Barriers in healthcare: providers should be as diverse as their patients
This article originally appeared on OpenCanada.org on September 29, 2017 as part of a larger series with 6 Degrees Citizen Space 2017 speakers entitled Walls that need to go: Ideas for a more inclusive world. See full post here.
Representation in medicine should be differentiated from the idea of cultural competency; a necessary component of healthcare systems that encourages an understanding of individual patients’ cultures and needs in order to provide appropriate care. Cultural competency is predicated on the idea that our patients are not homogenous bodies that simply face pathology — a purely biological breakdown — but rather whole persons that interact with their environments and carry history, personality, and struggles.
While cultural competency has greatly advanced the cause of health equity, it doesn’t have the scope to imagine a healthcare system where physicians of all backgrounds — socioeconomic, ethnic, racial, gender and sexuality — are shaping healthcare agendas. As a concept, it relies on the assumption that there is a minority population of patients that has to be catered to, without recognizing the possibility that some physicians may identify as minorities or marginalized themselves.
To be a physician is to exist in a position of power and privilege. One is given access to individuals’ lives and bodies in some of the most vulnerable and intimate ways, and thus is given the potential of also inflicting harm. On an institutional level, when the healthcare system is dominated by a particular perspective, blind spots appear and the potential to do harm is magnified.
However, for marginalized voices to become more apparent, they first need to gain access to the field. Within the past year, the conversation around medical school admissions in Canada have started to shed light on the fact that most medical students come from relatively high-income households and have limited ethnic and racial diversity. The challenge of applying to and entering medical school is rigorous and for some populations it may be well nigh impossible. However, it is these individuals, ones who can empathize, identify with and share the struggles of their patients, that need to be in medicine the most.
The implications for representation in medicine for our communities are far-reaching. When marginalized populations see themselves and their needs reflected in the healthcare system, their experiences in accessing care are enhanced and their outcomes are better. As more diverse voices participate in political discourse, the conversation begins to shift and expand to include a greater range of lived experiences and priorities. Once individuals are given the opportunity to seek health and well-being through safe and appropriate care, the vision of a thriving and inclusive community where all are able to actively participate in the life of society may become a reality.
Sara Alavian is a 6 Degrees Junior Fellow. She is a recent settler to Canada and is passionate about the intersection of politics and health. She is a member of the Baha’i Faith, a contributing writer to online journal platforms and a burgeoning advocate for increasing diversity in health professions through mentorship. Sara is currently a medical student at McMaster University, with an interest in community and emergency medicine.