Purpose: To examine relationships between religiosity, workplace discrimination, religious accomm... more Purpose: To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among US Muslim physicians. Method: In 2021, the authors surveyed 264 physicians from 3 U.S.-based Muslim clinician organizations. Religious commitment, as measured by multiple items, was evaluated as a possible predictor of workplace discrimination and accommodation; job turnover; career satisfaction; workplace motivation; and belonging, burnout, and depression. Bivariate regression models were used to identify possible significant relationships between predictor and outcome variables. Predictors with meaningful bivariate analyses were included in separate multivariate regression models for each outcome. Results: Participants' mean age was 39.5 years (standard deviation, 10.03). Most were male (160/246; 65%), U.S.-born (146/244; 60%), completed medical school in the United States (190/243; 78%), and wore a beard/hijab (135/235; 57%). Participants identified as African American (40/247; 16%), Arab (55/247; 22%), South Asian (82/247; 33%), and White (70/247; 28%). Multivariate models demonstrated that religious importance was positively associated with discrimination from patients (odds ratio [OR] = 3.78; P = .02) and depression (OR = 5.36; P = .002), and negatively associated with prayer accommodation at work (OR = .20; P = .001). Engaging in congregational religious activities was negatively associated with discrimination from patients (OR = .64; P = .006) and job turnover (OR = .63; P = .02) and positively associated with accommodations for prayer (OR = 1.42; P = .008) and general religious identity accommodation (OR = 1.47; P = .01). Additionally, participant race and ethnicity were variably associated with these outcomes. Conclusions: This study demonstrates how religious identity may negatively associate with workplace experiences and well-being among U.S. Muslim physicians and highlights the buffering role of religious practice. It spotlights an urgent need for academic medical centers to ameliorate religious discrimination and implement workplace accommodation policies for Muslim physicians.
Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adver... more Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adversity, ranging from overt discrimination to subtle microaggressions, which impacts their professional careers. Consequently, concerted efforts to promote workforce diversity in healthcare have begun to tackle these issues. In this study, we further these efforts by uplifting the voices of a minority religious community, Muslim physicians, and their experiences in the medical profession. Using a community-engaged research approach, we recruited 18 physicians from 3 national Muslim clinician organizations who had worked at a university hospital within the last 20 years to participate in semi-structured interviews focused on how their religious identity intersects with experiences of discrimination and accommodation. Deploying a phenomenological framework, we identified four emergent themes that cut across the 18 interviews. The physicians’ experiences demonstrated that they i) shouldered extra labor to uphold their religious identity, (ii) denied their personal experiences of religious discrimination, (iii) feared religious discrimination, and (iv) mislabeled their personal management of religious practices as institutional accommodations. These experiences suggest that the additional responsibilities and burdens that saddle underrepresented racial and ethnic identities in medicine – dubbed “the minority tax” – extend to this religious minority group. They also highlight a unique set of psychological and professional costs associated with carrying a Muslim identity in the physician workforce. Our findings underscore the need for healthcare systems to take bold action in creating non-discriminatory, inclusive, and equitable working environments that attend to the religious identities of diverse physicians.
Objective To assess Muslim physician experiences with religious discrimination and identify strat... more Objective To assess Muslim physician experiences with religious discrimination and identify strategies for better accommodating Muslim identity in health care. Data Sources and Study Setting Interviews were conducted with Muslim physicians from three US-based Muslim clinician organizations between June and August 2021. Study Design In-depth, semi-structured qualitative interviews used a phenomenological approach to describe experiences of religious discrimination and accommodation. A team-based framework approach to coding was used to inductively generate themes from interview data. Data Collection/Extraction Methods Physicians from the Islamic Medical Association of North America, American Muslim Health Professionals, and the US Muslim Physicians group were invited to participate using closed organizational listservs. Inclusion criteria sought English-speaking, self-identifying Muslims with current or past affiliation with a university hospital in the United States. Potential participants were segmented into groups based on responses to questions about perceived religious discrimination and accommodation. Purposive sampling was used to iteratively approach participants within these groups in order to capture a diverse respondent pool. Interviews stopped after thematic saturation was reached. Principal Findings Eighteen physicians (11 women and 7 men; mean age: 41.5 [standard deviation = 12.91] years) were interviewed. Nearly all (n = 16) held Islam to be important in their lives. Three overarching themes, with several subthemes, emerged. Participants (1) struggled to maintain religious practices and observances due to unaccommodating organizational structures; (2) experienced religious discrimination, which, in turn, impacted their professional trajectories and, at times, their personal well-being; and (3) believed that institutions could implement specific educational and policy interventions to advance the religious accommodation of Muslims in health care. Conclusions Muslim physicians frequently encounter religious discrimination, yet there are concrete ways in which health care workplaces can better accommodate their religious needs and combat discrimination. To improve workforce diversity, equity, and inclusion, educational forums and policies that support the religious practices of physicians need to be established.
WMJ : official publication of the State Medical Society of Wisconsin, 2018
OBJECTIVE The aim of this study is to understand how the physician-patient relationship is relate... more OBJECTIVE The aim of this study is to understand how the physician-patient relationship is related to referral practices for diabetes self-management education and physicians' perceptions of culturally competent health care delivery at a large health system affiliated with an academic medical center in a Midwestern city. METHODS Sixteen physicians (6 family medicine, 6 internal medicine, 4 endocrinology) participated in semistructured interviews. Interviews were audio-recorded, transcribed, and coded. Data were thematically analyzed using MAXQDA software. RESULTS All physicians considered diabetes self-management education a very important part of diabetes treatment, but physician referral patterns to diabetes education varied. Study findings indicated that both high and low referring physicians reported providing care that was responsive to personalized patient needs, including cultural beliefs, attitudes, and behaviors that affect health/health care. Building relationships and...
The purpose of this study was to explore providers' perspectives on the use of a novel techno... more The purpose of this study was to explore providers' perspectives on the use of a novel technology, "Large Customizable Interactive Monitor" (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit. We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015. The research team analyzed the transcripts using an iterative coding method to identify common themes. Study results highlight contextual data on providers' use routines of the LCIM. Findings from thirty six interviews were classified into three groups: 1) providers' familiarity with the LCIM; 2) providers' use routines (i.e. when and how they use it); and 3) reasons why they use or do not use it. It is important to conduct baseline studies of the use of novel techno...
To elicit the perspective of patients with type 2 diabetes, specific to communication with provid... more To elicit the perspective of patients with type 2 diabetes, specific to communication with providers and health care teams. We conducted 21 focus groups with 115 adults in Midwestern primary care, endocrinology, and bariatric surgery clinics. Facilitators analyzed the transcripts using an iterative coding method. The themes of encouragement and motivation, relationship building, compassion, and communication preferences highlighted effective strategies consistent with the core components of patient-centered care. Patients and providers benefit from systems in which patients are efficiently and compassionately supported in self-management within their abilities and in partnership with their support networks.
We implemented a quality improvement project for diabetes care in a faculty-resident internal med... more We implemented a quality improvement project for diabetes care in a faculty-resident internal medicine practice, using the Chronic Care Model framework. We created a planned visit clinic, used a stepwise medication algorithm, and self-management support. The intervention was effective for patients with glycohemoglobin A1c levels 10 or above (P = .0075) when compared with usual care after adjusting for all significant predictors. Compliance with foot examinations increased by 72% (P < .0001) and pneumococcal vaccinations by 25% (P = .0115). We believe that the Chronic Care Model can be successfully integrated into faculty-resident practices and provides a model for further exploration into disease management education in academic settings.
Purpose: To examine relationships between religiosity, workplace discrimination, religious accomm... more Purpose: To examine relationships between religiosity, workplace discrimination, religious accommodation, and related professional and psychological outcomes among US Muslim physicians. Method: In 2021, the authors surveyed 264 physicians from 3 U.S.-based Muslim clinician organizations. Religious commitment, as measured by multiple items, was evaluated as a possible predictor of workplace discrimination and accommodation; job turnover; career satisfaction; workplace motivation; and belonging, burnout, and depression. Bivariate regression models were used to identify possible significant relationships between predictor and outcome variables. Predictors with meaningful bivariate analyses were included in separate multivariate regression models for each outcome. Results: Participants' mean age was 39.5 years (standard deviation, 10.03). Most were male (160/246; 65%), U.S.-born (146/244; 60%), completed medical school in the United States (190/243; 78%), and wore a beard/hijab (135/235; 57%). Participants identified as African American (40/247; 16%), Arab (55/247; 22%), South Asian (82/247; 33%), and White (70/247; 28%). Multivariate models demonstrated that religious importance was positively associated with discrimination from patients (odds ratio [OR] = 3.78; P = .02) and depression (OR = 5.36; P = .002), and negatively associated with prayer accommodation at work (OR = .20; P = .001). Engaging in congregational religious activities was negatively associated with discrimination from patients (OR = .64; P = .006) and job turnover (OR = .63; P = .02) and positively associated with accommodations for prayer (OR = 1.42; P = .008) and general religious identity accommodation (OR = 1.47; P = .01). Additionally, participant race and ethnicity were variably associated with these outcomes. Conclusions: This study demonstrates how religious identity may negatively associate with workplace experiences and well-being among U.S. Muslim physicians and highlights the buffering role of religious practice. It spotlights an urgent need for academic medical centers to ameliorate religious discrimination and implement workplace accommodation policies for Muslim physicians.
Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adver... more Physicians from marginalized racial, ethnic, sexual, and gender backgrounds often encounter adversity, ranging from overt discrimination to subtle microaggressions, which impacts their professional careers. Consequently, concerted efforts to promote workforce diversity in healthcare have begun to tackle these issues. In this study, we further these efforts by uplifting the voices of a minority religious community, Muslim physicians, and their experiences in the medical profession. Using a community-engaged research approach, we recruited 18 physicians from 3 national Muslim clinician organizations who had worked at a university hospital within the last 20 years to participate in semi-structured interviews focused on how their religious identity intersects with experiences of discrimination and accommodation. Deploying a phenomenological framework, we identified four emergent themes that cut across the 18 interviews. The physicians’ experiences demonstrated that they i) shouldered extra labor to uphold their religious identity, (ii) denied their personal experiences of religious discrimination, (iii) feared religious discrimination, and (iv) mislabeled their personal management of religious practices as institutional accommodations. These experiences suggest that the additional responsibilities and burdens that saddle underrepresented racial and ethnic identities in medicine – dubbed “the minority tax” – extend to this religious minority group. They also highlight a unique set of psychological and professional costs associated with carrying a Muslim identity in the physician workforce. Our findings underscore the need for healthcare systems to take bold action in creating non-discriminatory, inclusive, and equitable working environments that attend to the religious identities of diverse physicians.
Objective To assess Muslim physician experiences with religious discrimination and identify strat... more Objective To assess Muslim physician experiences with religious discrimination and identify strategies for better accommodating Muslim identity in health care. Data Sources and Study Setting Interviews were conducted with Muslim physicians from three US-based Muslim clinician organizations between June and August 2021. Study Design In-depth, semi-structured qualitative interviews used a phenomenological approach to describe experiences of religious discrimination and accommodation. A team-based framework approach to coding was used to inductively generate themes from interview data. Data Collection/Extraction Methods Physicians from the Islamic Medical Association of North America, American Muslim Health Professionals, and the US Muslim Physicians group were invited to participate using closed organizational listservs. Inclusion criteria sought English-speaking, self-identifying Muslims with current or past affiliation with a university hospital in the United States. Potential participants were segmented into groups based on responses to questions about perceived religious discrimination and accommodation. Purposive sampling was used to iteratively approach participants within these groups in order to capture a diverse respondent pool. Interviews stopped after thematic saturation was reached. Principal Findings Eighteen physicians (11 women and 7 men; mean age: 41.5 [standard deviation = 12.91] years) were interviewed. Nearly all (n = 16) held Islam to be important in their lives. Three overarching themes, with several subthemes, emerged. Participants (1) struggled to maintain religious practices and observances due to unaccommodating organizational structures; (2) experienced religious discrimination, which, in turn, impacted their professional trajectories and, at times, their personal well-being; and (3) believed that institutions could implement specific educational and policy interventions to advance the religious accommodation of Muslims in health care. Conclusions Muslim physicians frequently encounter religious discrimination, yet there are concrete ways in which health care workplaces can better accommodate their religious needs and combat discrimination. To improve workforce diversity, equity, and inclusion, educational forums and policies that support the religious practices of physicians need to be established.
WMJ : official publication of the State Medical Society of Wisconsin, 2018
OBJECTIVE The aim of this study is to understand how the physician-patient relationship is relate... more OBJECTIVE The aim of this study is to understand how the physician-patient relationship is related to referral practices for diabetes self-management education and physicians' perceptions of culturally competent health care delivery at a large health system affiliated with an academic medical center in a Midwestern city. METHODS Sixteen physicians (6 family medicine, 6 internal medicine, 4 endocrinology) participated in semistructured interviews. Interviews were audio-recorded, transcribed, and coded. Data were thematically analyzed using MAXQDA software. RESULTS All physicians considered diabetes self-management education a very important part of diabetes treatment, but physician referral patterns to diabetes education varied. Study findings indicated that both high and low referring physicians reported providing care that was responsive to personalized patient needs, including cultural beliefs, attitudes, and behaviors that affect health/health care. Building relationships and...
The purpose of this study was to explore providers' perspectives on the use of a novel techno... more The purpose of this study was to explore providers' perspectives on the use of a novel technology, "Large Customizable Interactive Monitor" (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit. We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015. The research team analyzed the transcripts using an iterative coding method to identify common themes. Study results highlight contextual data on providers' use routines of the LCIM. Findings from thirty six interviews were classified into three groups: 1) providers' familiarity with the LCIM; 2) providers' use routines (i.e. when and how they use it); and 3) reasons why they use or do not use it. It is important to conduct baseline studies of the use of novel techno...
To elicit the perspective of patients with type 2 diabetes, specific to communication with provid... more To elicit the perspective of patients with type 2 diabetes, specific to communication with providers and health care teams. We conducted 21 focus groups with 115 adults in Midwestern primary care, endocrinology, and bariatric surgery clinics. Facilitators analyzed the transcripts using an iterative coding method. The themes of encouragement and motivation, relationship building, compassion, and communication preferences highlighted effective strategies consistent with the core components of patient-centered care. Patients and providers benefit from systems in which patients are efficiently and compassionately supported in self-management within their abilities and in partnership with their support networks.
We implemented a quality improvement project for diabetes care in a faculty-resident internal med... more We implemented a quality improvement project for diabetes care in a faculty-resident internal medicine practice, using the Chronic Care Model framework. We created a planned visit clinic, used a stepwise medication algorithm, and self-management support. The intervention was effective for patients with glycohemoglobin A1c levels 10 or above (P = .0075) when compared with usual care after adjusting for all significant predictors. Compliance with foot examinations increased by 72% (P < .0001) and pneumococcal vaccinations by 25% (P = .0115). We believe that the Chronic Care Model can be successfully integrated into faculty-resident practices and provides a model for further exploration into disease management education in academic settings.
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