Opportunities and challenges in discussing racism during primary care visits

Borowsky, Hannah M; Willis, Aubrey; Bullock, Justin L; Fuentes-Afflick, Elena; Palmer, Nynikka R.

doi:10.1111/1475-6773.14118

Cited by 3 publications

(1 citation statement)

References 51 publications

(73 reference statements)

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“…3,4 Race and racism are concepts that are completely appropriate in the clinical setting, even when such conversations feel awkward. 5 As the only Black man in my residency program and someone who has been confused for the cleaning staff on many occasions, I think it's important to continue to shed light on the need for diversity in medicine. This applies not only to Black people, but to a myriad of other underrepresented groups.…”

Section: The Color Of Medicinementioning

confidence: 99%

The Color of Medicine

Ukadike

2024

Ann Fam Med

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my family medicine residency training, I was the junior doctor on the wards team when we encountered a young Black man who was hesitant to begin a new medication. I was also the only Black person on the team. After some initial trepidation about speaking up, I discussed my experiences with the patient and his mother and helped them see that the medication was not something to be feared. Later I faced criticism from a senior team member for bringing up the topic of race. Race is in fact an important consideration when treating patients. Understanding patients' lived experiences, especially when it comes to race, is essential in providing equitable health care.

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Section: The Color Of Medicinementioning

confidence: 99%

The Color of Medicine

Ukadike

2024

Ann Fam Med

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Opportunities and challenges in discussing racism during primary care visits

Borowsky

Willis

Bullock

et al. 2022

Health Services Research

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Objective To understand how patients and primary care practitioners (PCPs) discuss racism and their perspectives on having these conversations during primary care visits. Data Sources/Study Setting We conducted semi‐structured interviews from September 2020–March 2021 at a Federally Qualified Health Center in the San Francisco Bay Area. Study Design We conducted an inductive qualitative descriptive pilot study using one‐on‐one, semi‐structured interviews with 5 members of a Patient Advisory Council and 10 internal medicine PCPs. Data Collection/Extraction Methods Interviews were conducted via video conferencing, recorded, and transcribed. An iterative analytic process was used to thematically assess participants' experiences and perspectives and identify key themes. Principal Findings Patients and PCPs identified benefits from engaging in conversations about racism during primary care visits and noted challenges and concerns. Patients and PCPs highlighted strategies to advance communication about racism in primary care. Conclusions Initiating conversations about racism with patients in primary care can be meaningful, but also has risks. More research is needed for deeper exploration of patients' perspectives and development of trainings. Improving how PCPs communicate with patients about racism represents an opportunity to advance antiracism in medicine and improve health outcomes for individuals who have historically been poorly served by our health care system.

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Guidance on Conversations About Race and Racism in Pediatric Clinical Settings

Clark,

Cohen,

Welch

et al. 2024

Pediatrics

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OBJECTIVE To develop guidance for pediatric clinicians on how to discuss race and racism in pediatric clinical settings. METHODS We conducted a modified Delphi study from 2021 to 2022 with a panel of pediatric clinicians, psychologists, parents, and adolescents with expertise in racism and child health through scholarship or lived experience. Panelists responded to an initial survey with open-ended questions about how to talk to youth about race and racism. We coded the responses using qualitative methods and presented them back to the panelists. In iterative surveys, panelists reached a consensus on which themes were most important for the conversation. RESULTS A total of 29 of 33 panelists completed the surveys and a consensus was reached about the concepts pediatric clinicians should consider before, during, and after conversations about race and racism and impediments clinicians may face while having these discussions. Panelists agreed that it was within the pediatric clinician’s role to have these conversations. An overarching theme was the importance of having background knowledge about the systemic nature of racism. Panelists agreed that being active listeners, learning from patients, and addressing intersectionality were important for pediatric clinicians during conversations. Panelists also agreed that short- and long-term benefits may result from these conversations; however, harm could be done if pediatric clinicians do not have adequate training to conduct the conversations. CONCLUSIONS These principles can help guide conversations about race and racism in the pediatric clinical setting, equipping clinicians with tools to offer care that acknowledges and addresses the racism many of their patients face.

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Opportunities and challenges in discussing racism during primary care visits

Cited by 3 publications

References 51 publications

The Color of Medicine

The Color of Medicine

Opportunities and challenges in discussing racism during primary care visits

Guidance on Conversations About Race and Racism in Pediatric Clinical Settings

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