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Gold, incentives and meh

White GPs have a role in calling time on racism from patients

Dr Claire Davies

Channel 4 recently broadcast a video of a BAME surgeon who felt obliged to uphold a patient request for her surgeon to be a white doctor.

The doctor explained to the camera that, tragically, he didn’t know if his NHS organisation would support him if he tried to challenge this patient and her racist views.

Racism from patients is completely unacceptable, but anyone working in the health service will know people who have been subject to racially-motivated hostility. Unfortunately, this happens on a regular basis.

Social media groups of GPs regularly report incidents where patients announce that they ‘don’t want the ‘Paki’ doctor’. Some patients who don’t get what they want from the doctor have been known to swear and make abusive comments about the doctor’s ethnicity.

Racism may also be more covert, taking the form of oblique remarks, such as expressing surprise at the doctor’s command of English, or doing the ‘where are you from? No, where are you really from?’ line of questioning that leave the doctor wondering whether or not to object.

Such regular, minor or veiled sleights add up over time, to become exhausting for the doctor to deal with.

I'm a white British GP, yet incidents I’ve recently been involved with include remarks about the crime rate in our area being down to the presence of black people; a patient saying a colleague ‘barely spoke English’ (blatantly untrue); staff verbally abused over their choice to wear a headscarf; and a patient saying they ‘don’t like Chinese people’, when seeing a clinician of South East Asian heritage. This would only be the tip of the iceberg.

A moral duty to better defend and support BAME colleagues if we want them to stay in the NHS

Yet I'm discovering another nasty element, where patients are expecting me as a white GP to collude with them. These usually start with ‘I’m not being funny, but…’ and go on to say how nice it is to see a white doctor for once.

Sadly, it's not just patients. Some BAME doctors have described being interrogated by their colleagues when they’ve disclosed an incident. A line of questioning might be ‘what did you say to the patient to provoke them?’, which perhaps implies that it was something the doctor did to create the problem and is akin to asking sexual assault victims what they were wearing.

All of us have biases, subconscious or otherwise. I doubt many white British GPs have had any formal training in recognising these or how to deal with racism from patients or colleagues, but BAME GPs are facing this on a regular basis and wondering where the next person is lurking with their demeaning and hostile remarks.

Everyone needs to give a clear message to patients - that racism will not be tolerated. It’s the responsibility of us all - not just the burden of BAME doctors - to carry this fight. Letting racism go unchallenged gives the perpetrator a sense that it’s okay.

Those making less direct comments should be asked to clarify what exactly they’re trying to say.

People often backtrack, because, deep down, they know that their views are unacceptable, and realise that they’ve mistaken you for their conspirator.

Every one of us has an individual duty to protect and support our colleagues, but we also need to know that we have the backing of the institution. Policies that make it clear that this behaviour won’t be tolerated are one thing, but they also need to be implemented through calling patients out, warning letters and removing patients from the list if necessary.

Racially-motivated abuse, verbal or otherwise, is also classed as hate crime and may be reported to the police.

White GPs also need to learn to better respond to those who’ve experienced racism, by listening and acknowledging their stories, rather than the all-too-common responses of minimising their experiences; denying they could have been that bad; or shutting them down.

Racism is everywhere. It will always be here. With Brexit, some people seem to believe that their views are more acceptable. But I believe that white British GPs have a moral duty to become better-informed about defending and supporting our BAME colleagues in the consultation room if we also want them to stay in the NHS.

Dr Claire Davies is a portfolio GP in East London

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Readers' comments (19)

  • Despite the complaints that come after I will continue to refuse to endorse racism, sexism and anti LGBTQ plus statements from patients or otherwise. I'd rather be unpopular than a bystander who did nothing. History tells us the consequences of being a nation of bystanders.

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  • THE PROBLEM IS THAT CLINICIANS ARE TERRIFIED OF PATIENTS-WHICH IS EXACTLY WHAT THE GMC,THE DOH AND THE DAILY B'STARD WANT. IT IS A DELIBERATE WAY OF CONTROLLING US. WHY GIVE IT UP?

    IF, FOR INSTANCE, A PATIENT WERE TO ATTACK A DOCTOR, THE DOCTOR WOULD LIKELY BE ASKED TO EXPLAIN WHY THE PATIENT FELT THE NEED TO BEAT THEM TO A PULP.

    THINGS ARE CLEARLY OUT OF CONTROL.

    THE ONLY SOLUTION IS A WIDESPREAD GOVERNMENT TV CAMPAIGN WARNING THE GENERAL PUBLIC THAT ANY SUCH ABUSE/ATTACK OF ANY PUBLIC SECTOR WORKER WILL RESULT IN CRIMINAL CHARGES-ONLY ONCE PROSECUTIONS ARE REPORTED IN THE NEWS WILL THESE CRIMES STOP BUT SINCE THERE IS 0% CHANCE OF THAT HAPPENING WE ARE DOOMED.

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  • Brilliant article and really well thought out. As a BAME Gp I never looked at it from that angle

    Your support is much appreciated

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  • David Banner

    If we’re serious about zero tolerance concerning racism then the guilty patients should be either removed from the list, or given a final written warning that any repeat behaviour will result in their immediate removal (and possible prosecution). If everything is properly documented then I don’t see PALS or any other patient rights groups being prepared to defend racists.
    GPs have to be prepared to follow through with action, rather than letting this odious behaviour continue. Receptionists must record and report every “I only want to see the British doctor” incident for further action. Zero Tolerance is an empty slogan if we don’t.

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  • My wife went to see a doctor recently whose English WAS terrible. He was going to advise a completely inappropriate treatment regime because he couldn't understand her and it was only because I was there that it got resolved. Do we need to keep quiet about things like this in the future for fear of causing offence?
    Please realize this is not me defending any racist behavior from patients. But native level English should be a non debatable criteria of being a health professional in the NHS.

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  • Just out of curiosity did you take any steps to get this recorded as an adverse event? Guy obviously needs some feedback but sounds like he’ll be getting some elsewhere anyway!

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  • Bad behaviour from patients is unacceptable. This has got worse since Brexit. This is one reason why many ethnic Doctors retire early. We are fed up of being racially abused and insulted. There need to be sanctions against patients such as a fine or removal. If an NHS staff member is assaulted then the patient should be required to pay £100 to £1000 fine. I would not recommend Ethnic Minority Doctors to come to the UK to work. This badly affects overall morale and workforce.

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  • Petty racism is unfortunately an issue I and many other BME doctors have to deal with in the UK's NHS on an almost daily basis. A sly comment here, a snide comment there. The judgemental "where are you from - no where are you really from" even if your spoken english and level of education is light years ahead of the person asking the question. I was asked this once from one of the TPDs at my VTS even after I had lived in the UK for over 25 years and my accent is as british as anyone's lol. I had a female british patient the other week chuckle in a condescending manner when I mentioned the name of a Nigerian doctor whom she had seen. Sick of this crap. If people have issue with people's spoken english they need to complain to the government who issue medical licenses. Maybe the government can pander to their needs by making english tests more stringent. Of course this will mean fewer doctors coming here to work and waiting times will lengthen. It has nothing to do with the doctor who is trying to do their job to the best of their ability and if the patient didn't get to see the doctor of their choice they need to stop being so arrogant and to accept that the NHS has limitations. If they don't like the service they're getting and the ethnic background of the doctors they're seeing they need to find another healthcare provider and stop complaining like entitled spoilt children. I agree with the above comment in that I would not recommend IMG doctors work in the UK for this reason alone.

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  • Racism is endemic in the NHS organisation too. Heard about the "Snowy white peaks of the NHS"? The full speil is "The snowy white peaks and sh**ty brown pits of the NHS". nEED TO SORT THE HOME FIRST BEFORE WE EVEN TRY TO SORT THE VISITOR (PATIENTS)!!

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  • Dear Claire,

    Excellent article. I work in OOH, I speak very fluent English, been in UK for 20 yrs. When on home visits, 98% of the times I am asked where do I come from?. I just answer, we are in a decade of globalisation and I am not here to answer about my heritage.

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