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The waiting game

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)

  • DrRubbishBin

    Racism is wrong. We should stand up to it and point it out where ever we can.
    Of cause Drs should be able to speak the language of the country they are practicing in to a level that enables them to practice safely - isn't this just basic common sense?
    This country is full of all sorts of objectionable people with objectionable options and behaviour, I quite often feel really uncomfortable with some of the people i see. Can i refuse too treat people who's opinions i find offensive? No
    This article is great.
    As always when the subject of racism is raised many of the comments are truly depressing. Openness and humility is what's needed to heal division. Is there a country in the world where bad people don't exist? Show me where and if i had to leave my country I''ll go work there

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  • Well written article! Thank you Claire a very relevant and profoundly prevalent issue- Racism! I have to agree it not just exogenous it’s intrinsically endogenous too!
    Sometimes I don’t know what’s worse racist patients or racist colleagues- who just treat you like dirt in coffee rooms/ Doctors Mess, on courses, ward rounds etc etc - they just carry on talking - disregarding your presence, excluding you from conversations ( like either you don’t have a brain or don’t know why you’re here)
    None of this is acceptable.
    Don’t just like exotic food, holiday or wine!! Constructive learning is the way forwards for everyone.

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  • I don't get this often now but when I started 9 years ago, I often had patients asking to see "an English doctor" and "are you sure he can speak English". Even now, every few years (thankfully not every game as some footballers get) I get racial abuse from patient who didn't get what he/she wanted.

    Having been living here for most of my life, not a great way to be treated.

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  • BAME doctors born and trained in the UK are more likely to have complaints against and more likely to have a visit to the GMC than their white colleagues. You know, the ones that don’t even sound foreign. Rates are higher in those doctors that do retain an accent and aren’t white. I’ve had patients removed from the practice list for overt racism. The casual racism traditionally has been allowed to slide. We wouldn’t want our white colleagues labelling us as snowflakes now would we. Great article but I shalln’t be holding my breath on any significant changes. A grass roots uprising is unlikely to succeed without help from the top.
    Appropriate complaints against doctors I have no problem with. Vexatious complaints don’t have appropriate penalties. Especially those where race is a primary factor. Not only is the existing culture within the wider NHS inexcusable in this regard but there are systemic organisational and systems issues. Politicians & leaders in peak bodies are mostly white. This is a problem for them for them to help address. You know that thing called leadership.

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  • |Sceptic Monkey | GP Partner/Principal|19 Nov 2019 9:08am

    Hang on a minute, asking if someone can speak English = racist???

    What if I asked a white Caucasian Polish/German/etc Dr here in the UK if they can speak English? That still racist?

    I'm sure the Japanese don't get accused of racism whenever they ask any foreigner, even Oriental ones e.g. Chinese, if they can speak Japanese.

    Don't be guilty of, as Dr Davies is doing, accusing EVERYTHING of racism. It simply devalues the term. Just saying...

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  • |Esmat Bhimani | GP Partner/Principal|18 Nov 2019 3:59pm

    When on home visits, 98% of the times I am asked where do I come from?

    - Could it be maybe the patients are curious and simply making conversation? What is it that makes you take that question so personally?

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  • Christopher Hi

    This is why asking people where they are from is really, really annoying

    https://youtu.be/RU_htgjlMVE

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  • Shaba,

    Annoying? I get asked if I'm from China, Singapore, Japan, Hong Kong, Malaysia, Korea, etc and I don't find that annoying. Someone earlier mentioned 'snowflake' behaviour?

    Then there's the obvious. Annoying is not = racism

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  • I find lots of questions annoying, maybe I should get them all criminalised under 'hate speech'.....

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