Cree-Anishinaabe doctor 'optimistic' about plan to combat anti-Indigenous racism

From the emergency room to the doctor's office — First Nations, Métis and Inuit patients in this country experience second-class healthcare, far too often.

On Thursday, Canada's medical schools announced a list of steps to help bridge those gaps.

The Association of Faculties of Medicine of Canada made 10 pledges, including developing new policies to identify and address anti-Indigenous racism, and a promise to admit a school-specific minimum number of Indigenous students each year.

Marcia Anderson is a Cree-Anishinaabe doctor and the chair of the Association's Indigenous Health Network.

Dr. Anderson spoke to As It Happens host Carol Off about her own experiences with racism in the health system and why she is optimistic about the initiative.

Here is part of their conversation.

Dr. Anderson, what does it mean that Canada's 17 medical schools have made this commitment to Indigenous health?

Well, it is incredibly significant. These 10 action statements were developed by a group of leading Indigenous medical educators from across the country and are a robust framework that will well position the medical schools to contribute to closing the gaps in Indigenous health in this country.

When you talk about the gaps, before we get into what exactly is being accepted, I also want to ask you about how Indigenous people are, in general, treated in the health care system in Canada. I think you have an example of what happened to your own father at one point.

So probably most people would have heard stories of experiences of racism, which can be things from blatant or overt racism, to misdiagnosis — like people who are confused for being intoxicated when they're actually having strokes.

Most people would be familiar with the case of Brian Sinclair.

In my own family, when I was a second-year medical resident, my dad had a heart attack and he was 49 at the time.

He's a visibly First Nations man and he actually drove himself to the emergency room and had a cardiac arrest. He was resuscitated. When I got there he was not sedated even though he was critically ill.

And when I asked the emergency room physician why he wasn't sedated, the emergency room physician looked at me and said, "We didn't know what he was on."

My dad doesn't drink.

In fact, he was having a massive heart attack that was not being actively or quickly managed because of this stereotyped and racist assumption.

It's very hard for us to deal with all of the stress that other medical students deal with and respond to, or recover from, these types of traumas.

What were your own experiences with racism as a medical student?

I would say there were daily, or almost daily, examples of what one might call racial micro-aggressions.

There was overt racism — like being told I didn't belong here, or I wasn't qualified, or I got in the easy way.

At one point, when I was a medical student on my obstetrics rotation, a senior obstetrics resident said that the best thing for Canada would be if Native people stopped reproducing.

When I moved to Saskatoon to complete my residency I was asked if I had to jump out of the gang The Indian Posse in order to move there, by an attending physician.

So it was repeated and regular and serious.

What effect did that have on you to be hit with that every day? 

So when I was more junior, it definitely felt like I had to just put my head down and take it.

As I progressed through my training, had more supports of other Indigenous students or physicians around me, then I would start to stick up for myself more. I would not tolerate that. I would complain and require behaviours to be addressed.

But that comes at a risk. You risk being known as a troublemaker. It's difficult to go through those processes. It adds on a lot of extra stress and sleepless nights on top of your already busy call and study scheduling.

The racism you're describing is really deep though, isn't it? These are very deep prejudices. So how does this Joint Committee to Action on Indigenous Health — what is it actually going to do to address that racism?

So in the early years of medical school, a lot of the racism that students experience is from their classmates. And so one of the commitments to action is to actually assess some baseline knowledge of anti-racism, or Indigenous studies, or cultural safety, or related concepts for every student who applies to medical school.

We talk about robust faculty development so that our faculty members and attending physicians are clear on what is expected from them in creating a safe learning environment for Indigenous learners.

So when you look at the entire suite of recommendations it really will shift the presence of Indigenous people, out of faculty and throughout positions of power within the schools of medicine, to influence right from the top through to the learners and recruiting an increased number of First Nations, Métis and Inuit learners.

You've described the kind of prejudice that you and your family has encountered, you sound optimistic though. Do you feel that this is really going to make a difference?

I feel like we are in the middle of a generational shift. Where we are today is reaching critical masses of Indigenous physicians, academics, other health professionals who are working with us.

We've worked hard on building relationships with our non-Indigenous allies and we know more than we ever have before.

We have been strategic in understanding how to leverage other movements that bring in accountability measures to increase the quality of healthcare. 

So yeah, I am optimistic and I am looking forward to the next 25 years or so of my career to continue contributing to this.

Written by Morgan Passi and John McGill. Q&A edited for length and clarity.