Racist medicine and contested citizenships : migration of Indian physician's to the United States and the paradox of return



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In American medicine, research has consistently shown disparities between the health experiences of non-Hispanic whites and minority groups (Shervington, 2000); but the practice of racial discrimination within the medical profession is less well acknowledged. Unlike other professions, medicine is a person-oriented field, where Indian physicians are susceptible to facing discrimination on a daily basis. My in-depth interviews with 108 Indian physicians show that individual physicians may achieve social mobility and gain economic parity in the United States, but only as exceptions to the rule, as evident by racial discrimination in promotions, referral patterns, and the 'glass ceiling' faced by them 'when it comes to really rising to the top'. Moreover, the social incorporation of Indian physicians is itself tied to paradoxes and discontents, when minority group members are not fully accepted either by the dominant group or by their own ethnic community. It is in this context that I seek to analyze the influence of social interactions at work on the social incorporation of first and second-generation Indian physicians and in determining their workplace experiences and migratory outcomes. Likewise, with the effects of discrimination being greater for men than for women, the existing gender inequalities in American medicine have differential impacts on the workplace experiences of Indian men vis-à-vis women. However, much of the production of gender and racial inequalities in organizations at large (Acker, 2006) and particularly in medicine, have focused on one or another of these categories, seldom attempting to study them as complex, mutually reinforcing or contradicting processes. My dissertation research strives to make this dimension a crucial part of the analysis. This study should contribute to our understanding of the interaction of recent migration of skilled personnel with developing racial/ethnic and gender relations in US workplaces. The healthcare workforce in the developed world has become increasingly dependent on immigrants from the developing world. I see addressing issues of racial and gender bias in American medicine as a priority in the social sciences and a necessity for a holistic healthcare system in the 21st century. My research is an effort in this direction.