North Shore Hospital patients plea to avoid Asian staff: We can’t stand racial intolerance in our healthcare system – Dr Nina Su

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As healthcare workers, we are increasingly encouraged to practice patient-centered care: a compassionate approach where we treat each person as an individual with their own needs and abilities, and do our best to accommodate their unique preferences. attention However, this raises an important question: What are the limitations of this care?

In the case of the Pākehā North Shore patient who refused to have Asian staff involved in his surgical care, I was surprised that this request was met.

At a time when we collectively reject racism, consider ourselves wiser than our backward ancestors, and try to integrate cultural safety, how could hospital management fail to respond appropriately to overt racism?

I was born in New Zealand to working-class Chinese immigrant parents and grew up in Warkworth, studied hard and became a pediatric emergency physician. On any given day, up to half of my nursing and physician colleagues are of Asian descent.

It would be ridiculous for any of our patients to refuse to be seen by an Asian staff member. We are highly qualified, speak perfect English and have lived and trained in New Zealand for years.

Growing up in a small Pākehā-dominated town, I was often reminded by strangers and classmates by the color of my skin and especially the shape of my eyes.

However, when I reached adulthood and moved to the city, I felt that things were getting better. In the 2010s I began to feel that my culture, my existence, my history were accepted.

I noticed that people were no longer shouting racial slurs at me from a car or telling me to “go home”. We were becoming a country of more and more tolerance and appreciation of difference. However, I now worry that recent efforts to expand tolerance and dispel racism are having the opposite effect.

meIn my medical training, I have attended several cultural safety workshops and implicit bias training, part of a movement commonly known as DEI (Diversity, Equity and Inclusion).

These have varied in quality and points of emphasis. The courses I found most helpful included the basic tīkanga training, which emphasized that everyone has an implicit bias.

They showed us that bias peaks when we’re stressed and overworked running on autopilot. Most importantly, they taught awareness skills to remember that the person in front of us is an individual, unique because of the demographic group to which they may belong.

Contrast this with many other workshops where facilitators seemed intent on making attendees feel guilty about “white privilege” or “white fragility” and heavily emphasized ideas of anti-racism and decolonization.

It is worth noting here that I believe it is important to critically examine the negative consequences of colonization and its downstream effects on the health and socioeconomic outcomes of Indigenous peoples.

The evidence of poorer health outcomes for Māori and Pasifika is blindingly obvious; I see it daily at my job. My concern, however, is that by labeling all health disparities as the result of systemic racism we risk increasing racism and ignoring the larger problem of intergenerational poverty.

I wonder if the DEI framework actually achieves more diversity, equity and inclusion.

Most research on DEI initiatives relies on the power of the Implicit Association Test (IAT) to uncover implicit bias and show that diversity training lowers people’s test scores. The problem is that taking a point IAT has never been shown to actually translate into an individual’s actual behavior toward others.

Even worse is that your IAT score varies significantly depending on the time of day, how tired you are, or just random variation. I have yet to find research that actually measures changes in workplace culture and performance after DEI training.

More worryingly, there is evidence to suggest that compulsory education can increase discrimination when people are made to feel shame or guilt about their own immutable, often ‘white’, characteristics.

So the question arises: Can we justify spending hundreds of thousands of taxpayer dollars on these courses for all of our public servants if there is no known benefit and in some cases harm?

In a public service like Te Whatu Ora-Health New Zealand, managers are more likely to receive mandatory diversity, equity and inclusion training. So why, when an example of manual racism was given, did management respond by perpetuating it on their own employees?

At best, these management decisions were made out of compassion for the patient and protectionism over our Asian staff. But that is not compassion. This is patronizing, condescending and, at worst, a violation of basic human rights by an employer that prohibits the ability of its employees to do their jobs simply because of race. Even more troubling are allegations that people were prevented from speaking out.

This sets a dangerous precedent.

Perhaps most enlightening was the response from NZ’s most acclaimed social justice experts. Despite the growing reports of hate crimes and violence towards the Asian population, the silence has been deafening from our staunchest advocates of the DEI social justice framework.

We must remember our core values. Our compassion must not extend to racism and we cannot tolerate intolerance.

* This opinion is my own and does not reflect Te Whatu Ora-Health New Zealand.