Organization regulating medical care in Manitoba apologizes for Indigenous-specific racism in health care

The organization regulating medical care and services in Manitoba is apologizing for racism directed towards Indigenous people when accessing health care in the province.

"The College of Physicians and Surgeons of Manitoba recognizes its failure to effectively regulate the medical profession to prevent racist and substandard medical care to Indigenous peoples," said the organization’s statement and apology on truth and reconciliation and Indigenous-specific racism in medical practice.

Manitoba First Nation leadership were presented the apology on Tuesday during the Assembly of Manitoba Chiefs (AMC) annual general assembly.

"I was shocked and I was surprised," said AMC Grand Chief Cathy Merrick on Wednesday.

Merrick said the apology was welcome, though not fully accepted, given the mistreatment suffered by Indigenous people in Manitoba by the health-care system.

"I don't think we're there at this point in time," Merrick said.

"I think that we need to be able to work together and educate people."

A major part of that education will begin with dismantling racist assumptions about Indigenous patients.

Chief Sheldon Kent, chairperson for the First Nations Health and Social Secretariat of Manitoba, said racism is something Manitoba First Nation members can experience as soon as they walk into a hospital or clinic. He added that oftentimes this results in people assuming Indigenous patients have alcohol or substance-related issues and not being afforded compassion during the intake process.

"Any individual, when you walk into any facility (should) be greeted with "How can I help you?'" Kent said. "Make them feel welcome and ask, 'What's the problem?’ It's basic human rights service.”

In its joint apology and statement, the College of Physicians and Surgeons of Manitoba (CPSM) notes historical instances of mistreatment of First Nations people at the hands of the health-care system, like segregated hospitals or unethical nutrition experiments conducted on Indigenous children.

Current examples of Indigenous-specific racism, like not recognizing the benefit of integrating Indigenous health-care practices in tandem with Western practices and outright derogatory comments, are also included in the statement, along with next steps forward, including a standard of practice to prevent Indigenous racism.

Physicians who do not comply with the new framework of conduct will be reprimanded.

"There are always those from whom a carrot is not a good thing, they need a stick," said Dr. Anna Ziomek, registrar with the college. "We will have a standard that will call out these things and you will be put through a disciplinary process."

Ziomek added that education will play a pivotal role in the CPSM's ongoing efforts to dismantle systemic racism in the Manitoba health-care system.

VERY REAL CONSEQUENCES FROM RACISM

Racism in Manitoba's health-care system has very real consequences for Indigenous people in the province.

According to a 2019 study, First Nations people in Manitoba are more likely to die a premature death compared to the average Manitoban. On average, the life expectancy for a First Nation man or woman in Manitoba is eleven years shorter than the average Manitoban.

That's despite First Nations people spending more than double the time in hospital compared to most Manitobans.

"I have no doubt that a lot of the poorer health outcomes are indirectly and potentially even directly related to racism," said Dr. Alan Katz, lead author on the study.

Katz said this can manifest in a number of ways. For example, he said there are specific clinics and emergency rooms in Manitoba that First Nation people will not go to because of mistreatment, which can lead to delayed medical care.

There are also differences in procedures, Katz added, like not completing certain tests when an Indigenous person suffers a heart attack.

"It goes from differences in investigations of symptoms to differences in treatments to differences in access to care because of respect and dignity," he said.

Waiting longer for an angiogram, inadequate pain control, and delayed referrals to a diabetes specialists are other ways racism can manifest in Manitoba's health-care system, said Dr. Marcia Anderson, vice-dean for Indigenous health, social justice and anti-racism at the University of Manitoba's Rady Faculty of Health Sciences.

"Because of past negative experiences, people avoid the health-care system when they do need health care, which can lead to delayed diagnoses in certain conditions," said Anderson said. "So there are significant impacts of racism on health care."

Medical professionals can also experience racism, added Anderson.

"When we think about the current health-care worker crisis. Then there are lots of reasons to address racism in the health-care system,” said Anderson, alluding to a shortage of health-care workers in Manitoba.