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. 2024 Jan 2;7(1):e2352818.
doi: 10.1001/jamanetworkopen.2023.52818.

Physician Perspectives on Addressing Anti-Black Racism

Crystal E Brown  1   2   3 , Arisa R Marshall  2 , Kristine L Cueva  4 , Cyndy R Snyder  5 , Erin K Kross  1   2 , Bessie A Young  6   7
Affiliations

Physician Perspectives on Addressing Anti-Black Racism

Crystal E Brown et al. JAMA Netw Open. .

Abstract

Importance: Uncertainty remains among clinicians regarding processes to address and resolve conflict around anti-Black racism.

Objective: To elicit clinicians' perceptions of their role in addressing concerns about anti-Black racism among Black patients with serious illness as well as their families.

Design, setting, and participants: In this qualitative study, one-on-one semistructured interviews were conducted with 21 physicians at an academic county hospital between August 1 and October 31, 2022. Participants were provided clinical scenarios where anti-Black racism was a concern of a patient with serious illness. Participants were asked open-ended questions about initial impressions, prior similar experiences, potential strategies to address patients' concerns, and additional resources to support these conversations. A framework based on restorative justice was used to guide qualitative analyses.

Main outcomes and measures: Perspectives on addressing anti-Black racism as described by physicians.

Results: A total of 21 medical subspecialists (mean [SD] age, 44.2 [7.8] years) participated in the study. Most physicians were women (14 [66.7%]), 4 were Asian (19.0%), 3 were Black (14.3%), and 14 were White (66.7%). Participants identified practices that are normalized in clinical settings that may perpetuate and exacerbate perceptions of anti-Black racism. Using provided scenarios and personal experiences, participants were able to describe how Black patients are harmed as a result of these practices. Last, participants identified strategies and resources for addressing Black patients' concerns and facilitating conflict resolution, but they stopped short of promoting personal or team accountability for anti-Black racism.

Conclusions and relevance: In this qualitative study, physicians identified resources, skills, and processes that partially aligned with a restorative justice framework to address anti-Black racism and facilitate conflict resolution, but did not provide steps for actualizing accountability. Restorative justice and similar processes may provide space within a mediated setting for clinicians to repair harm, provide accountability, and facilitate racial healing.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Kross reported receiving grants from the National Institute on Aging outside the submitted work. Dr Young reported receiving grants from the Chou Foundation and the National Institutes of Health outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. The 5Rs of Restorative Justice Used in the Health Care Setting to Promote Accountability and Repair the Harms of Anti-Black Racism
HCW indicates health care worker.
See this image and copyright information in PMC

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