Provider, Heal Thy System: An Examination of Institutionally Racist Healthcare Regulatory Practices and Structures

Abstract

U.S. history is fraught with examples of systemic racism-at all ecological levels and within all geopolitical contexts. Whether scholars historically punctuate these phenomena through white racial framing begun in the 1600s or the Black civil rights movement of the 1960s, research across disciplines brings into focus a twenty-generation story of injustice. These phenomena present a paradoxical struggle within healthcare systems populated by professionals who have made a "conscious commitment to equity and helping those in need." However, both healthcare systems and embedded care providers operate in relation to organizational structures that frequently reify racist policies. As natural and professional agents of change, medical family therapists are especially positioned to examine how regulatory systems at every level influence institutional racism within the medical and mental health fields. In this manuscript we examine health system policies and practices using the lens of C.J. Peek's Four Worlds: Clinical, Operational, Financial, and Training. Examples of institutional racism are discussed and recommendations for approaches to change are provided.Keywords Healthcare • Institutional racism • Medical family therapy • Healthcare policy "...Marriage and family therapists are defined by an enduring dedication to professional and ethical excellence, as well as the commitment to service, advocacy, and public participation. The areas of service, advocacy, and public participation are recognized as responsibilities to the profession equal in importance to all other aspects…" (American Association for Marriage and Family Therapy [AAMFT], 2015).

The School of Nursing has a problem with diversity, equity and inclusion. Can curriculum revision address it? An educational case study

“…[12] An examination of the curriculum for inequity and bias is not just the right thing to do, it is becoming a necessary task. Although historically perpetuators of systemic racism, [13] many agencies that accredit institutions of higher education have begun to recognize that inequity is part of education, and expect that is addressed in the accreditation process. Organizations that set standards for education of professional students, such as those going into the healthcare field, are also demanding that attention is given to racial injustice in the curriculum.…”