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California’s Central Valley needs health care workers, but a new study suggests it may be difficult to recruit and retain them — especially if they identify as female, non-white, and/or LGBTQ+.

Professionals in these groups have reported widespread harrassment in health care settings. Burnout, isolation, changing medical practices, or leaving the region entirely were some of the cited outcomes of these experiences.

The findings were published this week in JAMA Network Open.

Study participants cited a range of workplace abuse, including negative comments, vandalism, and loss of professional privileges.

The participants were speaking explicitly about their experiences with colleagues, staff, and administrators.

A total of 26 physicians, nurse practitioners, and clinic directors working in family medicine, internal medicine, and pediatrics in a variety of practices — including small community clinics and large health systems — were interviewed. All were currently or recently employed in the region. 

“Workplace discrimination, bias, and harassment can happen in any health care setting,” UC Davis health policy expert and study lead Michelle Ko said in a statement.

“But they are an even bigger problem in areas where there are shortages of primary care providers. The providers I talked with believed very strongly in serving their patients, but some felt forced out because they could no longer work in abusive environments.”

According to Ko, participants who did not identify with a minority group did not report any harassment or discrimination.

She is calling for additional research to determine trends and develop solutions.

“We are hoping to start a conversation throughout the health professions and medical schools about what constitutes acceptable interactions.”

Bullying from superiors

The findings echo the results of an August study that examined the treatment of internal medicine residents across the U.S.

It was found that about 14 per cent of the participants experienced some form of bullying during their training, according to the paper, published in JAMA.

Researchers from Johns Hopkins Bayview Medical Center pooled data from 21,212 U.S.-based trainees who took the 2016 certification exam. Some form of bullying, defined as repeated harassment from a person in a position of power, was reported in 13.6 per cent of the respondents.

Certain characteristics appeared to make individuals more prone to bullying, including speaking a native language other than English.