Tallulah Medhurst is a Chiropractor based in Stoke-on-Trent.
The death of George Floyd in 2020 sparked a global uprising, fighting for the equal rights of black people and the deformation of systemic racism. For many, this restarted the discussion on the role of racism in different aspects of our daily life; from work to social spheres to wider social responsibilities.
Following the events of last year, many people, both peers and patients, have asked me (given that I am of mixed heritage) whether I experience racism. My answer every time is, unsurprisingly, that I do. There is a lot to discuss about the various different ways in which racism has affected myself and other people of colour, both currently and historically. I understand that this is a lot to digest and, like most, I still have a lot to learn myself, so I will cut to the chase. I am going to explore my thoughts on what we can do as individuals, as well as within our profession, to help minimise the social and professional impact of racism on people of colour (POCs) in our communities.
So, lets get straight to the point; how does racism affect a person of colour in our profession?
In the U.K., a person of colour is at least 50% more likely to live in the most deprived parts of the country compared to a white individual. Black people are twice as likely to live in income deprived areas and between 2 to 4 times more likely to live in areas where they’ll face barriers to obtaining housing. This can have a huge effect on new graduate chiropractors. Debt accumulated during or before university can make it difficult to pay housing deposits, first year GCC and insurance fees in a short period of time. This can be exacerbated by the extra costs (financial, social and time cost) associated with supporting relatives both older and younger still in deprived areas. Moving from a deprived area to an affluent one increases this strain as housing prices are higher and guarantors are often required to rent a large portion of these properties. With a larger portion of relatives living in deprived areas, finding a suitable guarantor is more of a challenge. Of course, these difficulties can and do affect people from all races, however these situations affect marginalised communities at a disproportionately high rate compared to white people. These difficulties often result in POCs returning to work in more deprived areas, reducing their income and overall quality of life when compared to their peers. This perpetuates a system that keeps POCs in poverty in the U.K.. Whilst I am not expecting us as individuals to singlehandedly fix the issue of wealth disparity in the U.K., there are a few simple things which we can do to improve the standard of living for POCs in this country and ease the transition between new graduate to professional. For those employers in the position to provide financial support, grants and loans could be offered to help to pay associated fees or housing deposits. Paying in advance for the first month or two of work can also help assist new employees, without putting a financial strain on smaller or less financially stable businesses. Housing assistance can also be provided to varying degrees, from offering free or cheaper accommodation to assisting a graduate in finding guarantor-free housing or distributing information on local council and charity guarantor or rent deposit schemes.
International graduates also face struggles when applying to work within the UK. Housing guarantors are required to be U.K. residents. For non-EU members (and possibly EU members following Brexit), a VISA is required to work within the U.K.. Providing VISA sponsorship and similar financial and housing assistance as mentioned above can be the key difference in aiding integration of international POCs into the U.K..
Following the GCC Code, we are taught to uphold high professional standards and conduct, to challenge our own discriminatory attitudes and behave in a guided, fair and unbiased manner whilst respecting the beliefs, diversity and cultural differences of our patients, as prescribed by law. During university, we are taught numerous ways that this can be achieved through different scenarios which we may encounter. One lesson I vividly remember was on “hot topics”. We were instructed to either avoid these topics or practice formulating/preparing appropriate answers to questions on these topics. Doing this allowed us to stay honest, open and fulfil the GCC requirements to remain respectful and non-judgemental. Hot topics are topics in which opinions are often polarised and in which a person’s view may hold a large emotional attachment, such as politics or religion. Following the Black Lives Matter movement gaining momentum in 2020, a number of patients asked me for my opinion on the movement, what it represents, whether it should be “All Lives Matter” or “Black Lives Matter”, my thoughts on the protests etc.. This, I think we can all agree, would be considered a potential hot topic. When a patient begins a sentence with “I’m not a racist, but...”, you can more often than not expect the following statement to hold some form of discriminatory or derogatory view. In everyday British life, when POCs experience racism, it’s more commonly in a subtle or covert manner than in an openly “aggressive” way. Navigating these situations and simultaneously upholding a professional and respectful manner can be challenging. How much racism is an “acceptable” amount before I’m allowed to be openly offended? Should I try to challenge these views and risk backing myself into a difficult situation? A situation which, due to the subject matter, can result in white people becoming very defensive, trying to prove that they are “not a racist”, not realising that this can be very emotional and traumatic for POCs. This can be equally as challenging regarding religion. I know many other POCs who have been marginalised based on their religious beliefs or lack thereof. Whilst we cannot always dictate the conversations we have with a patient, there are things which we can do to support POCs that we work with who encounter these situations. Show POCs you work with that you would support them in these situations; explaining that, should a scenario like this arise, they have your full support in dealing with the matter. Discuss with the POC what they can tolerate and what situations they may need assistance handling. Be prepared to have this re-evaluated. Decide (with them) an appropriate action plan for different levels of offence, whether that be switching to another practitioner, refusal to treat full-stop or further legal action. Similarly, if you overhear something discriminatory, no matter how small you think it might be, it is important to action it. This could be documenting it or reporting it to a boss, colleague, association or appropriate outside source.
There are a lot of actions we can take to help POCs feel more comfortable and supported within the chiropractic community and I hope that I have outlined at least a few for you to consider today. These don’t have to put a huge strain on the individuals helping, but can affect both new graduates experiencing their first year out in practice and experienced chiropractors. Of course, there are some POCs who will never require more support, but a workplace that is actively showing they will support POCs as best they can really makes a difference to everyone.