When premed students are asked why they want to be a physician, I assume the answer is always along the lines of having a desire to help out those in need and to make a difference in the community. In light of the recent cases of police brutality on black people and the ongoing protests, we should also ask ourselves if the field we aspire to engage in also faces systemic racism.
“Systemic Racism includes the policies and practices entrenched in established institutions, which result in the exclusion or promotion of designated groups. It differs from overt discrimination in that no individual intent is necessary.” -ACLRC
http://www.aclrc.com/forms-of-racism
And sure enough, medicine and healthcare is not impervious to racism. If our reason to become a physician is to help those in need and to make a difference in the community, are we really achieving such if we perpetuate systemic racism in healthcare?
Faiza Amin has several great articles in Toronto CityNews discussing marginalization that the Canadian black community faces in the healthcare system (1, 2, 3). The recount of John River’s story about unreasonable delay in medical treatment, which was nearly life-threatening, only emphasizes the extent of this issue. Amin shows that besides suffering from medical illness and pain, many black patients also have to worry about the way they present themselves to healthcare workers. Something as simple as dressing a certain way can be seen to change the way healthcare workers interact and treat patients.
Other marginalized groups in Canada, such as Indigenous peoples, share similar experiences with the healthcare system. The death of Brian Sinclair is one tragic case where ER healthcare workers failed to even acknowledge the treatable suffering of this man. There is no doubt discrimination and systemic racism played a role in this tragedy. A paper discussing inequalities in healthcare for Aboriginal people in Vancouver shows a pressing need for healthcare workers and policy makers to even acknowledge racial discrimination.
The Social Accountability Working Group formed by The College of Family Physicians of Canada seems like a promising movement towards bringing more justice into Canadian healthcare. Their goal is to establish greater social accountability amongst physicians.
There is no doubt stigmatization and discrimination exists in healthcare. This reality is undeniable and deeply saddening. Institutional change in response to these types of systemic racism is extremely difficult to initiate and implement. However, as premeds, we can start by educating ourselves and addressing these inequalities. We should strive to bring greater awareness and reflections on behaviours that perpetuate systemic racism. The morals of our generation build the foundation for fundamental changes in our institutions.
I will continue to educate myself on these topics, and so should you 🤓 Here are some other interesting reads: Healing racism in Canadian health care, by Yvonne Boyer; Colour Coded Health Care: The impact of race and racism on Canadians’ Health
That is all. Bye for now ✊🏿 ✊🏾 ✊🏽 ✊🏼 ✊🏻
Nostalgic MD 