Relationships Between Religious Commitment, Workplace Experiences, and Professional and Psychological Outcomes Among U.S. Muslim Physicians.

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.

Predictors of Perceived Discrimination in Medical Settings Among Muslim Women in the USA.

Minority groups based on immigration status, gender, or religion often face discrimination in healthcare settings. Muslim women, especially those who wear hijab, are more likely to experience stereotyping and discrimination in and outside of healthcare, but little is known about the sociodemographic predictors of this discrimination. We examined sociodemographic factors and religiosity as predictors of discrimination in medical settings among Muslim American women. Muslim women (n = 254) were recruited from Muslim organizations in Chicago to self-administer a survey on perceived discrimination, religiosity, and sociodemographic characteristics. Many participants reported that they were treated with less courtesy than non-Muslims (25.4%) and that a doctor or nurse did not listen to them (29.8%) or acted as though they were not smart (24.3%). A multivariable regression model revealed that self-rated religiosity was negatively associated with discrimination. Race/ethnicity trended towards predicting perceived discrimination such that Arabs and South Asians reported less discrimination than African Americans. The current study sheds light on the important role of religiosity in shaping Muslim women's experiences in medical settings and points to the buffering effect of religiosity and the additive consequences of racial/ethnic identity in experiences of religious discrimination.

Muslim American physicians' experiences with, and views on, religious discrimination and accommodation in academic medicine.

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.

Religious Identity Discrimination in the Physician Workforce: Insights from Two National Studies of Muslim Clinicians in the US.

BACKGROUND: Discrimination negatively impacts physician career trajectories and well-being. OBJECTIVE: Quantify perceived religious discrimination among US Muslim physicians and compare trends over time. DESIGN/PARTICIPANTS/MAIN MEASURES: Two national surveys tabulated discrimination. The 2013 survey involved a mailed questionnaire to a random sample of 746 Islamic Medical Association of North America (IMANA) members, while the 2021 survey was administered online to subscribers of IMANA, American Muslim Health Professionals, and the US Muslim Physician network. Eligible participants had to be practicing US Muslim physicians, and English-proficient (the 2021 sample was further restricted to physicians in academic medicine). Questionnaires assessed experiences of religious discrimination and accommodation. KEY RESULTS: In 2013, the 255 participants had a mean age of 52 years, were mostly male (70%), Sunni (91%), South Asian (70%), and adult immigrants (65%). In 2021, the 264 participants had a mean age of 39.5 years, were mostly male (65%) and Sunni (75%). In contrast to 2013, the majority were born in the USA (59%; p<0.01), and respondents were more diverse with 33% South Asians, 22% Arabs, and 16% African Americans. Greater proportions of the 2021 sample reported facing religious discrimination frequently in their career (24 to 53%; p<0.01), experiencing job turnover (7 to 32%; p<0.01), and having patients refuse their care (9 to 33%; p<0.01). A higher proportion of South Asians, Arabs, and participants under the age of 40 reported discrimination and job turnover in 2021 when compared to 2013. Higher proportions of South Asians and Whites reported being passed over for professional advancement and having patients refuse their care in 2021 relative to 2013. CONCLUSIONS: Many American Muslim clinicians encounter religious discrimination at the workplace, and these experiences appear to be on the rise. Healthcare workforce diversity, inclusion, and equity programming should include a focus on accommodating the religious identities of physicians.

Research Conducted in Women Was Deemed More Impactful but Less Publishable than the Same Research Conducted in Men.

Background: Female scientists, who are more likely than their male counterparts to study women and report findings by sex/gender, fare worse in the article peer review process. It is unknown whether the gender of research participants influences the recommendation to publish an article describing the study. Materials and Methods: Reviewers were randomly assigned to evaluate one of three versions of an article abstract describing a clinical study conducted in men, women, or individuals. Reviewers assessed the study's scientific rigor, its level of contribution to medical science, and whether they would recommend publishing the full article. Responses were analyzed with logistic regression controlling for reviewer background variables, including sex and experience level. Results: There was no significant difference in perceived research rigor by abstract condition; contribution to medical science was perceived to be greater for research conducted in women than men (odds ratio = 1.7; p = 0.030). Nevertheless, reviewers were almost twice as likely to recommend publication for research conducted in men than the same research conducted in women (predicted probability 0.606 vs. 0.322; p = 0.000). Conclusions: These results are consistent with abundant data from multiple sources showing a lower societal value placed on women than men. Because female investigators are more likely than male investigators to study women, our findings suggest a previously unrecognized bias that could contribute to gender asymmetries in the publication outcomes of peer review. This pro-male publication bias could be an additional barrier to leadership attainment for women in academic medicine and the advancement of women's health.

Exposure to peers' pro-diversity attitudes increases inclusion and reduces the achievement gap.

There is a dearth of empirically validated pro-diversity methods that effectively create a more inclusive social climate. We developed two scalable interventions that target people's perceptions of social norms by communicating to them that their peers hold pro-diversity attitudes and engage in inclusive behaviours. We tested the interventions in six randomized controlled trials at a large public university in the United States (total n = 2,490). Non-marginalized students exposed to our interventions reported more positive attitudes toward outgroups and greater appreciation of diversity, whereas marginalized students had an increased sense of belonging, reported being treated more inclusively by their peers and earned better grades. While many current pro-diversity initiatives focus on raising awareness about the fact that implicit bias and subtle discrimination are widespread, our findings spotlight the importance of drawing people's attention to their peers' pro-diversity values and attitudes to create positive and lasting effects on the social climate.

Reducing implicit racial preferences: II. Intervention effectiveness across time.

Implicit preferences are malleable, but does that change last? We tested 9 interventions (8 real and 1 sham) to reduce implicit racial preferences over time. In 2 studies with a total of 6,321 participants, all 9 interventions immediately reduced implicit preferences. However, none were effective after a delay of several hours to several days. We also found that these interventions did not change explicit racial preferences and were not reliably moderated by motivations to respond without prejudice. Short-term malleability in implicit preferences does not necessarily lead to long-term change, raising new questions about the flexibility and stability of implicit preferences. (PsycINFO Database Record

Associations between religion-related factors and breast cancer screening among American Muslims.

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77% of respondents had at least one mammogram in their lifetime, yet 37% had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions.