COMMENTARY

When Patients Discriminate Against Doctors: A Muslim Physician Weighs In

Seema Yasmin, MD

Disclosures

April 14, 2017

Meeting Mrs Smith

"I want to see the doctor," the patient gasped, staring at my face.

I thought she'd mistaken me for a nurse. It happened every day to female doctors, even though in the United Kingdom, where I was working, nurses wore distinct uniforms and doctors dressed smartly in their own clothes.

"I am the doctor," I said.

"I don't like your kind. I want a white doctor. A man."

Seema Yasmin, MD

My cheeks burned. I pivoted on my heels and walked out, feeling a cool relief that I could close the door on Mrs Smith, that her racism and sexism could be contained inside a room and not let loose on the ward like a bad smell.

I should have called a superior to ask for help—maybe my consultant, a pragmatic Bengali man with expertise in emergency medicine and intensive care. I should have bleeped the on-call registrar, a no-nonsense Indian woman who might have been flustered but whom I imagined would find a brilliant solution.

It was 2010, and I was an intern in an East London hospital, where a significant minority of doctors was not white. But I felt too much shame. Interns weren't supposed to complain. And there wasn't enough time. It was a busy evening, with too few doctors and a steady stream of patients who needed to be clerked. I had troponin levels to check and lines to replace, and Mrs Smith, an older white woman admitted with worsening chronic obstructive pulmonary disease, needed her arterial blood gas tested.

Besides, this had happened before. Not a blatant request for a white doctor, but sly digs at my competence on the basis of my name, the color of my skin, or my dresses. "Speak slowly," one older patient had said as I pushed back the curtains. "I don't understand you people."

Then there were the racist and sexist insults cloaked in so-called compliments. "You're too pretty to be a doctor. Get me someone who went to went to medical school, not beauty school." Or, "Your English is wonderful, dear. How long did it take you to learn to speak like that?" And, "You are a clever girl, aren't you? In which country did you go to medical school?"

I had graduated from medical school at the University of Cambridge 9 months before I met Mrs Smith. It was at Cambridge that a Sri Lankan doctor with a six-syllable last name taught me how to slowly angle a fine-gauge needle through the delicate skin of a patient's inner wrist to draw arterial blood.

Instead of thrusting the more commonly used and wider 23-gauge needle, I could take an arterial blood gas measurement while eliciting the slightest of winces from my patients.

But Mrs Smith wanted a white doctor, and a man. And I simply replied, "OK," before exiting the room. There were no guidelines on how to deal with racist, sexist patients. It had never been covered in medical school or during intern orientation. I knew where the crash carts lived on each ward; I knew how to call hospital security. No one had told me what to do if my help was refused because I was brown and a woman.

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