June 26, 2020
A patient walks into the clinic with knee pain, the physical therapist responds:
“Are you sure that you have knee pain? Have you thought about the other people that are in pain? I don’t think this is important.”
How did the PT perform? Clearly, the PT performed poorly. Dismissing a patient’s identified problem the second they walk into the clinic is not the sign of a good clinician. We all have learned about providing “patient-centered care.” Guaranteed, the majority of us mentioned this in our application essays to PT school. Is it possible to provide patient centered-care while ignoring the needs and concerns of our patients? The answer is no.
A patient’s needs and concerns are not limited to body-structure and function. As students our goal is to learn about the situations we may encounter as we enter the clinic so that, when we graduate, we are as ready as possible to provide our patients with the best care. We will enter with biases that can negatively impact patients – whether we are aware of these biases or not. This is what forms the foundation of health-care disparities; the biggest barrier to providing quality patient-centered care.
At the end of the day we treat people, not injuries. It is our responsibility to make the healthcare system better than it is now. This is a call to arms to healthcare students: listen, learn, and advocate. Now is the time to dissect your own privilege and biases so that you do not bring these biases into the clinic. It is not an easy task, and is something we must continually work toward—personally, professionally, and collectively. To actively fight racism, homophobia, and the negative stigmas that contribute to healthcare disparities from the get-go is to build and be a part of a better healthcare system for all.
If you have read this far and are thinking, “I am not biased,” I encourage you to reflect deeper than that. Because all of us are. As a twenty-five-year-old female, who has been a member of the LGTBQ+ community for seven years, I still have biases that will prevent me from treating this community with quality care. As it is Pride Month, I’m here to talk through some of that with you. In support of the black lives matter movement it is imperative that we acknowledge the essential and elemental part that black people played, and still play, in the LGBTQ+ community.
Marsha P. Johnson was a trans activist who was at the forefront of the Stonewall riots that sparked the begining of the gay rights movement in America. For those of you who don’t know about Stonewall or the riots, I encourage you to read more on it—you will learn about a mafia-owned bar that payed off the cops, so that the bar would serve as a safe haven for the LGBTQ+ community (although, admittedly, it was not always safe, and the intent of the mafia was to profit off of people who had nowhere else to go). Despite her activism for LGBTQ+ rights, Marsha was brutally discriminated against by most of the LGBTQ+ community of the time: those fortunate enough to be out and feel, relatively, safe during that time period (primarily white, cis men). Marsha P. Johnson paved the way for LGBTQ+ rights during a time when it was incredibly dangerous to do so. Privilege check: as a native New Yorker I have gone to Stonewall easily five times and, until recently, knew nothing about its history. I have come to realize that I really know nothing about the LGBTQ+ community that I consider myself a part of. How can I expect to treat a population that I know nothing about, even if I am a part of it?
For seven years I have hidden behind the privilege of being able to mask my sexual identity whenever I want. In doing so, I neglected to fully recognize the ways that LGBTQ+ people are marginalized. I realize now that, because of this, I have risked my ability to provide effective care to my patients. I must also recognize that, as a white woman, I will never know or understand the discrimination faced on a systemic and personal level by BIPOC. The healthcare system we are all a part of has, and continues to, reinforce systemic racism—with, far too often, fatal consequences. Without first understanding my own privilege and without also imploring us all to educate ourselves, I cannot say I am being actively anti-racist. If I do not take the time to understand discrimination, there is no way for me to fight healthcare disparities as a PT.
We all need to listen and seek opportunities to be actively anti-racist, actively anti-homophobic, and actively inclusive of marginalized communities. If we do not listen, we will never hear. If we do not hear, we will never be able to understand. If we do not try to understand, there is no way we can provide quality care. We need to learn about the history and lived and told experiences of our patients. It is our duty, as healthcare providers, to listen when people say that they do not feel that they are being heard. Listening is step one, learning is step two, and action is step three.
-Ashley Drozd, Class of 2022