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Professionalism or prejudice? Modelling roles, risking microaggressions
  1. Emily Miller1,2,
  2. Sonya Tang Girdwood2,3,4,
  3. Anita Shah2,3,
  4. Chidiogo Anyigbo2,5,
  5. Elizabeth Lanphier2,5,6
  1. 1Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  2. 2Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  3. 3Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
  4. 4Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
  5. 5Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
  6. 6Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  1. Correspondence to Dr Elizabeth Lanphier, Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; elizabeth.lanphier{at}cchmc.org

http://dx.doi.org/10.1136/jme-2023-109295

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    We agree with McCullough, Coverdale and Chervenak1 that ‘medical educators and academic leaders are in a pivotal and powerful position to role model’ to counter ‘incivility’ in medicine, which can include ‘dismissing’ or ‘demeaning others’. They note that ‘women may be at greater risk for experiencing incivility compared with men’, as may other individuals who experience ‘patterns of disrespect based on minority status’. The authors promote ‘professionalism’ and ‘etiquette’ to foster civility within medicine. Yet theory and experience suggest that medical educators and academic leaders are also in powerful positions to mobilise these concepts to perpetuate exclusions from, and biases within, medicine, upholding racist, sexist and ableist norms.

    Mentoring versus microaggressions

    Feminist methodology reveals how ethical theorising historically excluded views and experiences of marginalised individuals and groups and provides frameworks for interrogating supposedly universal norms. Presuming dominant values and experiences reflect universal ones can further marginalise already oppressed groups and individuals. A feminist analysis reveals how ‘professionalism’ or ‘etiquette’ are historically shaped by white or male identity and experience, including norms of attire, hair, accessories, speech or behaviour.

    Part of the hidden curriculum of medicine becomes intuiting how leaders implicitly or explicitly define ‘professionalism’. McCullough et al define ‘professionalism’ in medicine as ‘sustained commitments to scientific and clinical excellence… making the protection and promotion of health-related interest the physician’s primary concern …

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    Footnotes

    • Twitter @EmilyMillerMD, @DrAnita_Shah, @EthicsElizabeth

    • Contributors All authors contributed to the conceptualisation of the commentary. EM, STG, AS and EL drafted sections of the text, and all authors reviewed and revised the work for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • ↵The authors thank Dr H Rhodes Hambrick for his contribution to the development of the ideas in this section.

    • ↵American Medical Association (@AmerMedicalAssn). 2023, June 13. Twitter. https://twitter.com/AmerMedicalAssn/status/1668761534305128448?s=20

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