I am white. I try to be culturally competent and check myself on intrinsic bias and read the many articles about certain racial minorities (particularly African American) having missed MIs, less pain med, longer visits…etc. However…I’m still white, and particularly in the ED pts have no idea whether or not I may be treating them differently because I don’t share their skin tone.
Comments are usually subtle, and I don’t always address them because I might be misinterpreting it. But last night a young man with abdominal pain who was not an appropriate candidate for the morphing he was requesting ended up crying that we “weren’t doing anything because l’m a young black man.” I tried to explain that I had a white woman with a similar situation who I treated in the same way the night before. I tried validating his concern, saying that he’s correct about racial discrimination in medicine, but that I was doing everything I could think of. I tried talking to his grandmother to see if there had been bad experiences before and assure her that I was trying. I told him that I was sorry if any doctor had treated him differently because of the color of his skin. The other times I’ve gotten similar comments tend to surround cyclic vomiting patients with marijuana as a likely cause but an unwillingness to quit. I feel like I’m failing these patients.
We didn’t have any docs of his race working in the ED, but if we had…would it be appropriate to swap docs? We do it for religious reasons. Are there better things I could have said to diffuse the situation?
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