A summary cannot really do Dr. Washington's work and words justice. I highly recommend you watch the Grand Rounds if you did not attend live, but nevertheless, here are some highlights. . .
Racism is not merely one individual's negative thoughts about another person of a different race. Racism is more layered and complex. It includes:
- internalized: the devaluing of one's own identity and culture according to societal norms
- interpersonal: the way in which we perpetuate racism on an individual basis
- institutionalized: the way in which institutions perpetuate racism
- structural: system of public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways, to perpetuate racial group inequity
Dr. Washington highlighted the legacy of inequity for African Americans in the US dating back 401 years (see image)
Dr. Washington reminded us that:
- There is racial bias built into almost every aspect of healthcare.
- Significant health disparities exist for people of color in chronic disease (diabetes, cancer, heart and kidney disease), infant and maternal mortality, stroke, addiction and mental illness.
- People of color receive fewer/less breast cancer screenings, kidney transplants, vaccinations, eye exams cardiac care, cancer pain meds, revascularization procedures, and mental health treatment.
In order to not be part of the problem, health care providers have a responsibility to be ANTI-racist: the active process of identifying and eliminating racism by changing systems, organizational structures, policies and practices, and attitudes so that power is redistributed and shared equitably.
What is allyship?
Allyship is a person of one identity group standing in support of another identity group
- allyship is not a noun, it's an action
- allyship is about listening
- allyship is not a proclaimed identity--> trust is earned
- allies don't take breaks
- allies educate themselves (and don't expect marginalized people should teach you)
- allies don't need the spotlight
- allies focus on those who share their identity
- when criticized or called out, allies listen, apologize, act accountable, and act differently going forward
What is an accomplice?
"While an ally will mostly engage in activism by standing with an individual in a marginalized community. An accomplice will focus on dismantling the structures that oppress that individual or group-- and such work will be directed by the stakeholders in the marginalized group" (Teaching Tolerance)
- accomplices assess an organization for inequities in hiring, promotion, pay, evaluation, termination, etc
- accomplices encourage major institutions benefiting from inequities to invest in marginalized communities
- accomplices engage in anti-racist assessment of laws, policies, institutions, and systems
- accomplices divest institutions from (private) prisons, detention centers, and institutions engaged in systems harmful to BIPOC
- accomplices promote self care for BIPOC
- accomplices create systems of accountability for supporting hate speech and behavior
Examples of what allies and accomplices can do in medicine:
- Petition the laboratory you use to stop reporting GFR differentiated by race
- Hold a fellow physician accountable if they send a racist email or make a racist comment
- Interrupt micro-aggressions when they are happening
- Don't vote to appoint someone to the board unless they divest from investments that perpetuate racist structures
- Pass the microphone to the marginalized person next to you whose voice is not often heard
Questions to ask yourself:
- In what ways can you be an ally?
- In what ways can you be an accomplice?
- In which institutions do you have agency to create structural change?
- What is holding you back from taking action?
- What commitment can you make to move you toward meaningful action?
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