Confronting racism in general practice

Amanda Lyons

21/06/2018 2:55:49 PM

Racism can be expressed in various ways. Dr Tim Koh told newsGP the best way to deal with it in general practice is to talk about it openly – and to not let it slip by.

Dr Tim Koh believes that openness to talking about and confronting racism is increasing in Australian society.
Dr Tim Koh believes that openness to talking about and confronting racism is increasing in Australian society.

Today’s Australia is culturally diverse and evidently proud of that fact, with research showing 85% of Australians believe multiculturalism has been good for the country.
It is no secret, however, that racism persists within Australian society. It can present in obvious ways, but also in words and behaviours that are more insidious – sometimes even well-meaning. This can occur in all areas of society, including general practice.
As Australia’s Race Discrimination Commissioner Dr Tim Soutphommasane said while speaking before a UN Committee in Geneva last year, ‘Our multicultural success can, at times, lead to some complacency … We can adopt a ‘colour blind’ approach as opposed to an openness to having conversations about race.’
Dr Tim Koh, GP and Chair of RACGP Council and RACGP Western Australia, has found openness to conversations about racism is increasing.
‘It is becoming more of a social norm to say racism is not acceptable,’ he told newsGP. ‘I think that’s the change people are experiencing, that it’s appropriate to say something [against racism].’
While it can be uncomfortable to address an incident of racism in general practice, Dr Koh believes it is very important for people to do so, regardless of whether or not they are the direct focus of the comments or behaviour.
‘The problem with racism is, if nothing gets said there’s a tacit implication that it’s okay,’ he said.
‘Choosing to do nothing is the path of least resistance, but by saying nothing we actually propagate the process of racism.
‘Beyond that, it has a very damaging and toxic effect for someone who has to experience it and deal with it.’
It is important for practices to address the issue of racism at a policy level in order to ensure a unified strategy and response, make practice values clear to all staff members, and provide protection and guidance to all team members in the event of future incidents.
‘It’s having that framework to fall back upon,’ Dr Koh said. ‘And that’s where practices and GPs can support each other, by talking about what’s acceptable and what’s not acceptable, because often on the spot we don’t get it right.’
Depending on the situation, responses to racism in general practice can vary. For example, if a patient vilifies a particular racial group during a consultation as part of a general conversation, the GP may need to engage them in a conversation and explain that such comments are offensive. But more severe incidents, such abusing staff or other patients because of their appearance or accent, may require refusing to accept the person as a patient.
‘There can be shades of grey, but there are also some black and white standards,’ Dr Koh said. ‘There are behaviours that are not acceptable, and you have to be prepared to say to patients that if a certain standard is crossed, you can’t consult and see them anymore.
‘There’s lots of situations where patients behave in an abnormal way, and what we talk about with registrars is recognising when a line has been crossed and defining that and saying, “You cannot do that in this situation”. And that’s not just an issue of racism or discrimination, that’s often an issue of safety.’
Dr Koh also believes it is essential to create a supportive, open environment that allows for discussion among staff members about racism in general practice, whether it is experienced from patients, peers or co-workers.
‘Talk about it and work out how you can problem-solve it. Contact a peer, contact your faculty, contact your college,’ he said.
‘And talk about it [with colleagues]. It’s easy to reflect on things that haven’t gone well, but that’s where other people can help.
‘Because we all experience these difficult things, and we can share those experiences and help each other.’

discrimination racism racism in general practice

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Philip Dawson   22/06/2018 11:08:40 AM

stop confusing "multiculturalism" with "racism". There is only one human race!! There is also only one colour but different shades of the two melalin pigments we all have. I can understand non medical journalists being confused on these issues, as they are on many issues, but there is no excuse for medical people. Call it for what it is-xenophobia, or worse, misanthropy!