A Need for Different Perspectives
Dr. Saroo Sharda, one of the College’s medical advisors, wrote in the British Medical Journal earlier this year about speaking at a conference for trainee doctors on the issues of diversity and inclusion. She listened as the attendees asked their carefully worded questions and the presenters responded, just as guardedly. Everyone tiptoed around the issue of racism without actually saying its name. When Dr. Sharda eventually said “I believe that what you’re talking about is racism,” the audience broke out into applause.
If we cannot even say the word racism out loud, it is little wonder that, as a profession, we have struggled to respond to it.
“When we talk about racism, things get uncomfortable, and as doctors we generally do not do well with discomfort,” wrote Dr. Sharda. “Doctors have grown up in a culture which teaches us that we must “know.” We must know the answer, the diagnosis, the treatment. Not knowing is considered failing, and failing is not tolerated. Our discomfort in talking about racism has caused us to magnify broad and sweeping statements about diversity and inclusion, while minimizing effort and resources toward embedding anti-racism and anti-oppression teaching into medical education.”
But the arrival and impact of COVID-19 has seen a growing recognition within the medical community that racism, in addition to being a societal ill, is also a public health crisis. In late July, Toronto Public Health reported that Black people accounted for 21% of the city’s COVID-19 cases, despite making up 9% of the population. In all, people of colour comprise half of Toronto’s population but 83% of cases and 71% of those hospitalized with the virus.
As you’ll read in our cover story, black communities are disproportionately affected not just by COVID-19 but, historically, by diabetes, strokes, hypertension and mental health issues, among others. Race isn’t a risk factor for illness; racism is.
In the wake of this summer’s Black Lives Matter protests, countless organizations came out with statements on racism and injustice. That included many hospitals, health care bodies and medical associations.
Dr. Onye Nnorom, President of the Black Physicians’ Association of Ontario, told Dialogue that she was cautiously optimistic whether the moment will continue to have momentum. “We will see over coming months and years who will walk their talk and engage in real, meaningful, uncomfortable institutional change.”
She says change must come from the top. For the CPSO, says Dr. Nnorom, that means making leadership diverse and equitable. She also urges the College to ensure that policies, practices and procedures are anti-racist — in part, by having under-represented patients/communities hold the organization accountable.
Over the last several months, the College has considered opportunities and the importance of increasing the diversity of our Council and Committees. And we are now reaching out to groups and associations with memberships that are underrepresented on Council, encouraging the groups to share with its members the importance and value in running in Council elections.
I believe a diverse Council is crucial in allowing us to draw on different perspectives and enhance our effectiveness as a regulator. The College must consider what work is required to not only diversify the organization but also to support equity and inclusion in all that we do. White privilege has ruled for centuries, it is not going to disappear overnight. We must see this work as long-term, a series of goals to be achieved in stages.
And to Dr. Nnorom’s point about better, stronger engagement with marginalized groups, well, I could not agree with her more. Not only is meaningful engagement a strategic priority for this College, but I have discussed previously in these pages the need to actively seek out, in different ways, the opinions of those patients who may feel disempowered and alienated by our usual processes of gathering public input.
There will be moments of discomfort. However, I believe that staying open and available during intense conversations is critical to seeing us making meaningful change. Quite simply, it is the only way forward.