Racism can flip the power dynamics between physician and patient

In the usual physician-patient encounter, it's the doctor who has the power. But that can all change when the physician is at the receiving end of a racist rant from a patient, writes J. Nwando Olayiwola, M.D., in a reflection piece in the Annals of Family Medicine.

Olayiwola, a physician faculty member at the University of California, San Francisco, who practices at San Francisco General Hospital, describes her encounter with a patient with some mental health issues who did not want to be treated by a black woman doctor, going so far as to use the "N" word.

While she usually feels powerful when she puts on her white doctor's coat, Olayiwola says, with that nasty encounter she felt a shift in power that left her trying to prove herself and negotiating with the man over his treatment. It is her last patient of the morning, an older black woman, who reminds her of her strength, resilience and accomplishments, she writes.

"This is probably the hardest lesson for me to exert but the most obvious one--I deserve to be here. I am black, of African descent, a woman, someone with a long last name, and so much more, and my seat at the table has been earned not given. And no racist rant can ever take that away," she says.

When patients refuse care on the basis of a doctor's race or ethnic background, it raises ethical, legal and clinical quandaries, as FiercePracticeManagement previously reported. Olayiwola said she related her story in the hope it will strengthen other family physicians and professional minorities that are victims of racism, discrimination, and prejudice for their race, sex, ability, sexual orientation, religion and other means of discrimination. 

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