“Where are you from?” “Orthopaedics”
Without context, seems like a normal exchange to ask about a colleague’s specialty, right? In the context of an Asian doctor being affronted by a Caucasian patient, it highlights how such racial prejudices have become so commonplace that ethnic doctors have to have a go-to, without batting an eyelid or indeed confronting the issue because, at that moment, we need to treat the patient and frankly do not have time to entertain and educate them. It says a lot that my first reaction was “huh that’s a neat way of dealing with such patients”, as opposed to acknowledging that it is unbelievable that we are still placating and dealing with racist patients. Microaggressions like this are a real problem – and the only way to overcome them is to call people out – something we as students often do not feel empowered to do. But, realistically, we cannot deny patients treatment, regardless of what they say or do – what we can do is support each other in these moments and not give in to the pressure and frustration to just say ok fine and allow the patients to demand a doctor of their choosing.
The vast differences between communities have been highlighted this year by the Covid -19 pandemic – we have all seen paper after paper trying to explain why ethnic minority groups seem to not only be spreading the virus more but also suffering from much more serious courses of infection. And yet this huge disparity was largely ignored and explained away by the correlation between ethnic minorities and lower socioeconomic background, which although does explain the increased rate of infection, cannot explain the more severe course of infection. We all study epidemiological differences throughout our education and are trained to recognise that some diseases are more common in certain populations – the fact that an infection affects a certain group of people more is nothing new to the medical world. So, I wonder why such a disparity isn’t being looked into more, or if there is anything we can do to protect those more at risk.
But then we must consider the flipside of “positive” epidemiological differences – clinical stereotyping is still rife, and hugely problematic. I was shocked that while researching for this article, I found that the term “bibi-itis” is still being used to describe typically older, south Asian women who come into Emergency departments with non-specific complaints not showing on any investigations – women who it is easier to put down as being overly melodramatic, than genuinely considering their concerns. Furthermore, black women are 5 times more likely to have significant complications during childbirth, but there are often reports of their concerns not being taken seriously by doctors and midwives in early labour. Such attitudes have led to a deep-running distrust of doctors amongst ethnic minority communities, and honestly, it’s not surprising that more and more people are not going to see their family doctors for “mild” complaints and waiting for conditions to present in fulminant, late-stage signs and symptoms that cannot be refuted, which sadly often means that such patients suffer and potentially die of a treatable disease.
Medicine is a caring profession, in which doctors often put the needs of patients before their own and as such can easily be exhausting even with wonderfully kind patients. It saddens me to see the profession becoming more and more one of customer service, in which patient autonomy is taken to the extreme with unreasonable demands, adding to an already burnt out workforce feeling angry and hurt, not just at the conditions we can’t treat, but now at patients too. These feelings build into the frustration that is emotionally exhausting for healthcare professionals to carry with them, not to mention the potential impacts this can have on patient safety.
Taranpreet is a 5th year medical student at LF1, Charles University and has several ambassador roles for the faculty. She is an Education Officer with UIMS and works with the Academic Affairs team and Alumni Network as part of LF1 MEDSOC. Taranpreet is looking to specialise into Paediatrics and Emergency Medicine, with a keen interest in Medical Education.