Systemic Racism: Dr. Naina Mahngar, Oncologist

Medicine has long been a male-dominated field. But that is changing. Women now account for 36.8% of physician’s according to census data, and 33% of medical oncologists are women. However they still encounter disbelief of their profession on a daily basis. Racist and sexist bias against patients is a prevalent issue, but often overlooked is the existence of racist and sexist bias against physicians from patients.

Meet my friend, Dr. Naina Mahngar. Dr. Mahngar is a medical oncologist and hematologist practicing in the Chicago Area. She is the first female oncologist in her medical practice. She is passionate about identifying medical inequality and barriers to healthcare in the United States.

1. What do you perceive as the greatest hurdle for female physicians of color in the U.S?

The most prominent hurdle for me is patient perception. Many women of color walk in the room with something to prove. I have had patients call me ‘little girl’ or ‘babe” and other words they would not call my male colleagues. Generally they’re words to diminish my degree and expertise. My average patient is about 60 years old, and many remember or grew up with segregation, in a time when women made up less than one in ten physicians.

 2. Did you encounter implicit bias while you were training to be an oncologist?  If so, what stood out to you?

Even if the bias is implicit, it is always there. I didn’t realize the bias I faced until I worked with a co-resident who was a white male. We had a difficult patient case, and the patient’s husband was also very upset with how sick the patient was, despite our interventions. I spent weeks measuring every lab value and trying to correct every lab abnormality. This was often met with, ‘when is the real doctor coming in to talk to us?’ My white male colleague, who was the same level as me at the time, arrived and the room completely changed. I then witnessed the respect he commanded when he walked into the room. The respect that comes with patriarchy and white supremacy. Since the beginning of my training, at least once a week, if not daily, a patient or other healthcare provider asks if I’m ‘the doctor’ when I walk into rooms. I’ve had patients ask if I was a good cook for my husband, asked if I had time for my family, or if my husband is okay with my work hours. Patients have told me ‘ your husband is a saint to help with housework’. These are things male physicians are never asked. It never becomes less frustrating and insulting.

3. As a successful Indian female oncologist, what bias or microaggressions do you face in your current position?

I once had a potential patient call our office to see if I was an ‘American doctor.’ I’m not sure what answer they were looking for. It’s in these moments I realize that even if I’m the best doctor in the world, people have biases that my skillset can never overcome. Ultimately, this is their loss.

4. As a female oncologist of color, do you feel there is excessive scrutiny of your physical appearance?

People discuss my appearance probably once a day at work, and patients often comment about my looks. Generally these are compliments, or what they believe to be compliments because society has tied a woman’s worth with her appearance. I once had a male doctor tell me a patient listened to me because “I am so pretty.” It was deflating and diminishing, as I had just spent 30 minutes counseling the patient on his decisions.

5. Has a patient ever refused care from you? How did you handle that?

I had a patient in fellowship who only wanted a ‘white American’ doctor when I walked into the room. My attending at the time told the patient he was not going to find that as he was Irish himself. Fortunately, this has not happened since.

6. Do you feel you’ve been given the same opportunities and respect as your white male peers?

Fortunately, I do think my training was ultimately merit based. Basically, if you could complete your work, you were a good trainee. Now, the daily hurdles seem greater than my male peers, but I personally haven’t had opportunities taken away from me

7. What would you like to share with your white, male peers?

Imposter syndrome was first studied and identified in a group of successful, high achieving women. From the time we are little, most girls, especially those of color, have lower self esteem than boys. This gap widens as we grow up. Women, especially those of color, have more to prove walking into any room, whether that’s a patient’s room or a Board room. Furthermore, female physicians have double the level of burnout compared to male physicians due to increased participation in childcare and household responsibilities, in addition to their busy careers.

8.  Are you seeing more females enter oncology?

My fellowship had more female than male trainees. However, this changed in the real world. Only 33% of oncologists are women. I am very aware of how often I am the only female physician in the room. I am the only female physician at my Cancer Center. I am the only female physician on our Cancer Committee. Among the twenty oncologists in my network, I am one of three women. I am the only female oncologist within 30 miles of my practice site. I hope to continue working hard and providing excellent patient care as well as inspire the next generation of women to chase their dreams, no matter how large.

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I am incredibly honored my dear friend Dr. Mahngar trusted me with her experience. Women and people of color have been dealing with stereotypes their whole lives and we need this behavior to become less pervasive. We need their privileged allies to step up and acknowledge this is happening and decide they will have a zero-tolerance policy for bias.  With the recent launch of TIME’S UP Healthcare, women in healthcare are initiating intentional change. We need action, and there has never been a better time to act.

This picture was taken at Naina’s wedding in 2019… Indian weddings are FABULOUS, read more about that here.

Would you like to share your own experiences with systemic racism and bias? Reach out in comments below or via Instagram or Twitter!