I attended a lecture today that addressed the problem of racial profiling in the medical profession. Apparently, the word "racial" imbues every person with a sense of self-defense generally reserved for giselle fleeing from a lion pride, becase the phrase 'sparse attendance' would be a gross overstatement. Doctors, who are prone to King of the Beasts complexes under benign circumstances, immediately switch species and enter protective grouping behavior when confronted, as evidenced by their small grouping at the back of the auditorium.
The presentation was so politically correct as to be bland. The research shows that people from races considered a minority have less access to hight technology treatments than their white counterparts, even when the study is corrected for age, income, health insurance, education, primary language, and geography. Another group of studies showed that the only way to correct this phenomenon was to match racial and ethnic factors between doctors and patients. Oops. That's bad. That means that if you take me and someone else with exactly the same life as I have and exactly the same symptoms but send us to a white doctor, then I am more likely to receive optimal treatment. The presenter never said that, though. He said the blanket statement and then he read the abstracts of the studies outlining this fact.
Bland or not, the moment the floor opened for questions, a doctor led with this statement, "Well, that completely disregards personal responsibility for health." Right. The minorities should have been more responsible. If they had truly wanted to be healthy, they would have been born white like all us other "healthy and responsible" people.
The amazing part was that NO ONE turned to this doctor and said, "My! Aren't you the racial bigot?!" Instead, they droned on about social factors, geographical perspectives, and genetic predispositions. As if all of that can dismiss the fact that we had proven the research to be correct. Vast racial prejudice exists among health care providers.
I am not talking about the kind of racism that burns crosses or experiments and kills thousands of people. This is the type of prejudice justified by stereotype. "Well, I can't give HAART therapy to Africans. They don't even have indoor plumbing." or "Hispanic women won't breastfeed. They think it's dirty." or "Asians won't listen to anyone that's not Asian." Maybe, once, it was true, but that doesn't make it always true. It certainly shouldn't change our approach. If it is best to give HAART when the viral count peaks, or if breastfeeding is always best or if education is indicated, then we should provide. If we do, then the personal responsibility argument can take place. But if I deny someone the opportunity to make a choice, I lose the right to blame them for not having the best outcome.
I left the auditorium resolved to do better in my own practice. I recognize that I frequently leave out the child discipline piece of my toddler feeding lecture when talking to Latino families because my experience in the Caribbean led me to feel that "Latinos won't discipline." But that's not always true. So, I will stop that. I will be culturally sensitive, but I will give the best information that I have and let the family figure out how to apply it. Then I will figure out what other stereotypes have entered my practice schema and work to eliminate those. I hope the doctors do the same. It is truly shameful that we would even have this discussion in a post-civil rights movement world.
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