Ethnic Diversity within Israeli Healthcare Organizations: Manifestations of Racism and Strategies of Coping

Introduction: Increasing workforce diversity in healthcare organizations enhances cultural competency and narrows disparities in health. Yet while the challenge to provide appropriate care to people of different ethno-cultural backgrounds in healthcare organizations has been studied extensively, racism towards ethnic minority health professionals has rarely been investigated. The public healthcare system in Israel is an interesting research field. Its workforce includes a relatively high proportion of Arab professionals who operate within the context of the Israeli-Palestinian conflict.

The objective of the research was to examine how racism is manifested as a social process across macro, meso and micro levels of healthcare organizations, by studying racist manifestations experienced by Arab physicians and nurses who work in Israeli public hospitals, and how they cope with these manifestations.

Methodology: During 2013 and 2014 we conducted in-depth interviews with 23 Arab physicians and nurses who work in Israeli public hospitals that serve a mixed Jewish-Arab population.

Findings: The Arab physicians and nurses we interviewed described various racist manifestations, ranging from refusal to accept treatment from an Arab professional, through verbal abuse, to physical violence directed against them. Nurses reported more racism at the micro-level (patients, their relatives and colleagues), while physicians reported experiencing discrimination at the meso-level (in hospitals and medical schools) and macro-level (policy and legislation). Arab nurses and physicians were found to employ diverse strategies of coping.

Conclusions: Israel has a policy to recruit healthcare professionals from linguistic and cultural minorities, but has no special guidelines on how to cope with racism towards them. The silence that envelops racism turns into denial, as evidenced by the lack of specific policies. Studying the issue of racism directed against minority health professionals is important for the formulation of effective coping strategies.