Reflection

I AM: home.

So, as per my previous note, and egged on by a fellow student and bloggerer (whose musings I've just discovered, and have most enjoyed catching up with :) ), I thought it a good time to start with more interesting topics than my evenings in front of the telly.

One of the requirements for me to pass this year is that I had to submit a portfolio of reflective writing, organised into predetermined headings. The assignment is collectively regarded as a waste of time other than to get us thinking in the right vein for our job applications in a few months (or for some of us, now - eek). Apart from the constraints of the nine headings I had to write under, though, I have to sheepishly confess to having rather enjoyed it.

There are two things you need to know to make sense of this. First, I'm a little off the wall in medical student terms, in that i'm interested in a lot of the 'non-medical' aspects of medical practice. (I hope that makes sense, because I wrote it on a form the other day.) I like thinking about ethical issues, and professional interactions, and how little policy changes could improve clinical practice, and so on. Second, I'm a closet writer. I've been scribbling nonsense from quite a young age, and have several notebooks full of stuff that for the most part has only been seen by me. I think it's also why I've got into blogging.

So, with these in mind, here goes the first instalment (slightly modified from the original). It is long, but since it's not published elsewhere I'm afraid I can't just link to it. It's also cheesy, as a product of being a course assignment. Enjoy, comment, or ignore, as you wish. Also, Aussie readers are of course free to tell me I'm entirely wrong about it!

"Diversity and Equality"

During a placement in Adelaide, I was involved in the care of several patients of Aboriginal descent, and was shocked by attitudes towards them expressed by medical staff.

Over the course of a 12 week rotation, I encountered several doctors, predominantly senior staff, voicing assumptions about their patients that were based on negative, judgemental stereotypes, often before even meeting the patient. Common assumptions included predictions that patients would not take their prescribed medication after leaving hospital, that they would self-discharge as soon as their condition allowed, that they were likely to be heavy drinkers, and that they would generally be resistant to following medical advice.

Clearly, some of these assumptions are based on doctors' previous encounters with patients of Aboriginal origin. Also clearly, however, they were not true of all, or even most, Aboriginal patients. Flinders has a dedicated Aboriginal Liaison social work team, whose members are all at least partly of Aboriginal origin, and whose remit is to facilitate communication and understanding between Aboriginal patients and the medical teams looking after them in order to make hospital care as effective as possible. It is obvious that this service would not be provided unless there existed a significant difference between the experience of indigenous and non-indigenous patients. It is not clear to me, however, what proportion of this difference is due to the cultural background of the patients concerned and what proportion attributable to the attitudes of their doctors.

An important factor to bear in mind in this discussion is the cultural difference that exists between Australia and the UK. London has a culturally and racially diverse population, and as healthcare professionals here we are accustomed to treating all with respect and dignity, and to approaching each patient as an individual, with an awareness of potential cultural issues but an open mind. In particular, it is socially and professionally unacceptable to voice prejudice against people based on their race or ethnic origin. In contrast, the general population of Adelaide is predominantly Caucasian (with the exception of the student and doctor populations, which contain significant numbers of people of East and South Asian origin; the Aboriginal population of Australia make up only 10% of the total in the country), and comments, even jokes, regarding racial stereotypes are considered more acceptable than they are in the United Kingdom.

Despite my apprehension regarding the paternalistic attitudes displayed towards the indigenous population by doctors in Adelaide, I am reassured by two things. First, these views were never, in my hearing, conveyed to the patients concerned, and all were treated with respect. Second, I did not encounter negative attitudes among the younger generation of medical professionals. Hopefully, these factors will ensure that future patient care is not compromised by the existence and expression of negative stereotypes.