• Marcella Nunez-Smith, Leslie A Curry, David Berg, Harlan M Krumholz, and Elizabeth H Bradley.
• Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 09520-8088, USA. marcella.nunez-smith@yale.edu
• J Gen Intern Med. 2008 Sep 1; 23 (9): 147114761471-6.

BackgroundAlthough experts recommend that healthcare organizations create forums for honest dialogue about race, there is little insight into the physician perspectives that may influence these conversations across the healthcare workforce.ObjectiveTo identify the range of perspectives that might contribute to workplace silence on race and affect participation in race-related conversations within healthcare settings.DesignIn-person, in-depth, racially concordant qualitative interviews.ParticipantsTwenty-five physicians of African descent practicing in the 6 New England states.ApproachLine-by-line independent coding and group negotiated consensus to develop codes structure using constant comparative method.Main ResultsFive themes characterize perspectives of participating physicians of African descent that potentially influence race-related conversations at work: 1) Perceived race-related healthcare experiences shape how participating physicians view healthcare organizations and their professional identities prior to any formal medical training; 2) Protecting racial/ethnic minority patients from healthcare discrimination is a top priority for participating physicians; 3) Participating physicians often rely on external support systems for race-related issues, rather than support systems inside the organization; 4) Participating physicians perceive differences between their interpretations of potentially offensive race-related work experiences and their non-minority colleagues' interpretations of the same experiences; and 5) Participating physicians are uncomfortable voicing race-related concerns at work.ConclusionsCreating a healthcare work environment that successfully supports diversity is as important as recruiting diversity across the workforce. Developing constructive ways to discuss race and race relations among colleagues in the workplace is a key step towards creating a supportive environment for employees and patients from all backgrounds.

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