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- Page navigation anchor for RE: Racism and the reshaping of physiciansRE: Racism and the reshaping of physicians
The authors make a host of good points. Every society and every individual harbours ideas tantamount to racism. Canadians have become adept at apologizing for our racist past; we're not so comfortable confronting our racist present.
The authors want nothing less than a wholesale reshaping of physicians' hearts and minds. Passive antiracism is complicity, they argue, we need a thorough “reorientation of the neutral physician identity”. CanMEDS, which currently calls on us to be patient-centered and to respect value and diversity, must adopt antiracism as a foundational competency. The re-education of physicians must be “explicit, intentional”, we must become “action oriented”, fiercely analytical and self-critical, committed to justice for all. We must be imbued with critical consciousness and taught to systematically analyze all aspects of our lives and medical practice in order to seek out and crush racism.
It’s been a while since I heard such a vigorous call for top-down social engineering. It is unrealistic. Courses and workshops readily spread facts, they rarely change personal values or deep social currents, what French social historians call the longue durée. The length and variety of problems noted by the authors shows how deeply and historically entrenched racism is.
Legal draftsmen have a saying: You cannot legislate good will. You can make people take courses on equity and fairness, you can’t make them buy in. If you push doctrin...
Show MoreCompeting Interests: None declared.References
- . 2022;:-.
- Page navigation anchor for We need to earn back public trust.We need to earn back public trust.
The previous 3 years of the pandemic showed that physicians are not in the position they thought they were in society. We heard many voices raising concerns about physicians’ ethics in relation to politics, government, mandates, dissenting opinions etc. In simple words, it looks like people stopped seeing doctors as ones who diagnose and treat and now see doctors as political actors. This shatters society’s trust in the medical profession. If you do not trust your doctor, you will look for medical advice somewhere else.
A physician’s politics and public voice can alienate potential patients; if a patient sees doctors as activists for a certain political camp, they may regard doctors as adversaries. Therefore, physicians must show neutrality. Regardless of our true political views, we must serve and welcome all people without exclusion. Neutrality ensures that we do not alienate anyone.
Critical race theory is a powerful political label and identifier, and advocating within this framework is political. The inclusion of its concepts in the CanMEDS framework will mean that Canadian doctors are confined to one political camp.
The medical profession is in a free fall in regard to public trust. People openly accuse doctors of being “biased”, “bought by”, and corrupt. Medical misinformation is at all times high. The COVID pandemic showed that the public will trust a non-physician with similar political views over a physician with seemingly opposite political...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Anti-racism as a foundational competencyRE: Anti-racism as a foundational competency
The single most important article I have read in CMAJ in 20 years. We have so much work to do - let’s get on with it.
Dr Virginia Robinson
White settler of European descent.Competing Interests: White privilegedReferences
- . 2022;:-.
- Page navigation anchor for RE: Anti-Racism Ideology in CMAJRE: Anti-Racism Ideology in CMAJ
It's really embarrassing to see how fervently the CMAJ has embraced the ideology of anti-racism. Viewing all aspects of life through the lens of race is a best unhelpful and at worst actively counter-productive to the goals of equity and inclusion. To assert that Western medicine is "founded upon the exploitation...of Black people" is laughable. Nobody is denying the many instances of mistreatment towards disadvantages populations by medical authorities in the past. But, to say that these are foundational to modern medicine and have somehow permeated the modern medical culture to the point that they affect the treatment of both Black professionals and patients is pure conjecture, with no real evidence behind it.
The concept of race is antiquated in the era of modern globalization, particularly in a nation as diverse as Canada. There are a multitude of plausible explanations (e.g., income, education level, health behaviours, access to care, etc.) for health disparities between different patient populations. Addressing health inequities between patient populations means identifying the real reasons for them based on scientific inquiry and not relying on superficial assumptions based on skin colour.
It goes without saying that all patients should receive the same level of care and the same access to care regardless of their race or ethnicity. Likewise, race and ethnicity should not be a barrier to advancement in the medical profession. These ide...
Show MoreCompeting Interests: None declared.References
- . 2022;:-.