In multicultural, multiracial Toronto, it’s not unheard of that a person seeking medical care would select a physician from the same ethnic group. Yet, in a recent position statement the Society of Obstetricians and Gynecologists is urging hospitals and clinics to resist patients’ preferential requests for doctors based on religion, ethnicity or gender. Specifically, the group says preferential requests in medical circumstances that are classified as “time-sensitive” should be resisted.
The argument for selection of the best physician on duty and not by racial or ethnic preference is not as clear-cut as this medical group would hope, however. Given the overarching problem of racial bias, the inference might be that the best doctor is not someone with distinctive ethnic or cultural identity. Yet, in the case of recent immigrants whose first language is not English or French, having a physician who speaks their language, especially in a medical crisis, would surely be preferable where possible. Consider also traditional customs with regard to Muslim women who would lean toward choice of a female doctor.
Patient preferences relating to language, religious or cultural tradition are understandable considerations, so despite the medical group’s recommendation such requests should not automatically be rejected where the request has legitimacy.
However, rejecting a medical practitioner because of his or her race is another matter entirely. A recent case in Michigan points to this issue of bigotry entering into rejection of medical professionals based on race. Nurse Tonya Battle has just settled a lawsuit against Hurley Medical Center in Flint, Michigan, after administrators allowed a racist’s request that Black nurses not provide care to his newborn in the hospital’s neonatal intensive care unit. We know similar discrimination occurs here as well.
Conversely, for members of the Black community seeking medical care, the issue that threatens health is lower quality care because of racial bias on the part of many doctors. Access to care is important, and we are blessed here in Canada to have a universal healthcare system, but quality of care is critical. Enough studies have been done to warrant concern.
While doctors tend to do more talking than listening to patients generally, talking increases while listening decreases even more in consultations with Black patients, for example. Even more disturbing, some who seek medical attention from Black or West Indian medical professionals right here in Toronto have complained about coming away from appointments feeling disrespected; feeling that the medical practitioner was condescending toward them. Along the same lines, Black patients complain of preferential treatment accorded White patients by non-White medical practitioners.
The encouraging news is that a number of healthcare and health advocacy organizations in the Greater Toronto Area focus specifically on the Black community. Among them, the Black Coalition for AIDS Prevention (Black CAP); the Black Health Alliance; the Caribbean Chapter of the Canadian Diabetes Association; the Sickle Cell Association of Ontario; TAIBU Community Health Centre; the Walnut Foundation (a men’s health and prostate cancer support group) and Women’s Health in Women’s Hands.
Healthcare is a serious matter. It is the last place any Black person would want racial bias to interfere. However, it does. One solution in the longer term is for medical schools to make race relations training standard in their curricula. To not do so would be a disservice to their students and to the wider community. Furthermore, doctors already practicing who have never had training in cultural sensitivity should make it their duty to access such training. That includes doctors in the Black community.
Patients must also be proactive despite the presumed position of authority assigned to physicians. Black people who are concerned that they may not be receiving adequate attention for their health conditions must commit to frank discussion with their physician about this issue. It may be uncomfortable, but honest and open communication with the person who could make the difference in the outcome of medical care is critical.