Abstract
BACKGROUND: Discrimination and harassment are common in cardiology but data on its impact are limited. OBJECTIVES: This study sought to identify the prevalence and impact of workplace mistreatment among U.S. cardiologists overall and when engaged in clinical and academic work. METHODS: The American College of Cardiology conducted an online survey of 1,583 U.S. cardiologists in 2022. Demographics, types of mistreatment, professional experiences, and impact were self-reported. Multivariable logistic regression analyses were used to determine the predictors of "negative professional impact" defined as a composite of any of the following outcomes: being less productive, taking sick time, leaving a position, leaving cardiology, or leaving medicine. RESULTS: Three-quarters of cardiologists experienced workplace mistreatment, including incivility (34%), discrimination (62%), emotional or physical harassment (32%), and sexual harassment (13%). Unfair treatment was reported by 54% working in any clinical setting, including issues related to professional advancement (31%), clinical work expectations (27%), and compensation (23%). Unfair treatment was reported by 58% during academic work. Consequently, 20% avoided training, employment, or promotion opportunities, 20% felt silenced, and 16% reported social avoidance; 11% considered leaving medicine. Predictors of negative professional impact included type of mistreatment (harassment [OR: 10.01; 95% CI: 5.25-19.10], discrimination [OR: 3.03; 95% CI: 1.56-5.80]), identification as homosexual (OR: 5.60; 95% CI: 1.87-16.78), and woman gender (OR: 1.57; 95% CI: 1.19-2.07). CONCLUSIONS: Three of 4 U.S. cardiologists report workplace mistreatment, including two-thirds reporting discrimination and/or harassment. Mistreatment negatively impacts professional lives, career trajectory, well-being, productivity, workforce retention, and ultimately impacts the delivery of patient care. These data highlight the need to improve the climate within cardiology.