A few years ago, I used to watch "Desperate Housewives." I know it's an incredibly popular show - one of the ones where office mates gather by the water cooler at 8:30am to discuss the latest love lives and drama of the night before. I watched it occasionally, enjoying the craziness of motherhood and single life. But, a few years ago, activism in the Asian community rose up around a comment made by one of the characters on the show. While in a hospital room, one of the characters commented about the qualification of the doctor attending to her and stating, "I want to make sure (your diplomas) are not from some med school in the Philippines". The Filipino community erupted. Every doctor in my family, with the exception of my brother who is still in medical school, earned their diplomas in the Philippines. As Filipinos living in the Philippines, where else would they go? And, why wouldn't their diplomas be valuable.
Needless to say, my casual watching of Desperate Housewives ended. And, every time I hear the 8:30am conversations by the water cooler, I shudder.
Growing up within a medical family, much of our lives were spent in doctor's offices or hospitals. We would stop there on the way to church for my dad to see an emergency patient. We would stop there after church for another emergency patient, and to eat a cheap lunch in the cafeteria. When I was growing up, I would often go to the VCR to work out with my Jane Fonda aerobics tape, only to press <PLAY> and find footage of a surgical demonstration of cataract removal. Some nights, when I would go to kiss my dad "good night", I would find him at the dining room table with his surgical tools practicing his suturing techniques on a grape. Eventually, as I got older, I worked in my dad's office every summer to assist him with patient care.
In 2005, the hospital became an integral part of my life again when my 2-year old daughter was diagnosed with cancer. We went to a teaching hospital where the residents and fellows were from diverse backgrounds - both domestic and international. And, now, I envision my Filipino brother doing his rounds at the local teaching hospital.
Racism is an interesting dynamic in medicine. In the Washington Post, the American Medical Association recently issued an apology for the racism against African Americans:
The country's largest medical association today issued a formal apology today for its historical antipathy toward African American doctors, expressing regret for a litany of transgressions, including barring black physicians from its ranks for decades and remaining silent during battles on landmark legislation to end racial discrimination.
"The apology is important because a heritage of discrimination is evident in the under-representation of African Americans in medicine generally and in the AMA in particular," said the report's lead author, Robert B. Baker, professor of philosophy at Union College in Schenectady, N.Y., and director of the Union Graduate College-Mount Sinai School of Medicine Bioethics Program.
In many of my conversations with students - especially at a predominantly white college - we talk about representation, myths, inaccuracies they were taught, etc. In one exercise I conduct in diversity conversations, I ask participants to list the names of their doctor, neighbor, best friend, favorite movie star, favorite book author, etc. Most often than not, the list of names are all of white people. The next part is challenging students to expand their immediate circle by making intentional decisions around what movies they watch, what books they read, etc.
In every workshop, someone always says, "But, there aren't any Black doctors."
In challenging the students, we do get into the fact that you can likely find an Asian doctors from which to choose, there is certainly an over representation of white doctors, and unfortunately few Latino doctors, and even fewer Black doctors. The AMA Minority Affairs Consortium reports these figures:
Race/Ethnicity Number Percentage White 514,254 55.8 Black 32,452 3.5 Hispanic 46,214 5.0 Asian 113,585 12 American Native/Alaska Native 1,444 .02 Other 12,572 1.4 Unknown 201,383
Hopefully, this apology and recognition wakes people up to see the historic disparity and institutionalized racism that has existed in this field for so long. Recognizing that there is a problem is the first step. Now, I hope that the AMA actually does something to increase recruitment and retention of African American, Latino, Asian and Native doctors.