Microaggressions in Medicine

Brittany Feaster, MHS; Lynn McKinley-Grant, MD, MA; Amy J. McMichael, MD

Disclosures

Cutis. 2021;107(5):235-237. 

In This Article

What are Microaggressions?

Microaggressions are behaviors that stem from implicit bias and occur at an interpersonal level. Implicit bias refers to unconscious stereotypes, assumptions, and beliefs held about an individual's identity. One of the earliest microaggressions—invisibility—was characterized by Ralph Ellison in his novel Invisible Man. Ellison states, "I am invisible, understand, simply because people refuse to see me … When they approach me they see only my surroundings, themselves, or figments of their imagination—indeed, everything and anything except me."[4] This concept of invisibility is a primary microaggression faced by people of color.

In medicine, microaggressions and implicit bias may be encountered throughout medical training and clinical practice in interactions with colleagues, superiors, patients, and patients' families.[5,6] Examples of microaggressions in medicine include demeaning comments, nonverbal disrespect, generalizations of social identity, assumption of non-physician status, role- or credential-questioning behavior, explicit epithets, rejection of care, questioning or inquiries of ethnic/racial origin, and sexual harassment.[7]

An example of microaggressions in medicine was fully displayed when physician Tamika Cross described her experience of being turned away from helping an unresponsive passenger during a flight emergency.

[T]he flight attendant yells "call overhead for a physician on board." I raised my hand to grab her attention. She said to me "oh no sweetie put [your] hand down, we are looking for actual physicians or nurses or some type of medical personnel, we don't have time to talk to you" … Another "seasoned" white male approaches the row and says he is a physician as well. She says to me "thanks for your help but he can help us, and he has his credentials." [8]

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