You overhear a GP partner making a racist comment in the practice. How should you react?
Nip it in the bud
Some dilemmas in daily practice can be tricky to solve. Everyday clinical or moral challenges can require some head scratching and pencil chewing. This one, however, is easy. It is the 21st century. Racism belongs in the past, if it belongs anywhere at all. As a profession based on science, disliking people for tiny genetic differences defies all logic.
So what would I do if I heard a colleague make a racist remark? Dead easy: call it out. Bring it up, however you wish to do it, and highlight it. It should not be tolerated.
Broaching the subject might be difficult. Hearing such views and comments may ultimately change the way you view a trusted colleague.
Personally, I would take them to one side, and advise them that this isn’t something that should be thought, let alone openly voiced. Remind them it is illegal to discriminate on the grounds of race, nationality or ethnicity under countless pieces of legislation.1 The professional bodies we belong to have equality and diversity regulations.2 So do many of the organisations we work for, not to mention the law.3 From a practice point of view, this might be a good time to firm up practice policy on discrimination.
Speak up, stamp it out, nip it in the bud. Just don’t tolerate it.
Dr Matt Piccaver is a GP in Sudbury, Suffolk
Consider formal disciplinary action
When I received the brief for this dilemma, I initially misread ‘partner’ as ‘patient’. In these post-Brexit times, a small, but significant cohort of patients seems to feel liberated to make discriminatory remarks about the ethnicity or religious affiliation of our staff, hospital colleagues, or indeed the population at large. I don’t tolerate any bigotry from such patients, and neither would I accept it from any of my colleagues.
As partners, we are employers to a large staff from a variety of backgrounds. Regardless of the context – a consultation, a private conversation or a practice meeting – our employees deserve to work in an environment free from racist remarks. I’m not a huge fan of the term ‘zero tolerance’, but I feel this is an area where there is no room for justification.
Making a racist remark in the workplace would be a direct breach of our partnership agreement and the GMC’s Duties of a doctor.2 I would challenge my colleague directly at the time and take the matter immediately to the partnership for wider discussion.
If an employee was the subject of the comment, or indeed overheard the remark, I would request that the practice manager seek immediate advice from a human resources professional. While we manage some issues in house, we use external human resources support for more serious employment law problems. A formal disciplinary hearing may be the most appropriate way to proceed.
The integrity of the partnership would rely on a satisfactory resolution, and I would want to be able to look my staff in the eye, comfortable that we managed the problem decently.
Dr David Coleman is a GP in Conisbrough, South Yorkshire
Carry out your professional duty to act
Everyone has a right to a positive working environment free from discrimination, bullying and harassment and all doctors have a duty to promote this.
In the first instance, you should consider GMC guidance on treating colleagues and patients fairly and with respect and prohibiting unfair discrimination against patients or colleagues by allowing personal views to affect professional relationships.2
The Equality Act prohibits doctors from discriminating, directly or indirectly, against others, or from harassing them on grounds of a protected characteristic such as race.3 Any racist comment may call into question the doctor’s ability to comply with the law when treating patients.
All practices should have an up-to-date policy on equality. The policy might say, for example, that concerns should be raised at a practice meeting.
It is important to resist the temptation to overlook the incident – you have a professional and ethical duty to act. Again, the GMC offers guidance, stating that ‘you must take prompt action if you believe that patient safety, dignity or comfort may be seriously compromised’ and you must tackle discrimination when it arises, and challenge colleagues who do not meet that standard.
Doctors can turn to a colleague or medical defence organisation for advice. This should be done before the problem escalates. How you proceed may depend on the nature and severity of the comment, who it was directed towards (if anyone), who heard the comment and the impact and intent.
Consider the relationship you have with the partner and the implications of discussing it directly. It may be appropriate to see if the issue can be resolved without reporting it, but consider the consequences – it may be counterproductive to go directly to the doctor. Other factors that may influence how you deal with the situation include whether there have been previous conduct issues that may mean this is part of wider performance concerns.
You may decide that the best action is to raise the issue with the practice manager or another partner. If you believe dealing with it objectively would be difficult, consider taking it outside the practice, for example to NHS England or the local health board. As always, document everything clearly.
Dr Myooran Nathan is a medical adviser at Medical and Dental Defence Union of Scotland
1 UK Government. Discrimination: Your rights tinyurl.com/yb2lhwb9
2 GMC. Good medical practice: Duties of a doctor tinyurl.com/y9538bmd
3 UK Government. Equality Act 2010 tinyurl.com/yaf3quyz