An Asian-American physician who sparked debate when she revealed some white patients in Oregon had refused to be treated by her because of her ethnicity, has revealed she has experienced the same thing in every state she has worked.

Writing in the aftermath of the neo-Naz-led violence in Charlottesville, Esther Choo, a doctor at Portland’s Oregon Health & Science University, said there were a lot of “white nationalists” in her state and two or three times a year, a patient would insist on being treated by a white person - even if it was the intern.

“We’ve got a lot of white nationalists in Oregon. So a few times a year, a patient in the ER refuses treatment from me because of my race,” she started a twitter thread that was shared by thousands of people.

Yet Ms Choo said that while Oregon had a history of white supremacism, despite the relatively progressive views of the residents of its largest city, Portland, she had encountered similar incidents in every place she had worked as a doctor - Connecticut, California and Massachusetts.

“There is a little bit of racism everywhere you go. These things happen everywhere - its not isolated to one state,” she told The Independent.

Ms Choo, who has more than 15 years experience, said she had not written or spoken out about her experiences before. “It’s not something you come out of a hospital wanting to talk about,” she said.

White supremacist patients refuse treatment' by Asian-American doctor

Yet as she saw the images of violence taking place in the Virginia college town, she felt inspired to write. She said as she watched the television cameras zoom in on the faces of those taking part, she “realised she had seen those ideas before in the emergency room”.

She added: “When it happens in a hospital shift you are very busy, running around like a crazy person, and you have to move on. It might not even stand out from the shift. The last traffic accident you dealt with, may be the thing you remember from the night.

“When I was watching Charlottesville, I started to feel the anger and hate I had never really stopped to think about.”

Violence on the streets of Charlottesville Show all 9 1 /9 Violence on the streets of Charlottesville Violence on the streets of Charlottesville Protesters clash and several are injured White nationalist demonstrators clash with counter demonstrators at the entrance to Lee Park in Charlottesville, Virginia. A state of emergency is declared, August 12 2017 Violence on the streets of Charlottesville Trump supporters at the protest A white nationalist demonstrator walks into Lee Park in Charlottesville, Va., Saturday, Aug. 12, 2017. Hundreds of people chanted, threw punches, hurled water bottles and unleashed chemical sprays on each other Saturday after violence erupted at a white nationalist rally in Virginia. AP Photo Violence on the streets of Charlottesville State police stand ready in riot gear Virginia State Police cordon off an area around the site where a car ran into a group of protesters after a white nationalist rally in Charlottesville, Virginia AP Photo Violence on the streets of Charlottesville Militia armed with assault rifles White nationalists, neo-Nazis and members of the 'alt-right' with body armor and combat weapons evacuate comrades who were pepper sprayed after the 'Unite the Right' rally was declared a unlawful gathering by Virginia State Police. Militia members marched through the city earlier in the day, armed with assault rifles. Getty Images Violence on the streets of Charlottesville Statue of Confederate General Robert E Lee The statue of Confederate General Robert E. Lee stands behind a crowd of hundreds of white nationalists, neo-Nazis and members of the 'alt-right' during the 'Unite the Right' rally 12 August 2017 in Charlottesville, Virginia. They are protesting the removal of the statue from Emancipation Park in the city. Getty Images Violence on the streets of Charlottesville Racial tensions sparked the violence White nationalists, neo-Nazis and members of the 'alt-right' exchange insults with counter-protesters as they attempt to guard the entrance to Lee Park during the 'Unite the Right' rally Getty Violence on the streets of Charlottesville A car plows through protesters A vehicle drives into a group of protesters demonstrating against a white nationalist rally in Charlottesville, Virginia. The incident resulted in multiple injuries, some life-threatening, and one death. AP Photo Violence on the streets of Charlottesville Rescue personnel help injured people after a car ran into a large group of protesters after an white nationalist rally in Charlottesville, Virginia AP Photo Violence on the streets of Charlottesville President Donald Trump speaks about the ongoing situation in Charlottesville, Virginia from his golf club in Bedminster, New Jersey. He spoke about "loyalty" and "healing wounds" left by decades of racism.

Ms Choo said the impact of a patient refusing to be treated could be not just insulting, but embarrassing and distressing, particularly when she was less experienced. Nowadays, she adopted a more practical approach.

Many people who commented on her Twitter thread suggested she ought to have simply walked away from any such patients and left them to it. Yet she said, she had never felt that. “In a real life situation, my instincts are to do my job.”

She said since posting her thread, she had received messages from doctors of colour from across the country sharing similar stories and experiences.

She had also heard from lots of white doctors, expressing outrage and also asking how they can best support colleagues of colour. She said: “That was one of the positive things - people asking how to reach out and help others.”

The violence in Charlottesville happened during one of the largest white supremacist gatherings in a number of years. The demonstrators were met by scores of anti-fascist protesters and the clashes left up to 20 people a hurt.