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by Steven Daveluy, MD
 Our country has come to a moment of ethical reckoning. As physicians, we are entrusted with the health of our patients, and we have a duty to advocate for the health of all patients. We cannot uphold that duty completely without investigating social justice and the impact of racism on social determinants of health (1). As I have started educating myself on the problem, the root causes and
the potential paths to improvement, the overwhelming majority of my physician colleagues are on a similar journey of learning and discovery. However, I have also encountered colleagues with other viewpoints on the issue. I am a non-confrontational person by nature. When I encounter a colleague with strong opinions in opposition to my own, I usually simply change the subject to avoid conflict. When the subject holds great importance, however, I make my case.
The impact of racism on healthcare outcomes is too important for any of us to avoid these awkward conversations. Governor Whitmer’s recent announcement that the State of Michigan will require physicians to complete training on implicit bias has sparked more conversation among physicians. It’s time for all of us to join the conversation. It won’t be easy. Discussions of racism are uncomfortable. Delivering bad news to a patient is also uncomfortable, but we must do it.
This article is a call to action to the members of the Wayne County Medical Society of Southeast Michigan. Prepare yourself to have uncomfortable conversations on racial disparities, and more importantly, make a commitment to overcome the discomfort. Engage colleagues whenever the opportunity arises. The following are some of my experiences and lessons learned. I hope they may help you in becoming a positive force for social justice in medicine.
The American Medical Association has created a Center for Health Equity (2). The site is updated frequently with validated information and resources, including videos. While gaining knowledge on the issues, collect the resources that you find informative and helpful. Share these resources with your colleagues to spread knowledge, and be prepared to provide these resources in support of your conversations. If you are struggling to understand why physicians are talking about these issues, then it’s vitally important that you seize this opportunity to learn.
I often start the conversation by sharing the fact that I’m no expert on the subject. I’m learning and working to improve my knowledge. I know that there are racial disparities in medicine, and I am seeking to understand them in order to take steps to eliminate them.
When a colleague expresses an opinion that doesn’t align with my knowledge, I ask, “What makes you feel that way?” or “What makes you say that?” As physicians, we must always be ready to present the evidence to support our decisions. Don’t be afraid to press someone to provide actual evidence. We live in an unprecedented time of misinformation. Requiring a colleague to provide evidence may help them realize that the evidence doesn’t exist.
 4 Detroit Medical News Third Quarter 2020

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