Is there a difference between an “ism” and an accommodation?

I was watching Global News in Canada June 20,  when a segment appeared: A white woman yelling for a Canadian Doctor while waiting in clinic with her sick child.She lives in an area that is multi-ethnic. “More than half of Mississauga’s 700,000 residents are ethnic minorities, according to the Canadian Census, and more than 20 percent hail from South Asia.” I found this statistic in the Washington Post which picked up the story. I heard part of the conversation: among other requests, she wanted someone who was white and could speak English.


But it was the expert whom Global called upon to speak about this incident that caught my attention. Her name is Dr. Cheryl Teelucksingh a sociology professor at  Ryerson.  Her response was that this is racism. It seems to be the response from many.You can watch the interview at 27 minutes.

And that got my “ooh factor” up and running; questioning definitions. I want to make this clear. I am not responding to the white woman’s actions as much as I am to the expert. It was her response that triggered my questions.

When I was a resident studying to be a Chaplain, our Baptist supervisor told us many times to listen to that little something in the back of your mind that tingles because something just does not make sense. He called it listening to the “ooh factor.” He would tell us that we had to tease it out. Question it. So here is my question.

What is the difference between an “ism” and an accommodation? Or is it a double standard?

As a hospital trained multi-faith endorsed Chaplain I am deemed capable of helping people of all religions and no religions at all. Yet, we were told when called to a patient who was Catholic that we were to offer to call the Priest on call. And we were all told that only Jewish Chaplains were to attend to Jewish patients-mostly because past experience had shown that non-Jews would try to convert the patient.

Is this an “ism” or an accommodation? Or a double standard?

We assume that all doctors in our hospitals are competent to care for all people, no matter where they took their medical degree because they had to pass our exams.

Yet, women who are raped have the right to ask for a female doctor and nurse according to Erin G. Clifton, MA, Department of Psychological Sciences, Case Western Reserve University and Norah C. Feeny, PhD, Case Western Reserve University

I assume that male victims have the right to male attendants.

Is that an “ism” or an accommodation?

Should all female patients have the right to request a female doctor?

“Does it happen that a patient or a client or person would ask for a preference of provider type?” said Dr. Nicole Nitti, medical director of the Access Alliance clinic in Toronto. “It happens all the time.” There are doctors who say that “accommodating such a preference when it is based on a new immigrant’s deeply rooted cultural background can actually lead to better health care.” The  Society of Obstetricians and Gynecologists CEO, Jennifer Blake, said the organization does respect that many people feel more comfortable with a doctor of the same culture, language or gender – “when that can be achieved.”.

Dr. Aasim I. Padela, an emergency room physician at the University of Michigan and a Muslim who devotes most of his time to research on Islamic medical ethics has written a paper regarding the need to respect religious/cultural requests of Muslims, particularly women.

Quoting from the New York Times article “I don’t want to be misconstrued — I’m not advocating for separate but equal facilities” of the type that exist in hospitals in Muslim countries. Sometimes it’s a simple matter of asking a patient, “Is there some way I can make you more comfortable?”

He wrote “As physicians encounter an increasingly diverse patient population, socioeconomic circumstances, religious values and cultural practices may present barriers to the delivery of quality care. Increasing cultural competence is often cited as a way to reduce healthcare disparities arising from value and cultural differences between patients and providers. Cultural competence entails not only a knowledge base of cultural practices of disparate patient populations, but also an attitude of adapting one’s practice style to meet patient needs and values.”

And as stated in the article written by RONI CARYN RABIN  “many health care centers have already taken steps to accommodate Muslim patients.”

According to Dr. Padela, the health care system may not always be able to fulfill all of a patient’s requests, but the providers should at least explain what can reasonably be done and what the limits are. “This way the patient feels heard, and cared about,” as opposed to, “You’re in my hospital, this is how we do things.”

Not all doctors agree with is approach.

But are these examples of an “ism” or an accommodation? Or a double standard?

I have a mental illness. There are times I require a psychiatrist. I have been fortunate over the past twenty years to have received excellent care from men and women of different races, religions and colours. The common factor amongst these physicians is the ideology in which they were raised-western values. There is a unique relationship between a psychiatrist and a patient, and a psychotherapist and a patient. We are sharing our deepest fear and anxieties. Do we have the right to request care from someone who is familiar with our culture or are we to accept whatever healthcare provider comes up in the queue? In Ontario, today, it can take 12 to 15 months for an appointment.

In Ontario a doctor can refuse to treat a patient.

An effective physician-patient relationship is essential for the provision of quality medical care, and it forms the foundation of the practice of medicine. It is also a partnership which benefits from the mutual trust and respect of both the physician and the patient. While this relationship is of central importance to the practice of medicine, circumstances may sometimes arise which lead either the physician or the patient to end the physician-patient relationship.

Can a patient refuse a doctor and request another?

Would that request be an “ism” or an accommodation?

Which brings me back to the white woman. Let me repeat, I did not base my questions on the behaviour of the woman. Rather, the questions are the result of the conclusion of “racism” as espoused by the chosen expert, Dr. Cheryl Teelucksingh, by Global News.

If this white mother feels more comfortable with someone of her own culture, should she not have the same rights afforded to her and her child as we are affording to the diverse members of our society? And why is “white” not part of that diversity?

I don’t have an answer.