The Prevalence and Stress Impact of Decredentialing as a Form of Gender Microaggression: A CERA General Membership Study.

Background and objectives: This study sought to quantify the anecdotally reported experience of decredentialing in the profession of medicine, specifically as it applies to gender. Decredentialing is defined as the experience of being addressed by first name without permission or being mistaken as a nonphysician provider.

Methods: Eight questions regarding decredentialing microaggressions and resultant stress reactions were submitted as part of the 2023 Council of Academic Family Medicine Educational Research Alliance general membership survey.

Results: Women physicians reported significantly higher rates of unauthorized first name use by patients (15% vs 3% for men patients; 7% vs 3% for women patients). Women physicians also reported significantly higher rates of decredentialing by being mistaken as a nonphysician by patients (39.8% frequent vs 1.1%), clinical staff (13.0% frequent vs 0.7%), and other physicians (10.9% frequent vs 1.1%). Women respondents reported more substantial stress responses after unauthorized first-name use (36.9% more stressful vs 6.3%) and mistaken roles (47.7% more stressful vs 8.4%). Subgroup analysis of self-identified underrepresented in medicine (URiM) populations showed significantly higher rates of microaggressions among URiM women physicians compared to men physicians and in total URiM respondents versus non-URiM respondents.

Conclusions: Women physicians experience the gender microaggression of decredentialing via unauthorized first-name use by patients and being mistaken for a nonphysician more frequently than men physicians. Women physicians also more frequently experience a stress response from these microaggressions. Decredentialing, long acknowledged anecdotally by women physicians, is a valid gender microaggression disproportionately affecting women physicians.