A radiologist on the staff of a large community hospital was stopped after a staff meeting by a colleague in internal medicine. On Monday of the previous week, the internist referred an elderly man with chronic, productive cough for chest X-ray, with a clinical diagnosis of bronchitis. Thursday morning the internist received the radiologists written X-ray report with a diagnosis of probable bronchogenic carcinoma. The internist expressed his dismay that the radiologist had not called him much earlier with a verbal report. Visibly upset, the internist raised his voice but did not use abusive language. The family and community medicine division of a large staff model HMO serves a population that is ethnically diverse. The senior management team of the HMO, spurred by repeated complaints from representatives of one racial group, has encouraged the division, all of whose physicians are white, to diversify. Several black and hispanic physicians with strong credentials apply for the open positions but none are hired Weeks later, a young woman family physician learns from several colleagues that the division director has identified her as racist and the obstructionist to recruiting. The comments attributed to her are not only false but are typical of discriminatory statements that she has heard the division chief utter The rumors about her behavior have circulated widely in the division.
