ORIGINAL RESEARCH
Madeline Byrd, MEd; Melissa K. Filippi, PhD, MPH; Anam Siddiqi, MPH; Sarah Fleischer, MS; Andrew Bazemore, MD, MPH; Annie Koempel, PhD, RD
Corresponding Author: Madeline Byrd, MEd; American Board of Family Medicine.
Email: mbyrd@theabfm.org
DOI: 10.3122/jabfm.2025.250291R2
Keywords: Career Counseling, Diversity, Family Medicine, Gender Differences, Health Workforce, Physicians, Primary Health Care, Qualitative Research, Social Justice, Social Problems, Women Physicians, Workforce
Dates: Submitted: 07-29-2025; Revised: 10-01-2025; 10-28-2025; Accepted: 11-10-2025
Status: In production.
BACKGROUND: Women physicians face multiple systemic and social biases in the clinical setting that erode mental and physical wellbeing. Gender-based discrimination was reported by 76% of early-career women physicians, decreasing to 57% for mid-career, and 36% for late career. While these trends suggest that these biases may diminish with career progression, they remain a persistent burden of women physician's careers. This article offers a unique contribution by centering early career women family physicians, a group underrepresented in qualitative research on workplace bias. This article focuses on participants’ microaggressive experiences in the clinical setting to better understand the biases they face.
METHODS: Via email we recruited 25 geographically and racially diverse early career women physicians who responded to the 2021-2023 American Board of Family Medicine National Graduate Survey. A semi-structured interview guide was developed following a life history approach to better understand the transitionary phase from residency to the practicing workforce. Interviews were transcribed verbatim, cleaned, and analyzed via Inductive Content Analysis in NVivo by qualitative researchers.
RESULTS: We identified three main themes that emerged from the data. First, biased communications within the clinical setting exposed a pattern of gender bias. Second, patients invalidate physicians’ positions based on appearance and perception. Third, women physicians described navigating the emotional and psychological labor of clinical and societal expectations.
CONCLUSION: In the context of primary care, microaggressions demand direct and intentional intervention. Failing to address these experiences jeopardizes both equity and workforce sustainability. Leadership must be equipped to recognize, interrupt, and respond to microaggressions—not only to support individual clinicians but to strengthen organizational culture and the broader primary care mission. Interference reflects the broader societal imperative and commitment to equity in healthcare.