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Flatlining

Adia Harvey Wingfield

 

IN BRIEF

Harvey Wingfield shows how hierarchy, gender, and race intersect to affect the experience of blcak professionals in healthcare.

Key Concepts

 

Harvey Wingfield introduces a term “racial outsourcing” to describe how when organizations fail to invest in equity, this work falls on the shoulders of black employees 

“In this book, I argue that when organizations wrestle with determining how best to reach diverse communities while, at the same time, trying to maximize market values and minimize the resources they devote to labor, this leads to a process I term racial outsourcing. Racial outsourcing occurs when organizations fail to do the work of transforming their culture, norms, and workforces to reach communities of color and instead rely on black professionals for this labor. As a result, I contend, black professionals do equity work, which I define as the various forms of labor associated with making organizations more accessible to minority communities.” 


Black doctors experienced direct bias only sporadically, driven by their high status in the medical profession

“When black doctors I spoke to described the ways that race affected their work, they would usually acknowledge an interaction where they had to deal with a patient or colleague’s negative racial stereotypes. To be sure, these were annoying and frustrating. However, respondents also very clearly pointed out that these types of occurrences were rare and not at all representative of their daily experiences.” (p. 41)

“Consequently, doctors’ high status, coupled with occupational norms that often allow them to work alone, may free them from some of the more routine forms of racial harassment.” (p. 47)


When the black professionals did face bias, it was grounded in the assumption of their incompetence

“This is coming from early on, where my mentors would be like, ‘You need to prove yourself a little bit more.’ I had two mentors when I started out in medical school, and one was a black female. And she was saying, ‘Most of the people here are white males. You need to show that you’re just as good.’ That means you have to study two hours longer, you need to be the first one there, you need to always answer questions. So I think it was kind of always a thing where we were told to ‘stay up on your p’s and q’s, make sure you’re always doing that.’ And don’t let anyone even come across the thought that, ‘Okay, she’s not as prepared as someone else.’ ” (p. 50)

“For Davis, racial issues at work are not defined by colleagues who constantly question his judgment or doubt his capabilities. But racial undertones shape the general atmosphere, requiring impeccable performance in all areas in order to avoid triggering racial stereotypes. The specter of racial stigmatization and the attendant stereotypes of black inferiority leave Davis constantly aware that he might have to disprove these unspoken beliefs at any time, even if his routine interactions with white peers and superiors are generally sanguine.” (p. 53)

“Assumed incompetence is one of the issues that most frequently dog black professionals across the industry, workplace, and occupation. Note that while black doctors characterize their racial interactions as generally pleasant and unremarkable, even they observe that they have to combat the presumption that they are not as skilled and capable as their white colleagues. Jackson’s experience as a technician thus has some similarities to what doctors encounter, in that the stereotype of blacks as less qualified than their white counterparts runs constant. There is a notable difference, however. While black doctors describe this as a relatively minor annoyance, akin to background noise, black technicians find these perceptions more commonplace and more likely to come from those in positions of greater authority.” (p. 104)


Across races, women doctors also faced the assumption of incompetence

“She, too, cites parallels in the ways women of all races are treated: “It is different, but I’m sure there are some similarities. For example, some female doctors may feel like they’re having to prove themselves; or sometimes you get called Ms. Flood instead of Dr. Flood. You sometimes wonder if people are questioning you or second-guessing you. In the back of your mind, you always wonder about that; and that type of thing is hard to prove. So it’s one of those uncomfortable feelings, like you’re always having to prove yourself.” Like Aliya, Jayla describes this as a common phenomenon for women in medicine, and one that binds black and white women together through shared experience.” (p. 60)


Without the hierarchical status of doctors, black nurses and technicians experienced far more bias 

“Recall from the previous chapter that for black doctors, explicitly racist interactions are rare and characterized as infrequent incidents that happened “that one time.” This is decidedly not the case for the nurses in my study. Most nurses shared numerous, much more overt examples of the ways that routine interactions with colleagues and patients include racial stereotypes, biases, and hostility. For nurses, inflammatory statements and behaviors are a routine part of work, not isolated incidents.” (p. 83)

“Working in jobs that afford them lower status relative to doctors and nurses means that technicians routinely encounter situations where patients’ families openly question them. Their experiences are more similar to those of nurses rather than doctors, in that they are accustomed to being second-guessed in ways that evoke their racial standing and occupational status. However, their position as technicians means that interactions with nurses also are a source of racial tensions.” (p. 103)

Quotables

 

“You know, I’m equal, I’m here, I made it, we have the same degree, the same everything. I still feel like I have to prove myself a little bit more.” (p. 50)

“Based on this study, I theorize that black workers in other high-status professions (e.g., law or finance) similarly find that they do not necessarily encounter daily, overt expressions of racial bias. However, these professionals may be attuned to the ways structural and cultural processes work to their disadvantage, and may do equity work through their resulting pursuit of systemic changes.” (p. 166)

“These findings suggest that when it comes to understanding race, black professionals’ experiences cannot be divorced from their occupational and organizational status. Sociologists have yet to theorize extensively how race is embedded in organizational structures in ways that have concrete outcomes for people of color (for exceptions, see Ray 2019; Wingfield and Alston 2014).” (p. 167)

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