Experiencing racial discrimination in medicine

12 April 2022

To deny that doctors and medical students experience racial discrimination is to hide from an unpleasant truth. This discrimination can come from a variety of sources including medical colleagues, other healthcare workers and patients. While we must have zero tolerance to racial discrimination we must also acknowledge that it does occur. Unconscious bias, leading to stereotyping, false assumptions and prejudice, is a human trait. As individuals it is essential to carefully examine our own attitudes and behaviour and be aware of how preconceptions may impact on our decision making and stance. Self-reflection is the best weapon we have available to eliminate racial discrimination as individuals. In addition, we must all be prepared to call out any discrimination we observe.

Discussion here will be confined to the experience of racism by medical students, doctors and other healthcare workers. Racism experienced by patients also needs to be addressed and should not be tolerated. They are related and ignoring one risks a failure to address the other.

Some examples of racial discrimination that have been publicly reported include:

I was once told by the head of department that I was “too Asian to ever get onto a program”.

When I was a medical student, I swapped with another student on a surgical case. The scrub tech asked the surgeon if the student changed, and she said “that or they dipped the last one in bleach.”

Patients who refuse to shake hands or say they want to see a “white” doctor.

Associate Professor Kelvin Kong was striding into John Hunter Hospital in Newcastle to treat a patient with COVID-19 when he was stopped in his tracks. “Deliveries are out the back,” a hospital worker said to him. A surgeon with 13 years’ experience, Associate Professor Kong was offended to be mistaken for a truck driver. But he didn’t get angry. He simply explained who he was, entered the hospital and got on with his job. When the incident was described on Twitter by a colleague, Associate Professor Kong remained remarkably gracious. “Awareness of unconscious bias is required, so we treat everybody kindly,” he wrote. “I can manage, I worry for my mob.” The tweet prompted others to share similar experiences. One Indigenous general practitioner said he had been asked to refrain from eating food that was set up for a committee meeting he was attending. Associate Professor Kong said these acts are generally not malicious but highlight how much people need to be taught about unconscious bias and racism.

Experiencing racial discrimination in medicine impacts on the wellbeing of those targeted but also contributes to a toxic environment in a medical workplace. A positive workplace culture and psychological safety are dependent on fair and just management. Therefore, eliminating racial discrimination is important to all working in healthcare. Tolerating the presence of any bias or prejudice puts everyone at risk as it creates an environment in which values do not recognise the maxim of “do no harm”. If racism is tolerated, then other biases such as gender discrimination will also be tolerated. When the healthcare workforce tolerates discrimination within the workforce then it will also tolerate discrimination in the provision of healthcare. A lack of psychological safety in healthcare creates a risk to the safety and wellbeing of patients. The highest standards of respect must exist within the profession for the best patient outcomes.

If you experience racial discrimination:

If you observe racial discrimination:

Remember the words of Desmond Tutu

If you are neutral in situations of injustice. You have chosen the side of the oppressor.

Kay Dunkley
AMA Victoria Coordinator of Doctor Wellbeing

 

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