Dan Egan: I’m a White man and coming from my space as a gay man, it’s not as obvious as it is for my colleagues who talk about walking into the room and immediately being identified as Black. I haven’t had the same experiences of not being trusted that I’m a doctor; however,
every single job that I’ve had, I’ve been called the name of the other gay doctor, who at one hospital, was Asian. I’ve been called “faggot” by patients. I’ve been told by male patients, “You can’t do my rectal exam.” Over time, you have to develop a way that you’re going to respond. That intrinsic anger needs to translate into a professional response.
How do you approach the situation when your clinical abilities are questioned — whether by patients or other colleagues in the emergency department (ED)? Dr. Adaira Landry: That’s happened with me and residents in this program
About the Panelists Adaira Landry, MD, MEd, is the assistant residency director of the renowned Harvard Affiliated Emergency Medicine Residency, assistant professor of emergency medicine at Brigham and Women’s Hospital, ultrasound fellowship director for the department of emergency medicine at Brigham and Women’s Hospital, and advisor and associate director of the Walter Bradford Cannon Society at Harvard Medical School. Alden M. Landry, MD, MPH, is an assistant professor of emergency medicine at Beth Israel Deaconess Medical Center, assistant dean for the Office for Diversity Inclusion and Community Partnership, associate director and advisor for the William B. Castle Society, and director of health equity education at Harvard Medical School. He also serves as senior faculty at the Disparities Solutions Center at Massachusetts General Hospital and is the founder and codirector of the nonprofit organization Motivating Pathways. Dan Egan, MD, is the program director of the Harvard Affiliated Emergency Medicine Residency. He is the former vice chair of education for emergency medicine at Columbia University and the former program director for Mount Sinai St. Luke’s and Mount Sinai Roosevelt in New York City.
