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Allowing patients to choose the ethnicity of attending doctors is institutional racism

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g265 (Published 04 February 2014) Cite this as: BMJ 2014;348:g265

Rapid Response:

Re: Allowing patients to choose the ethnicity of attending doctors is institutional racism

This is an interesting article, and set of responses. We were particularly intrigued by Sam Lewis' nuanced response.

One of us has experience of people not wanting to be seen by a German. Having worked with older people, some of whom came to the UK as refugees from Germany in the 30s and 40s, this is not surprising.

Our experience overall, however, is that the number of patients who demand not to be seen by professionals of particular racial or ethnic backgrounds because it is genuinely "triggering" for them is extremely small. Most people - perhaps particularly those who have suffered serious racism themselves - have a nuanced view of their persecutors and are happy to be seen by German professionals, despite their earlier experiences.

Part of the problem, and the risk of acceding to such requests, is that the organisational culture unwittingly becomes supportive to racist attitudes within it, and the ethnic minority professionals then become perceived as the problem, resulting in discrimination against them.

While it may be true that there are a small minority of patients for whom it may be reasonable to make adjustments, as Sam Lewis suggests, we would suggest that their number is extremely small: plain, old-fashioned racism is far commoner. The overwhelming majority of such requests should be rebuffed; and colleagues and NHS organisations should all provide clear support and leadership on this.

Competing interests: One of us (DB-E) is German

09 February 2014
Dorothee B Bechinger-English
Lecturer in Health and Social Care/PhD Student
Peter M English
Open University/University of Winchester
Ewell