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When Professionalism Doesn’t Look the Same to Everyone

What does professionalism mean to you? What does it look like? No matter your vision it probably focuses in the manner that one carries themselves, speaks to others, presents themselves in dress and deed, and upholding standards. How much you value professionalism could be different than others you know and possibly work with.

In the healthcare setting, women, minorities, and LGBTQ workers value professionalism more than their white, male counterparts, and are more likely to leave a position because of issues of professionalism, according to the results of a large-scale survey of staff, faculty, and students in a large, academic health system and published in JAMA Network Open.

How professionalism was measured

First, researchers surveyed 3,506 people: 64.4% were women, 10.5% identified as gender or sexual minority groups, and 11.3% were non-Hispanic Black individuals.

Respondents were asked to rate their responses (from strongly agree to strongly disagree) to three statements related to professionalism:

1. “I have considered changing jobs due to inappropriate, disruptive, or unprofessional behavior by a coworker or supervisor.” Respondents who self-identified as female, LGBTQ, non-Hispanic Black individuals, when compared with white, heterosexual men, were statistically significantly more likely to report considering changing jobs because of “unprofessional” behavior.

2. “I value institutional initiatives, policies, and/or educational resources related to professional behavior in the workplace.” In response to this statement, 52% of women and 54% of Black individuals agreed or strongly agreed, compared to 45% of male and 49% of white respondents.

3. “My institution supports a culture of professionalism.” There were no statistically significant differences were found among respondents who agreed with this statement.

To follow up on these responses, the research team solicited narratives via email about professionalism. They asked for respondents to answer: “Tell us a time that you felt valued or devalued, or welcomed or not welcomed by your organization.”

Many of the 52 narrators who self-identified as members of marginalized populations expressed infringement on their professional boundaries during interactions at work or learning environments. These ranged from microaggressions to blatant racism, sexism, xenophobia, and homophobia.

Other narratives stated that professional standards were applied differently to certain groups, and those groups perceived that they were subject to greater scrutiny. Experiences cited ranged from facing differential disciplinary practices and feeling unwelcomed, to experiencing pressure to conform and being asked questions about childbearing, living situations, and tattoos.

What this means for the healthcare workplace

A consistent theme throughout the stories was that the respondents from underrepresented groups felt they were subjected to greater scrutiny, while simultaneously reporting greater infringements over their professionalism boundaries.

These findings, suggest that health care institutions must reevaluate and redefine professionalism standards in order to successfully make the culture of academic medicine more inclusive and to improve the retention of minorities and women.

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