Managed care offers some potential relief. This sector is large, growing rapidly and will not go away soon. HMO's are subject to Federal enabling legislation and will not prove to have unlimited immunity in discriminatory retention practices affecting Black professionals. Also, as the proportion of the population covered through managed care arrangements increases, the absolute number and proportion of the insured group present as minorities will increase, acutely in some localities. Sensitivity to ethnic mix in the work force will become a minimal assumption in award granting by corporations and municipalities because, in part, the served and the provider communities are beginning to demand it.
Academic life offers a productive outlet for trained specialists.
Employment opportunities for surgeons in the discipline of trauma seem to be available. Meanwhile, traditional private practice should be viable for Black practitioners in group settings which will likely be increasingly multi-ethnic in mix without reference to the origination of the group. This means successful situations for Blacks will entail joining established groups which cannot be characterized as Black, or expanding successful Black originated practices to include non-Black providers. By way of constructive response to a harshly judgmental practice environment which exercises disproportionately punitive initiatives in privileging and licensure against Black practitioners, we have evolved an extremely conservative pattern of practice. Obviously this has been bad to the extent that Black professional life is characterized by less than leadership performance.