The death of George Floyd at the hands of Minneapolis police officers has again shined a heartbreaking light on the enduring racism and brutality faced by African-Americans. Given that racism and discrimination are also common in health care settings, affecting patients and health care professionals alike, it’s essential to consider what DOs and osteopathic medical students can do to take a stand against injustice.
The DO recently spoke with Tyree Winters, DO, an osteopathic pediatrician in Morristown, New Jersey; Jennifer Caudle, DO, an osteopathic family medicine physician in Stratford, New Jersey; and Octavia Cannon, DO, an osteopathic OB-GYN in Charlotte, North Carolina. Following are their recommendations on combating racism and being an ally to the African-American community in the health care setting.
Examine your implicit biases.
In order to be an effective ally, it’s critical to identify, and work to eliminate, our own implicit or unconscious biases.
“We have to be willing to look at any implicit bias we may have, whether it’s racism or any other type of discriminatory bias,” Dr. Caudle notes. “As health care providers, we’re charged with doing right by other people, and in order to do that, we have to look inward.”
There are various ways of addressing implicit bias, including slowing down and challenging your initial assumptions about people and situations; taking a questionnaire such as the Implicit Association Test to become more familiar with your own biases; and taking part in bias training for health care professionals.
If you see something, say something.
If you hear a racist comment, it’s important to speak up. It will not be easy, but it must be done. “We have to be agents for change—if you see someone say something inappropriate, it’s important to address that, whoever it’s directed to,” says Dr. Caudle. “That culture of everyone taking responsibility for each other is what’s needed to move the needle.”
For students, who may have less experience navigating such conversations in a clinical setting, Dr. Cannon notes that there are several ways to proceed.
“To a colleague who says something racist, you might say something like, ‘I felt uncomfortable with what you said—I wonder if the patient did too,’” she says. “If it’s something truly uncomfortable, you may need to speak with your program director.”
Learning about historical and present-day racism against African-Americans in the U.S. is essential for osteopathic physicians and medical students, Dr. Caudle says.
“In light of recent events, people are asking themselves, ‘How can I further my knowledge about the injustices that African-Americans in this country have faced?” she says. “These are exactly the things we have to ask ourselves as doctors.”
At the same time, Dr. Winters notes, it’s important to take on the burden of this work yourself, rather than relying on others to teach you.
“Sometimes as a black man, it’s like, why do I always have to be the solution to a problem I didn’t cause?” he says. “We’ve been yelling it from the mountaintops for so many years. Things are not going to change until others do the work to make that change.”
If you’re looking to start a reading list, this compilation of titles from Ibram X. Kendi, director of the Antiracist Research and Policy Center at American University, is one place to begin.
Check your privilege.
Ideally, the concept of privilege should be introduced in early childhood, says Dr. Winters, who is a pediatrician.
“Starting when kids are 2 or 3, we need to be talking about racial equality and how we all have differences but we’re all equal,” he says.
As kids grow up, they should understand which aspects of their own identity give them privilege and how that affects their interactions with the world.
“As DOs, we talk about the holistic approach, and that’s exactly what this is,” Dr. Winters says. “Conversations about race should start when we’re very young, leading to a continuation of self-reflection throughout life.”
In her essay “White Privilege: Unpacking the Invisible Knapsack,” Peggy McIntosh, PhD, provides an introduction to some of the indicators of white privilege, such as:
- “If I should need to move, I can be pretty sure of renting or purchasing housing in an area which I can afford and in which I would want to live.”
- “I am never asked to speak for all the people of my racial group.”
- “I can go shopping alone most of the time, pretty well assured that I will not be followed or harassed.”
For a broader look at privilege that also considers social class, religion, sexual orientation and gender identity, check out BuzzFeed’s “How Privileged Are You?” quiz.
Be mindful of how the effects of systemic racism can play out in the clinical setting.
DOs and osteopathic medical students should be knowledgeable about the ways in which generations of systemic racism in the U.S.—affecting access to housing, education, health care, job opportunities, and more—could be affecting their patients.
“To take one recent example, the same communities that are affected by racial injustice are also disproportionately affected by health disparities, economic disparities, and now, COVID-19 deaths,” notes Dr. Winters. “The degree to which these disparities are concentrated is staggering.”
Similarly, Dr. Caudle says, it’s essential to be aware of how the events surrounding the death of George Floyd might be affecting patients.
“As osteopathic physicians, we take a holistic approach, and that means bringing up current events and asking how patients are feeling,” she says. “There are a lot of things we can do to really affect patients in a positive way—but we can’t pretend these issues don’t exist, or that they don’t affect us if we’re not African-American.”
For Dr. Cannon, these types of conversations are an essential part of patient care.
“What has helped me become a better physician is the ability to respectfully inquire about other people—their culture, their background, their social situation,” she says. “Asking questions and getting to know each patient as a person helps me treat them better and advocate for them if necessary. To me, that’s what the osteopathic philosophy is all about.”