Guest columnists: Discrimination has no place in medicine

Drs. Britt Peterson and MaryShell Zaffino | GUEST COLUMNISTS

We have been greatly concerned about the recent reports of harassment toward patients of different ethnic and religious groups. An Asheville Citizen-Times article by Julie Ball in March, “Local doctors speak out about incidents of hate speech” reported an incident of verbal assault in a waiting room toward a Muslim woman expressing her faith by wearing a hijab, as well as reports of patient-on-patient and patient-on-staff intimidation and harassment.

Unfortunately it appears that incidents like those have not been as isolated as we would like to believe.

The WCMS Foundation is the home of WIN (WCMS Interpreter Network), which provides professional medical interpretive services to limited English-speaking and deaf patients in many different health care settings. WIN’s professional medical interpreters, who are in health care settings assisting patients on a daily basis, are witnessing multiple similar incidents. We take these reports seriously because of research linking these experiences to adverse health effects. These include a 2004 study that found that the presence of hate speech directed toward those in ethnic immigrant groups was a predictive factor for rates of suicide and a 2015 study that documented increased occurrences of stress, anxiety, depression and thoughts of suicide, as well as increased incidence of physical ailments such as hair loss, diabetes and heart disease among people reporting experiences of racism.

The reports we are hearing include a notable number of Spanish-speaking patients being harassed by other patients in waiting rooms across our region. Examples of intimidating behavior include glaring, muttering unpleasant comments within earshot, or direct confrontation, telling the person to go back to their presumed country of origin. Melisa Soto Escobar, one of our organization’s Spanish interpreters, says, “I see [those who are making harassing comments] target people who can’t really do anything about it – mothers who have young kids with them or elderly people. I am worried patients will stop going to the doctor.”

Another Spanish interpreter, who requested we not use her name, voiced concerns that reports of increased cooperation between Immigrations and Customs Enforcement (ICE) agents and local law enforcement agencies in certain counties has led many immigrants, even those with legal documentation, to fear leaving their homes. Consequently, many individuals are avoiding doctor appointments and trying to treat themselves at home when they should be seeking professional medical attention. She provided a recent example of a man who was seriously injured and waited days before going to the doctor because he was afraid of being stopped and questioned on the way to or at the doctor’s office.

Regardless of one’s political stance for or against certain immigration policies, we believe there are basic rules of decency that apply to everyone in the United States, whether they are citizens, green card holders, immigrants with refugee status, undocumented immigrants, tourist visa holders, or any other status. This is particularly true in health care settings where people are in need of a safe place to heal from illness.

We have advocated for our community to stand with the Western Carolina Medical Society to condemn any xenophobic, racist, anti-immigrant, and/or anti-Muslim rhetoric or actions that impedes access to needed medical care in our region. We believe it is important to support the American values of inclusion, equality and freedom of religion for our patients as outlined in documents such as our Constitution and the Civil Rights Act of 1964. We respectfully ask that our political leaders in the future consider how the creation, implementation, and enforcement of immigration policy may adversely impact many of our patients’ ability to receive critical health care services.

We uphold the dignity and value of each and every patient who comes through our doors. We hope you will join us in our efforts to make our health care settings “discrimination-free zones,” where any human being will feel comfortable receiving appropriate medical treatment when it is truly needed. Our community’s health and well-being are at stake.

C. Britt Peterson, MD, MPH, is the Western Carolina Medical Society Foundation Board Chair. Mary Shell Zaffino, MD, WCMS is the Association Board President.