Physician Perspectives: Examining the Intersections of White Privilege and Racism in Medicine

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Racial insensitivity, stereotyping, and racially based decisions continue to occur in medical school admissions, recruitment, and management, as well as patient care.
Racial insensitivity, stereotyping, and racially based decisions continue to occur in medical school admissions, recruitment, and management, as well as patient care.

Two powerful articles published in the Annals of Family Medicine examined the issue of white privilege within the medical community.

In the first piece,1 author Max J. Romano, MD, MPH, from the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, opens with an anecdote of an experience during work at a hospital, when he witnessed other staff members making generalizations about a recently deceased patient based on that patient's race:

"One hospital staff member removed a cell phone from the patient's pocket, and then removed a second phone from the same pocket. A medical resident, wearing three pagers and two phones...joked, 'Maybe he was on call.'

"Another resident corrected him, 'No, I've seen The Wire, I know what this is about,' referencing a fictional television series set in Baltimore about drug-dealers who use multiple cell phones to evade police wire-taps.

"In an instant, the room switched from nervous cleaning to nervous laughter."

The experience stayed with Dr Romano, who used it as a catalyst to begin examining how racism and privilege benefits himself and his colleagues who are also white physicians.

Throughout his reflection, Dr Romano provided other examples of the ways in which he has benefited in his career by virtue of his skin color, such as never struggling to find mentors who shared his race, being able to speak his native language in professional settings without being viewed as uneducated or out of place, and being constantly aware of the medical discoveries made by white physicians while being ignorant to the exploitation of people of color for some of those discoveries. Dr Romano entreated his fellow white physicians to recognize the roles of racism and privilege in their own careers, and challenged them to speak out against this racism and seek justice for their fellow colleagues and patients.

In an editorial published in the same issue,2 Joseph Hobbs, MD, from the Department of Family Medicine at the Medical College of Georgia at Augusta University, provided his own commentary on white privilege in healthcare from a physician who does not possess that privilege.

Racial insensitivity, stereotyping, and racially based decisions continue to occur in medical school admissions, recruitment, and management, as well as patient care, noted Dr Hobbs. In his discussion of the effects of privilege, he points to a 2003 Institute of Medicine report3 that determined that disparities in the quality of healthcare provided to whites vs nonwhites exists at a systematic level, as well as at personal, institutional, and societal levels. This privilege of healthcare quality, he explains, can account for differences in life expectancy and overall health outcomes between different races.

To eradicate the healthcare disparities caused by racism and privilege, Dr Hobbs emphasized that recognizing the effect of privilege is the first step. This should be followed by active efforts to diminish these gaps on both personal and institutional levels. To experience bias in healthcare and fail to act is a missed opportunity, Dr Hobbs concluded; addressing such an opportunity can facilitate change. As Dr Romano urged his colleagues, recognizing and using one's privilege can lead to justice for fellow healthcare professionals.

References

  1. Romano M. White privilege in a white coat: how racism shaped my medical education. Ann Fam Med. 2018;16(3):261-263.
  2. Hobbs J. White privilege in health care: following recognition with action. Ann Fam Med. 2018;16(3):197-198.
  3. Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Smedley BD, Stith AY, Nelson AR, editors. Washington, DC: The National Academies Press; 2003.
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