In the Blog
Take Two Pills a Day and a Dose of Racism
Photo by Gordon Meyer (Flickr)
Even with all the progress that has been made in civil rights and equality, prejudice and discrimination can still be found in every corner of the world. As I interact with people and see how people interact with my family on a daily basis, I wonder when our perceived ethnicities come into play in how we’re treated. When is bad customer service actually discrimination? Or, when is a denial of access to something because of distrust instead of policy rules? However, I always thought there were at least some places where your ethnic heritage wasn’t held against you.
We can all sometimes fall into a false sense of security when it comes to certain places. Ignorance is one of the main sources of racism, so I thought organizations that fostered education and understanding would be devoid of it. Unfortunately, I discovered through research that some of the most intellectual people can also be the most closed minded of all. Institutions such as hospitals harbour some of the greatest minds found on earth, but even these individuals can get ensnared in the ugly web of racism. Even though medical professionals take an oath to provide the best possible care to patients, some let their prejudices or unconscious biases inhibit them from truly aiding people in need of their treatment.
Racism in medicine — or scientific racism — has deep roots in Western history. Although the discrimination against people perceived to be different than the majority has occurred since the beginning of time, some say that Aristotle was the father of scientific racism, insisting that some people by nature are meant to be slaves. From then on, other men of science from Europe and North America — including Carl Linnaeus, Dr. Samuel George Morton, Josiah Nott, and many more — performed their own observations and studies to contribute to the erroneous findings of this pseudoscience, sure that race influenced the intelligence, temperament, biology, and worth of an individual.
Even today, despite the human genome project in 1999 making it clear that race is something humans constructed and not based in biology, a person’s ethnic heritage is taken into account in medicine. Some medical devices are still adjusted for race, even though evidence states that people of different racial backgrounds can be genetically more similar than people of the same ethnicity. What appears to be a race specific malady can actually be due to socioeconomic and environmental factors, but these causes are less likely to be looked into. This mistreatment is because our society is racially biased. It doesn’t take one individual to be discriminatory — it takes an upbringing, an entire community teaching you that people are different and less than human because of the colour of their skin or the country they’re from. Until that is addressed in both society and medicine, racial prejudice will remain an issue.
Although we don’t see too many shocking headlines regarding racism in hospitals, it’s still an occurrence that negatively affects the lives of patients of minority backgrounds. As recently as 2014, medical textbooks still taught falsehoods on the pain tolerance and medication preferences of different ethnicities. What appear to be the biggest issues are the (sometimes unconscious) medical professionals’ lack of trust and due diligence when it comes to responding and treating non-white presenting patients. Such patients’ symptoms and knowledge are at times not taken as seriously and ulterior motives are sometimes expected of them — such as a ruse to get pain meds to feed an addiction, which a black patient of Dr. Monique Tello was suspected of when visiting a local emergency room. It is due to these assumptions that BIPOC people have a higher chance of receiving painkillers below the recommended amount when entering an emergency room with a painful condition.
Even when serious signs of an underlying ailment are present, some doctors are more likely to prescribe over-the-counter medication rather than run more tests to dig deeper into the cause of a patient’s discomfort. For example, after taking a trip to Zambia, Africa, Dr. Ron Wyatt — a man of African descent — developed a fever that reached 40 degrees Celsius. Concerned, he and his wife went to the hospital. After receiving less than optimal care from the nurses, the physician followed suit, barely giving Dr. Wyatt a proper exam. When another nurse voiced her concern that they should do more for their patient, the physician instructed the nurse to tell Dr. Wyatt to just take some Tylenol when he returns home. Even though Dr. Wyatt was a physician himself, his status as a patient shifted the power to the doctor that was treating him. What Dr. Wyatt said became irrelevant as the acting physician’s expertise became the final and valued word. As we all know, though, the doctor isn’t always right and the patient isn’t always wrong.
A medical professional’s body language alone is also enough to tell how they really feel about a patient. A study led by Professor Dr. Amber Barnato of the University of Pittsburgh School of Medicine showed that doctors were not as compassionate or warm with their body language with BIPOC patients as they were if the patient was white. Based on the grading system of the test, the physicians being tested scored an average seven percent lower on nonverbal communication with black patients than they did with white patients. Some of the doctors would keep their distance or choose to look at other things and people rather than the patient. With their hands crossed or in their pockets, they did not communicate a message of interested involvement, but one of distaste. However, the test was mostly conducted with white male physicians, so more research with a diverse subject group needs to be done to collect more substantial results. After all, BIPOC medical professionals can harbour their own racial biases as well, like when Dr. Jennifer Adaeze Okwerekwu — a person of colour — believed her care of a patient with sickle cell disease may have been compromised by racist teaching in medical school. Whether medical professionals know they are acting from a place of bias or not, just the act of being discriminated against takes a tremendous toll on a patient’s physical and mental health. Individuals that experience racial bias are known to not only have issues with sleep and blood pressure, but also an increased risk of heart disease, stroke, and respiratory problems.
If you try searching online for what you should do if you’re facing discrimination from medical professionals, resources to help patients are few and far between. There is no end to how doctors should engage racist patients — an equally important issue to address — but patients should be given as much consideration. First off, if you feel a doctor or nurse has expressed a racial bias towards you, practice care and remove yourself from the situation if you are able to do so. There’s nothing you can do or say in the moment that will make them give you the care you deserve as a human being. Next, you will want to write down exactly what happened during your visit so you can report your case to a medical ethics board or hospital administrator. Also take advantage of the hospital’s patient advocate to help you figure out what your options are and decide the best course of action. If medical consequences do occur because of a lack of treatment or testing due to your race or ethnicity, then you may need to contact a lawyer since there may be additional legal actions you can take.
Just because someone wears a white coat it doesn’t make them an infallible expert. There needs to be an open dialogue on racism in medicine. It happens far too often to be ignored anymore. More evidence-based practice in hospitals is required and less reliance on inaccurate and out-dated beliefs on racial difference. Medical schools have to educate their students on being aware of patient’s societal, familial and cultural backgrounds, as well as their own personal biases. Hospitals must foster stricter policies concerning patient discrimination so that everyone is able to receive proper care regardless of what they look like. No one should have to suffer racism, especially in a hospital. Hospitals are meant to be places where you receive care when you might be at your most vulnerable. They should never be a place where you’re judged and condemned. Although concepts like slavery and segregation appear as though they are in the past, we must not forget that racism is still alive and breathing — even in hospitals. That’s why we must remain vigilant and vocal until this plague of prejudice is finally treated.
This is part one of a two part series on racism in medicine. Read Part two here.