Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Talk About Diversity With Minority Physicians


Before asking minority colleagues about discrimination, gain their consent first.

“You’re my first African-American friend.”


Good gods, not again.


“What’s it like being Black in America?”


I actually identify as African-American. And well, it’s America, so not great.


“How’re you doing after George Floyd?”


Numb, full of sorrow that’s threatening to overwhelm me, fury that murdering African-Americans continues unabated as usual, despair that what I see in the hospital is but a microcosm of the macrocosm that is America, unfulfilled hopes that America will be better, but I’m coping. It’s what I do. I’m coping, smiling, and must go about my day being the perfect physician.


Because physicians who are minorities can’t be anything less than perfect.


“What’s it like being a Black doctor here?”


I’ve told you what it’s like. The daily horror, the anxiety, the exhaustion. Please stop asking but not listening.


“I never want to burden you with speaking about these issues. However, if you want to talk about racism you’ve experienced, I’m here to listen.”


“I never want to burden you with speaking about these issues. However, if you want to talk about racism you’ve experienced, I’m here to listen.”


Oh, now this is different. The phrasing makes me pause. It shouldn’t but it does. To hear an attending ask about race in such a manner, with invitation, without accusation, without voyeurism, is rare. In our emergency department, my attending and I—an African-American, gay psychiatry resident—have some down time together. We’ve seen all of our patients needing care for the moment and we’re shooting the breeze a bit. Then comes the aforementioned opportunity. One where I could speak about the racism and homophobia I’ve encountered. I could speak about such things because I know it often broadens minds and opens hearts. Or I could skirt neatly around the question.


My attending had set a different tone. The fact that he asked for consent to broach such topics was starting at a different point than many prior interactions in the hospital. There was no dismissal of my experiences. There was no overt probing into things I was still grappling with. And so, we talked. We were two people sitting in our little area in the ED, talking, listening, and growing together.


When I think back to that conversation, I remember feeling safe. In this time where nearly every minority in America feels unsafe, my attending and I created a small bastion of safety in that moment.


Here are four things that helped me feel safe: 


1. If you ask colleagues who are minorities about discrimination, gain their consent first.

When many minorities are asked about their experiences of being x, y, or z, it can feel like an invasion. Thoughts of, “Why is this person asking? Are they safe to discuss such matters with?” run around our heads each time we enter these discussions. You’re not the first to ask about these topics. You won’t be the last. So, each time, ask for our consent because one day we may want to talk about these issues, while the following day we might not.


2. Truly listen to our stories.

Actively listen to our lived experience, thoughts, opinions, about the space we need to be fully ourselves, and all of the pain, joy, and emotions we carry around with us every day as minority physicians in America.


3. Understand that physicians who are minorities are often entering conversations around discrimination with heightened sensitivities and fears.

Many minority physicians have experienced a lifetime of instances of overt and subversive discrimination. When asked a question about discrimination, we often wonder if you’ll stand up for us, if we’ll be able to stand up for ourselves, or if this will be another instance where we must close our mouths and smile to get by.


4. It’s not our job to give you answers about fixing discrimination.

Many colleagues are desperately searching for answers to “fix” the system and are asking minorities to tell them how. As in the past, many minorities continue to be tokenized and tasked with spearheading diversity efforts only to be ignored. It’s the job of those who are privileged to leverage their privilege to create systemic change.


Although there are many other pieces of advice I could impart, the above are a start. I promise that I’ll be sharing more of such thoughts in the months to come. Above all else, if you forget those four suggestions, always remember that when we answer questions about discrimination, we’re inviting you into our lives, and we’re trusting that you’ll honor the stories that we share.