"Can’t I get an American doctor?"

I worked as the chief of primary care for a federal agency for several years. I saw patients myself, and was in charge of approving reassignments from one physician to another when one of our patients was not happy with their assigned physician. I am a middle-aged white female. The majority of our patients were elderly white men. Most of our other primary care physicians were female, minority or foreign-born. When I started out, I was sensitive and idealistic and tried to “prove myself” to the (few) bigoted insensitive curmudgeons among our patients. That never worked. What worked was professional behavior and direct confrontation. I pointed out that they could see the blond, blue-eyed white male phycician of their choice anytime they wanted to go to the private sector and pay for the privilege of indulging their prejudices. If they wanted to use their Federal government benefits, then they could not complain about not being able to act out on their prejudices in our clinic. I would provide the phone number of our local Congressman’s office and my card so they could complain further and spell my name right. I stumbled upon this method in a frustrated moment of desperation. The individual I confronted was taken aback – and became one of my favorite patients. A lot of people who bully others about this stuff just need to be called on it, and they respect you more if you do.

I think the original article missed the point. Patient care comes first. If you are the only guy on the spot and must confront the patients prejudice to get them to accept your care, then that is the route to take. If the quickest surest path to getting the patient taken care of it to accomadate the patients request–then that is the ethical course of action.

It is no more our place to try to reform our patients social attitudes than it is to convert them to our religion.

The doctors personal feelings are a personal issue for them to handle.

I think in fact the letter borders on paranoid hysteria. This is not a new problem just invented for Middle Eastern immigrant docs. 25 years ago we dealt with it in our clinic with gender and race in other contexts. Some of the elderly black patients as well as white patients didn’t want the black residents. We handled it with a little discomfort for all. What about all the women who want a female OB. Is she to be made to hear a lecture by the rejected male OB about how his feelings are hurt? Are we to treat her like some atavistic freak? What about the hispanic patients who drift to the hispanic doctor in the clinic? The vietnamese doctor in our clinic who is asked for by most of the vietnamese patients?

So moving to a foreign country and trying to practice medicine there is hard. So what. How does it work out for foreigners where you came from? 100% acceptance from 100% of the population from day one?

Much ado about nothing.