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Practice without prejudice

Discrimination in the workplace takes many forms and is destructive emotionally, mentally and physically.

Practice without prejudice
Working in an environment that allows discrimination to thrive is incompatible with talent retention.
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I read a blog post by a Hispanic veterinarian who shared her experience of navigating racial and gender discrimination in practice. I found myself nodding along at her story and pondering all the similar stories I have heard over the years from practitioners who said clients told them their animals “didn’t like [insert group of people here].” The stories often contained some humor focusing on how silly they were, but the veterinarians and team members who shared them experienced negative impacts from the interactions.

Practice owners and supervisors need to know, understand and appreciate the challenges of being different when clients, and even fellow colleagues, discriminate against veterinary professionals from underrepresented backgrounds.

Discrimination Makes Us Sick

According to Merriam-Webster dictionary, discrimination is a “prejudiced or prejudicial outlook, action or treatment.” Certainly, a great deal of evidence reveals the long-term systemic and institutional effects of discrimination, but we often stray from an adequate understanding of how discrimination affects individuals. In a culture quick to label those who are offended as “snowflakes,” it is important to break down just how interpersonal discrimination affects us.

A large body of literature shows that continued exposure to individual episodes of discrimination is correlated with lower self-esteem, depression, anxiety, psychological distress and life satisfaction. Individuals experiencing discrimination have a higher incidence of next-day depression, and when the discrimination is persistent, the ability to recover on a day-to-day basis — the bounce back, if you will —is muted.

Numerous findings indicate an ongoing vigilance for prejudice or discrimination and how this emotional state triggers threat emotions such as anger and hostility. In attempts to reduce opportunities for exposure to discrimination, individuals might withdraw whenever possible, which limits discrimination exposure and opportunities for intervention. A 2014 study found that discrimination had a strong negative overall impact on well-being.

The effects of discrimination are not just related to mental health. Over the long term, discrimination has measurable physical health impacts as well. A 2012 study found that merely anticipating prejudice triggered increased cardiovascular stress. Emotionally internalizing discriminatory behavior also can lead to weight gain, diabetes, heart disease, higher risk of substance abuse and reduced immunocompetence. In fact, the well-known and well-documented health disparities seen in minority communities around the world are believed to largely stem from long-term exposure to discrimination.

Discrimination Leads to Big Problems

This is not your parents’ or grandparents’ discrimination that was clearly documented in history books. Discrimination in the practice setting can be less overt, more passive-aggressive and, to untrained eye or ear, nothing to fret about. The reality is that many do fret about it, and it is affecting their work.

Think of the client who insists her dog does not like black people. Or the colleague who insinuates that someone’s admittance into veterinary school displaced a better-qualified student. It might show up at the staff meeting where no one seems to hear the comments offered by the veterinarian of a different race. It could be the happy hour that includes everyone at the practice except the gay colleagues. It could be the off-color jokes casually and routinely circulated around the office. It could be a lack of awareness that leads to numerous incidents of microaggressions or small, indirect, subtle insults that focus on areas of difference. All these things add up to an undesirable work environment.

If employers allow discrimination and prejudice to persist unchecked, you can expect to see the development of a toxic work environment. These environments simply do not work well. Here is why.

  1. A lack of trust among coworkers will flourish. Why would you trust someone who you believe treats you poorly? The ability of a team to function optimally relies on mutual trust and respect. Environments with unchecked discrimination are not respectful and do not engender trust.
  2. Open hostility within the team will grow. When discriminatory behaviors are allowed to persist, emotions eventually will run high. An individual can emotionally shoulder only so much in an environment that neither supports nor protects them.
  3. Medical mistakes will increase. Being subjected to discrimination is correlated with lower self-esteem and self-confidence, and this will shape performance. Often when this happens, the perceived incompetence is not blamed on just the practitioner. In the most toxic environments it might be broadly attributed to a group of individuals “like the practitioner.” While the individual certainly shoulders the burden of the medical mistakes, best medicine simply cannot be practiced in toxic environments.
  4. A loss of clients and revenue is likely. If the staff is not working well together and mistakes are being made, clients will go to a clinic that is less drama-filled. If the staff is not happy, no one will be happy.
  5. Poor staff interactions will escalate until a loss of talent occurs. Eventually, staff will leave. Working in an environment that allows discrimination to thrive is incompatible with talent retention. And it might not just be your staff of color or your LGBT staff; it might be those team members who identify as allies and are no longer willing to be complicit in a discriminatory environment.

What You Can Do

In dealing with discrimination, you must take an all-or-nothing approach. Otherwise, you will have invested a lot of energy and resources to create a work environment that is a little discriminatory. If you have committed to addressing discrimination, commit to eradicating it.

One of the best things that you can do for your workplace, staff and clients is to have a clear, enforceable non- or anti-discrimination policy. You can find helpful guidelines from the U.S. Equal Employment Opportunity Commission at http://bit.ly/2TinTTH.

Your policy should articulate that discrimination will not be tolerated. It should describe the disclosure process and protections, and outline the consequences of violating the policy. While federal, state and local laws might provide anti-discrimination protections, the policy you and your staff develop is an opportunity to outline how your practice will operate in an inclusive way.

The second-best thing to do is to use the policy. Include information in job-opening notices and during staff onboarding. Post the policy around the workplace, including in areas visible to clients. Apply the policy consistently to both staff and clients. When an incident arises, apply the policy and take corrective action when necessary.

Cultivating an inclusive work environment benefits everyone. It supports teamwork, talent retention and the practice of good medicine. At a more personal level, it promotes the health and well-being of everyone in your clinic. It is not just the right thing to do; it’s the smart thing to do.

Diversity Toolbox columnist Dr. Lisa M. Greenhill is senior director for institutional research and diversity at the Association of American Veterinary Medical Colleges. AAVMC’s “Diversity & Inclusion” podcasts are available at http://bit.ly/2APLtk4.

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