Inequality dynamics in the workplace among microbiologists and infectious disease specialists: a qualitative study in five European countries.
OBJECTIVE
To explore the social, cultural, psychological and organizational factors associated with inequality in the workplace among clinical microbiologists (CM) and infectious disease (ID) specialists in European hospitals.


METHODS
We analysed data from 52 interviews and five focus groups involving 82 CM/ID specialists selected from university, research or community hospitals in five countries, one each in Northern, Western, Eastern, Southeastern and Southwestern Europe. The 80 hours of recordings were transcribed, and the anonymous database coding process was cross-checked iteratively by six researchers.


RESULTS
Inequality affects all the institutions in all the countries we looked at, denying or reducing access to professional assets with intensity and form that vary largely according to the cultural and organizational context. Discrimination is generally not explicit and uses disrespectful microbehaviours that are hard to respond to when they occur. Inequality affected also loans, distribution of research funds and gender and country representation in boards and conference faculty. Parenthood has a major impact on women's careers, as women are still mainly responsible for family care. Responses to discrimination range from reactive to surrender strategies.


CONCLUSIONS
Our study offers an effective model for diagnosing discriminatory behaviours in a medical professional setting. Knowledge of inequality's drivers could help national ID/CM societies in collaboration with major European stakeholders to further reduce such discrimination. The effect of discrimination on the quality of healthcare in Europe needs further exploration.
Infection Control Program, Geneva University Hospitals, Switzerland.
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Huttner
Knowledge and Innovation, Rome, Italy.
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Cacace
Knowledge and Innovation, Rome, Italy.
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d'Andrea
Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen and Marburg GmbH, Germany.
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Skevaki
National Institute for Infectious Diseases, Bucharest, Romania.
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Otelea
Knowledge and Innovation, Rome, Italy.
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Pugliese
Division of Infectious Diseases, Department of Internal Medicine 1, University of Tübingen, Germany. Electronic address: evelina.tacconelli@med.uni-tuebingen.de.
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Tacconelli
D003141:Communicable Diseases; D004501:Education, Medical; D005060:Europe; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008829:Microbiology; D010820:Physicians; D012955:Societies, Medical; D012959:Socioeconomic Factors; D013038:Specialization; D017132:Workplace
Clinical microbiology; Discrimination; Gender; Inequality; Infectious diseases; Profession