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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
racial inconsistency
WHAT HAS A DOCTOR DO WITH RACE & ETHNICITY
Re: Race and Medicine
Race and Medicine
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Charese C Pelham, North Augusta, SC MD
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I am extremely offended by this article's cavalier use of "white" as a term, while simultaneously using "African-American" and "Latino". What is "white"? Is that bread, or sugar, or what? The authors didn't use the term, "black"; they used, "African-American." Please, let's have consistency here. Either say, "black" and "white" and even, "brown" or say "African-American" and "European-American". Why does every other racial group get either a capital letter or a hyphen, and European- Americans get "white?" Inconsistent, racist, demeaning, unfair. Thank you. Sincerely, Charese Pelham, MD (European-American) Competing interests: None declared |
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Dr. Rajesh Chauhan. MBBS (AFMC), DFM, FCGP, ADHA, FISCD, 309/9 AV Colony, Sikandra, AGRA -282007. INDIA Consultant Family Medicine & Communicable Diseases., Dr. Akhilesh Kumar Singh, MBBS, MD, Dr. Parul Kushwah, MBBS, MISCD.
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Dear Editor, The article by Chen FM, Fryer GE, Phillips RL, Wilson E and Pathman DE, titled “Patients’ Beliefs About Racism, Preferences for Physician Race, and Satisfaction With Care” published in your journal (Annals of Family Medicine 2005; 3: 138-43 ), has brought out a very disturbing trend of affairs. What has a doctor do with race, ethnicity, caste, creed or sex of a patient? Are we doctors not affirming our faith to the ‘Hippocrates Oath’, or has it turned redundant in today’s world. This research reflects a study of only 3,884 individuals, out of which nearly one quarter of African Americans and one third of Latinos preferred that their personal physician was of their same race or ethnicity. If we were to extrapolate this result on the total population, it would amount to a very huge figure, which ought to be quite disconcerting to one and all. Fostering racial suspicions and belief of discrimination as brought out in the article, does not auger well. Radical changes in the attitudes are required. We agree with the authors that the ‘sources of patients’ beliefs about racism and discrimination are deep-seated and complex and will require similarly thoughtful and multifaceted solutions’. Since ours is a shrinking world with more interracial contacts, this problem has to be addressed not merely in local terms but on a global term also. The earlier we introspect and find solutions, the better it would be for the humanity. Regards, 1. Dr. Rajesh Chauhan MBBS, DFM, FCGP, ADHA, FISCD Consultant Family Medicine & Communicable Diseases. 2. Dr. Akhilesh Kumar Singh MBBS, MD Sr Resident Neurology Institute of Human Behavior & Allied Sciences, Delhi. 3. Dr. Parul Kushwah MBBS, MISCD Family Medicine Practitioner. Competing interests: None declared |
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Diego Osuna, Denver, Colorado USA Sr. Intructor Univ Colorado Dept Family Medicine, Clinician Researcher Kaiser Permenente Colorado
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Acculturation and Racism In their study investigating the link between patients’ perceived racism in their healthcare system and personal preference for physicians of concordant race and ethnicity, Chen et al raise important issues, not the least of which is the fact that some minorities perceive the healthcare system as racist. The authors, however, perhaps missed an opportunity to further shed some light on factors contributing to perceived racism in Latino subgroups. Although this survey was conducted in both English and Spanish, the Latino subgroup was not stratified by language preference. Omission of language, therefore, misses an opportunity to recognize important differences within Latino subgroups. Language is strong proxy measure of acculturation. Although in some cases higher levels of acculturation into the dominant culture in Latinos is associated with an increase in some detrimental behaviors such as drug use and poor dietary habits, acculturation marked by increased English proficiency has been shown to be associated with improved access to care and use of preventive services. (1) It is possible that limited English proficiency and its associated disenfranchisement from services in the Latino group contributes substantially to perceptions of racism. So when investigating patient’s beliefs and preferences, we should understand qualities such as acculturation that define subgroups within racial and ethnic groupings. Then we can ask ourselves not only what are the specific patient and physician qualities that contribute to perceptions of racism but also what are the factors that protect against racism in the healthcare system. 1. Lara M, et al. Acculturation and Latino Health in the united States: A Review of the literature and its Sociopolitical Context. Annual Rev Pub Health. 2005.26:367-97. Competing interests: None declared |
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Laeth S Nasir, Omaha Nebraska Associate Professor, Department of Family Medicine University of Nebraska Medical Center
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This paper contributes significantly to the literature on issues of race in the clinical interaction between physician and patient. I also believe that we as physician educators need to step up to the plate to vigorously research and remedy this state of affairs. I would agree with the authors that the issues go beyond just patient perception; although much racism in the medical system is likely to be subtle, the fact that it is detectable in numerous studies argues for redoubled efforts to study and eliminate it. I also believe that until we begin to seriously study our own attitudes and perceptions as physicians and teachers (1), we will not be able to entirely rid ourselves of racism in the medical system. Laeth Nasir MBBS 1-Nasir L. Portrayals of African Americans In Family Medicine Recruiting Literature. Nebraska Medical Journal 1996; 81: 37-8. Competing interests: None declared |
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