Hepatology Not Immune to Workplace Discrimination

Female hepatologists, as well as those who were Black or Hispanic, were more likely to report workplace discrimination, a researcher said.

In a survey of nearly 200 hepatologists, three-quarters of women reported workplace discrimination compared to only 37% of men, reported Lauren Feld, MD, of the University of Washington in Seattle.

And compared to their white female counterparts, more Black female hepatologists and Hispanic female hepatologists cited an unfair lack of consideration for promotion (18% vs 50% vs 25%, respectively) and unequal pay or benefits (41% vs 50% vs 50%), she said at a poster presentation at the virtual annual meeting of the American Association for the Study of Liver Diseases (AASLD).

This “is both shocking and yet glaringly evident of our current societal norms which frequently spill over into our workplaces,” said Sajid Jalil, MBBS, MS, of Ohio State University Wexner Medical Center in Columbus, who was not involved in this study.

Feld said the AASLD has made prior efforts to combat disparities, including the development of the Women’s Initiative Committee and the Inclusion and Diversity Committee, both with a series of projects set to launch with AASLD support.

She added that the Women’s Initiative Committee discussed studying workforce gender equality back in 2019.

“We knew that it was important to first identify the prevalence and the nuances of workplace discrimination to guide meaningful, targeted interventions to reduce disparities,” Feld told MedPage Today. “There is widespread workplace discrimination that has been described in other aspects of medicine that hasn’t yet been described in hepatology and were also lacking on national data.”

Feld explained how there is an “upcoming shortage of hepatologists,” as well as data to suggest “women are dissuaded against gastroenterology and hepatology because of concerns of lack of mentorship in the field” as well as a perceived “incompatibility with child rearing and parental leave.”

Her group evaluated cross-sectional survey response data from 199 AASLD physician members in January 2021. Hepatologists responded anonymously to a 33-question survey based on “perceived workplace discrimination by race/ethnicity and gender.”

Most participants were white (60%), and about two-thirds were women (65%). While about a quarter were Asian (27%), only 6% were Black and 5% were Hispanic.

More female hepatologists than male hepatologists reported the following concerns:

• Lack of inclusion in administrative decision-making (41.1% vs 22.4%)
• Disrespectful treatment by nursing/support staff (40.3% vs 7.5%)
• Nonequivalent pay or benefits compared to peers (39.5% vs 13.4%)
• Being held to higher standard of performance than peers (24.8% vs 4.5%)
• Lack of fair consideration for promotion or senior management (17.1% vs 10.4%)

In addition, two women reported sexual harassment.

“Women represent only 18% of the current practicing gastroenterologists (and presumably hepatologists) and only four female AASLD presidents (out of 68 presidents, or 6%) since its inception,” Jalil told MedPage Today. “I am proud to be working at such an academic center where such implicit and explicit biases are addressed head-on and where well-qualified female and ethnically diverse faculty are actively recruited and retained.”

“This is the America I would like to live and work in as a father of two college-age daughters,” he added.

The analysis had several limitations, the researchers acknowledged, including the small sample size and limited generalizability, as it included only AASLD members. Men and racial/ethnic minorities were also underrepresented in the sample.

“I hope this data helps fuel meaningful interventions to reduce bias and recruit, promote, and retain women and physicians from underrepresented ethnicities,” Feld said.