India is the most pluralistic society in the whole world. The language changes every 12 miles. No antagonism existed between various communities although India was a pluralistic society. Politicians and politicking have made it a divided society.
Ethnicity has a role to play in all aspects of life in India and clinical practice is no different. Patients select and reject their healthcare provider on the basis of his ethnicity. At times they want their healthcare provider to be of his same ethnic group and at times they specifically seek a health care provider of a different ethnicity .
Clinicians and even senior and learned clinicians also tend to brand their patients on the basis of their ethnicity.
I have had patients whose first question was” Doctor ,which language you speak?”as they sat on the dental chair.
I have a frame of Tirupati Balaji in my clinic. I remember a patient asking me “Doctor you look North Indian but the frame of Lord Tirupati Balaji is usually hanged by South Indians”. He was so perplexed.
I have had a receptionist who used to ask the patients about their ethnicity the first time they come. This used to cause embarrassment to patients. And I came to know about this very late.
Over a period of last 31 years there have been some interesting and some unpleasant experiences with patients regarding my ethnicity.
It is not possible to cover all of them in one blog.
In this first part I will outline the steps clinician needs to take to remain professional in his interactions with patients and ensure that no ethnic issues are raised in all interactions with patients. The patient, clinician and the staff are human beings first of all and of different ethnicity later. They must be treated with dignity and the clinician and the staff must expect patients to reciprocate.
If the patient is unable to do so or if the clinician feels that the patient is uncomfortable with clinicians ethnicity then it will affect the quality of healthcare provided then it is best to phase out such patients. Remember that ethic issues are raked up by inferior minds and such people are not worthy of your consideration.
Do to various reasons the rate of population shift is highest now in India and clinician may find that he is practicing in a locality in which the population of his ethnic group are less, nonexistent or in a majority. This may or may not work to his advantage.
So a few points:
1. First of all concentrate on improving your clinical skills. Everything else is secondary. Over the period of time you will find that patients from all ethnic groups will avail of your skills.
2. Develop good communication skills .This has been covered in detail in other blogs.
3. Develop a mastery over the local language. You must be able to speak the local language better then those of whom it is their mother tongue.
4. A no nonsense attitude is a must. There will always be patients who will try to rake in the ethnicity of the clinician in their interactions with the clinician. Clinician should ensure with courteous firmness that all interactions of himself and staff remain professional.
5. Phase out of few patients: – In spite of your best efforts there will always be patients who will rake up your ethnicity. This usually happens when clinician is from ethnic group who are traditionally businessmen and patient is from an ethnic group which are not. Such patients should be diplomatically phased out. An entry of the same be made for future reference in the patients records.
Clinicians must also ensure that their auxiliary staff do not rake up ethnic issues in their interactions with patients.
So to conclude ethnicity does not have a very important role to play in Indian life.
However a clinician should concentrate on improving their clinical, communication and managerial skills.
Very soon you will find that ethnicity is a non issue in your clinical practice.
