Hepatologists experience workplace discrimination, survey finds

Hepatologists -- physicians who specialize in liver disease -- say they experience workplace discrimination, especially if they are women or BIPOC (an acronym that stands for Black, Indigenous or People of Color). A new survey by a UW Medicine researcher resulted in this finding.

Dr. Lauren Feld, a transplant hepatology fellow at the University of Washington School of Medicine, presented her results at the American Association for the Study of Liver Disease this month. The study was conducted through the AASLD Women's Initiatives Committee.

Widespread workplace discrimination has been described in other areas of medicine but less is known about discrimination in hepatology, said Feld during her presentation at the AASLD's Liver Meeting.

Certainly these statistics are disturbing, but they are not surprising."

Dr. Lauren Feld, transplant hepatology fellow, University of Washington School of Medicine

Among the her key findings:

• 75% of women and 37% of men report workplace discrimination.
• Twice as many women as men say they are not included in administrative decision-making.
• More than 40% of women and 7.5% of men report being treated disrespectfully from nursing or support staff. Feld said in addition to impacting hepatologists personally, tensions can affect the quality of patient care.
• About 40% of women and 13% of men report receiving unequal pay. Usually, women are just advised to "negotiate harder," Feld notes. "If the starting offer is different, or if women are viewed more negatively when they negotiate, then we should also be addressing the underlying systematic inequality."
• About a quarter of women say they were held to higher standards of performance than their peers.
• 17% of women feel they are not fairly considered for promotions or senior management positions.

When responses were sorted by ethnicity the negative experiences reported increased.

• Half the Black or Latina women doctors said they did not receive equivalent pay to their peers.
• Black women doctors felt they were not consulted on policy decisions or received fair considerations for promotions.
• For BIPOC men, 35 percent of the Latinix men say they did not receive fair pay or benefits compared with their white counterparts.

In a separate but related study, Feld found that parental leave polices for hepatologists were patchy, if they existed at all. Where they did exist, the leave policies allowed for only seven weeks off or less.

"We are requiring our workforce to take significantly less leave than is recommended by our own medical societies," said Feld, who is due to have her second child soon.

About 70 percent of the women doctors reported delaying having children because of how they may be viewed and how becoming mothers would impact their careers.

As for next steps, Feld said that the AASLD Women's Initiatives committee, on which she serves, is committed to advocacy and policy changes. It won't happen all at once, however.

Now, when a woman or minority man makes a complaint, the view is they need to negotiate harder or work to ignore someone who is throwing micro-aggressions their way, she noted.  More needs to be done, she added, to work with administrators and leaders in the medical community to address these problems head on.

"Awareness is a good first step, but there needs to be a culture change, as well as training to provide inclusive work places and reversing harmful policies," Feld said.

Both surveys were sent out to 199 recipients through the AASLD list serve in January. The AASLD funded the study.