Diversity in the Field of Anesthesia 

Healthcare providers interface with patients of all ages, ethnicities, genders, and sexual orientations, and thus it is important that the demographic makeup of these providers reflects the patients they care for and that patients feel comfortable and understood by their providers. This claim is backed by data; multiple studies have shown that female patients have better outcomes when treated by female physicians, across all specialties³. Another retrospective analysis of 1.8 million hospital births found that pairing a newborn with a physician of the same race reduces in-hospital mortality by 50%, as well as decreasing communication barriers between patients and physicians, and increasing healthcare utilization by these patients². Anesthesiology providers, in particular, interact with patients during some of their most vulnerable moments: immediately before and immediately after surgery, managing their perioperative pain, and caring for them in the ICU setting. Thus diversity, equity and inclusion initiatives are even more important in the field of anesthesia, for patient safety and satisfaction.  

Despite the well-demonstrated importance of diversity in medicine, there are still significant disparities in many specialties, including anesthesia. For example, even though gender parity is much better in matriculants to medical schools in the United States in modern times, there remains a large gender gap in practicing anesthesiologists¹. 64.3% of all anesthesiologists are men, with only 36.6% being women and no data on other gender identities¹. Women are also largely overlooked for leadership positions. For example, only 13% of department chair positions are held by women¹. Furthermore, in 2020, anesthesiology residents who identified as American Indian/Alaskan Native, Black/African American and Hispanic/Latino combined made up less than 15% of all anesthesiology residents across the country¹. The barriers to increased diversity in anesthesia are in large part like the barriers in medicine as a whole; they are historic and institutional in nature¹. For most of their history, higher education institutions denied admission to minorities and women¹. While that is not the case today, standardized testing and legacy admissions have been shown to overwhelmingly benefit wealthy, White applicants¹. Despite both departmental and national DEI initiatives, these historic barriers have been difficult to overcome¹.  

Nonetheless, there is important work being done to overcome these barriers. For example, a national imitative, Raising Anesthesiology Diversity and Antiracism (RADAR), launched in 2022⁴. This program is a joint effort from the departments of anesthesiology at University of Michigan and Washington University in St. Louis, and it aims to engage and support historically marginalized medical students, trainees, and early faculty in the field of anesthesiology⁴. It also aims to address the problem from the top: RADAR provides anti-racism training and resources to senior leadership⁴. There is also a call to action for departments across the country to join in this initiative, so it becomes and remains a widespread and sustainable effort⁴. While this program is too new to study the outcomes of it, national initiatives are an important way to keep improving diversity in the field of anesthesias⁴.  

References 

1. Estime SR, Lee HH, Jimenez N, Andreae M, Blacksher E, Navarro R. Diversity, equity, and inclusion in anesthesiology. Int Anesthesiol Clin. 2021 Oct 1;59(4):81-85. doi: 10.1097/AIA.0000000000000337.  

2. Greenwood BN, Hardeman RR, Huang L, Sojourner A. Physician-patient racial concordance and disparities in birthing mortality for newborns. Proc Natl Acad Sci U S A. 2020 Sep 1;117(35):21194-21200. doi: 10.1073/pnas.1913405117.  

3. Tsugawa, Y., Jena, A.B., Figueroa, J.F., Orav, E.J., Blumenthal, D.M., Jha, A.K., 2017. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Internal Medicine 177, 206.https://doi.org/10.1001/jamainternmed.2016.7875 

4. Wixson MC, Mitchell AD, Markowitz SD, Malicke KM, Avidan MS, Mashour GA. Raising Anesthesiology Diversity and Antiracism: Launching a National Initiative. Anesth Analg. 2022 Jun 1;134(6):1185-1188. doi: 10.1213/ANE.0000000000005817.