From the
President
Wayne Tuckson, MD
GLMS President | [email protected]
WORDS AND ACTIONS Matter
I
n the physicians’ lounge of a local hospi-
tal, a TV was turned to one of the histri-
onic daytime talk shows on which guests
are willing to discuss intimate topics
for TV immortality. The sound was off,
but the topic “I’m carrying the baby of my
girlfriend’s boyfriend” was on the screen. As
the writing dissolved, the guests, two young
African-American women, were shown. At
that moment, a colleague who was sitting
next to me exclaimed with great vitriol that
these two young ladies were “costing him
money,” because “they were welfare cheats.”
I was then, and remain today, impressed
at how, by merely seeing these two young
ladies on TV, he knew their character and
status. Now, imagine that you were one of
these ladies or someone who looks like
them, and happened to be a patient in his
office, what type of care do you think you
would receive?
Yes, doctors, we may be racist. Perhaps
this may be too bold a statement for me
to make, as clearly none of us knows what
another person is thinking. I admittedly
cannot see into the depths of another’s soul,
nor can I accurately say what someone else
is really thinking. However, I can say with
some degree of certainty, that one’s actions
and words do have impact.
Racial bias and stereotyping in health
care is neither new nor unique to this
community. The Institute of Medicine’s re-
port, “Unequal Treatment,” documented
observed differences in medical care and
postulated that this may be a consequence
of racial stereotypes held by health care
providers.
As recently as three years ago, Dr. Ron-
ald Wyatt, an African-American and Med-
ical Director in the Division of Healthcare
Improvement at The Joint Commission,
while a patient in a Chicago hospital, was
the recipient of what may be generously de-
scribed as less-than-standard care because
of his race. After his experience, Dr. Wyatt
wrote “racial bias and discrimination in
health care as well as outside of medicine
contribute to poor health for African-Amer-
ican patients and other racial and ethnic
minorities.” He concluded, “A racist system
of health kills people.”
In spite of our limited progress, as a
group, in leaving our biases at the door, I
still see the glass as half full. As Dr. Lisa Coo-
per states, “acknowledging that the problem
exists is half the battle and though it is hard
to change subconscious attitudes, behavior
can be changed once we are made aware
of them.”
I ask that we should all think about the
code words that we use and what we may
be consciously or unconsciously saying. Let
us think about what patients hear when we
refer to people as welfare queens, thugs,
criminals, vermin, illegal aliens, rednecks,
hillbillies, and other “dog whistle” deroga-
tory terms. I don’t know who is a racist, but
I, like our patients, know racist words when
I hear them and racist actions when I see
them, and they affect us all.
Yes, what we think and feel about a pa-
tient in front of us does impact their health
outcome. When that patient feels that we
are interested in them, they are more likely
to become better participants in their own
health care. Patients who have positive in-
teractions with their doctors are more likely
to follow through with care, make follow-up
appointments and better control their dis-
eases. 3 These are the ones who get better and
stay healthy, and at the end of the day, isn’t
that what we want for all of our patients?
So, yes doctor, let us watch the words
that we say and how we say them, for we
all know what they mean. We went into
medicine because we want to help people,
so let us remove one of the obstacles that
we can control, one that interferes with our
providing good quality care to all that come
through our doors.
Referenc es:
1 Unequal Treatment. IOM 2002
2 Williams DR, Wyatt R. JAMA. 2015
3 Cooper L. Amer J Pub Health. 2012
Dr. Tuckson is a practicing colon and rectal
surgeon.
AUGUST 2018
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