Title: Standing Up Against Systemic Discrimination in Health Care: Insights from a Physician’s Experience
In a poignant episode of The Podcast by KevinMD, family doctor Atharva Joshi reveals a personal and distressing tale of how pervasive discrimination within the U.S. health care and legal frameworks can ruin the life of a physician who dares to resist conformity. Drawing from his impactful article, “How the system targets physicians who refuse to bow,” Joshi sheds light on a rising worry among medical practitioners—especially those belonging to minority groups—concerning covert, bureaucratic forms of exclusion.
This narrative transcends the theme of individual injustice. It serves as a powerful call for action aimed at physicians who encounter similar forms of discrimination. Joshi not only shares his own experiences but also discusses how doctors who are underserved and underrepresented can push back against the structural injustices they face.
Systemic Discrimination: Subtle, Bureaucratic, and Harrowing
Atharva Joshi’s story is a compelling case study of how systemic discrimination manifests in real-world contexts. A former physician practicing on the secluded island of Molokai, Hawaii, Joshi became entangled in a series of traumatic occurrences. Following a baseless legal accusation that led to a SWAT team arrest and later dropped charges, Joshi lost his parental rights, public esteem, financial security, and ultimately, the medical practice that catered to an entire island population.
Joshi emphasizes that the true weapon wielded against him was not physical force—but rather, bureaucracy. He outlines the court’s legal tactics, which eagerly exploited cultural stereotypes, using phrases like “men do not babysit or care for children” and “that’s women’s work.” Such rhetoric not only invalidated his rights as a parent but also attacked the authenticity of his cultural background.
From Physician to Advocate
Instead of succumbing to the hopelessness imposed by the system, Joshi redirected his efforts toward advocacy. He chronicled his ordeal in an article and spoke out about the phenomenon he labels “the hunt”—a calculated institutional tactic to neutralize individuals who defy norms based on cultural or racial factors.
In response, he has suggested five strategic approaches for physicians encountering systemic harassment:
1. The Chameleon Principle:
Be quietly essential. Joshi proposes that minority professionals may need to adapt while retaining their core identity—providing value in ways the system cannot afford to lose.
2. Weaponized Absence:
When needed, make the system feel your absence. Illustrate the significance of your role by withdrawing from it when unjustly treated.
3. Reputation Obfuscation:
Broaden your professional identity. By maintaining multiple pathways (academia, clinics, community engagement), one’s professional reputation becomes more challenging to target or dismantle with a single blow.
4. Narrative Supremacy:
Own your story. As Joshi exemplified with his article and podcast participation, physicians should narrate their own experiences before others do so for them—often incorrectly.
5. Yamdoot Doctrine:
Joshi’s most provocative suggestion. He advocates for meticulous documentation of abuses to be disclosed only when no other option remains—transforming truth into a strategic asset.
The Personal Toll of Bureaucratic Struggles
Even with formal exoneration—such as dropped charges and cleared legal records—Joshi’s personal and professional existence is in shambles. He highlights how challenging it is for targeted physicians to endure this kind of persecution without external support. His CPA, employers, and even family suffered collateral damage for supporting him.
In the end, Joshi made a principled departure. He stopped practicing in the U.S., indicating a desire to return to India, where he could practice medicine free from the systemic discrimination he encountered domestically. He suggests that many like him may need to seek dignity and autonomy beyond the borders of a nation that regarded them as “Other.”
Empowering Future Generations of Physicians
Joshi’s experience particularly resonates with early-career and international physicians—those most susceptible to institutional gatekeeping. He shares frank advice:
– Anticipate the need to exert more effort than peers to be recognized or valued.
– Document everything.
– Navigate institutional channels intelligently—including HR and media—to elevate your situation if attacked.
– Master the “language of power.” In his words, “When someone targets you, ensure they bring evidence, not arrogance.”
He underscores the importance of community. Though isolated during his trials, he found support and encouragement through virtual connections—messages from colleagues, friends, and even strangers—and draws strength from the notion that others may yet find solace in his suffering.
A Rallying Call
At its core, Joshi’s narrative serves as a call to action for physicians—especially minorities—not just to endure institutional discrimination, but to confront it with intent and strength. By publicly sharing his experiences, Joshi provides both a cautionary tale and a guide.
His final message resonates not only with his peers but also with his children:
“What they refer to as chaos is choreography. What they label madness is a structure they can’t comprehend.”