Hospitals and clinics should resist patient requests to be treated by doctors of a particular race, religion or sex, a top medical group is telling its members, highlighting a touchy yet reportedly common health-care phenomenon.

The Society of Obstetricians and Gynecologists argued in a recent position statement that “time-sensitive” services especially should be provided by the most qualified professional available — with no heed to personal background.

“Patients can decline the care offered, but should take full responsibilities for those actions,” says the statement.

Other physicians confirmed that patients, even in emergency departments, sometimes ask for a doctor or nurse of their own sex or ethnic background, or balk at being treated by a professional of a particular race.

Their actions would seem to reflect an increasingly diverse population, where patients and health professionals of very different cultures can be thrown together in potentially sensitive situations.

“Does it happen that a patient or a client or person would ask for a preference of provider type?” said Dr. Nicole Nitti, medical director of the Access Alliance clinic in Toronto. “It happens all the time.”

Some doctors, however, say accommodating such a preference when it is based on a new immigrant’s deeply rooted cultural background can actually lead to better health care, and call the Society’s position overly rigid.

“To me, it feels like industrial conformity, where efficiency is being put forward for efficiency’s sake,” said Dr. Kevin Pottie, an Ottawa doctor who helped draft the Canadian Guidelines on Immigrant Health. “I have a problem … with statements like this that increase inequities, that can lead to illness and death.”

In her immigrant-focused practice, Dr. Nitti said female patients frequently request a woman doctor because of their cultural or religious background, or past experiences. Alternatively, a patient might say “I would like to see a Southeast Asian provider.”

Dr. Nitti also does fill-in work at an emergency ward in the Ontario cottage-country town of Huntsville, where the reverse can be true, patients complaining about a visible-minority practitioner. “[They say] ‘I don’t want that nurse, I don’t like that doctor.’ They’re being very nasty and bitter. That happens, absolutely. We live in a discriminating society.”

Asking for a doctor of a particular sex, however, seems to be the most common request.

Tradition often impels Muslim women to want a female doctor, though the religion does not necessarily forbid them from being treated by a man, said Dr. Pottie, a University of Ottawa family-medicine professor.

Meanwhile, he said he has observed “Canadian patients” object to being treated by physicians from other countries or by non-Caucasian Canadian doctors.

The obstetrician-gynecologist society’s statement notes that many procedures and services are time sensitive or become that way without warning.

Providing such services should “not ever” be based on gender, race, sexual orientation, age or religion, and facilities “should not be expected to provide alternative care providers,” it says.

A spokesperson for the group was unavailable for comment, although a Society official said the statement arose because of incidents in Quebec. Other physicians had mixed reactions to the position.

“I think it’s a little harsh,” said Dr. Nitti. She said she understands the Society’s concerns but that patients’ cultural-based requests can often be accommodated in non-urgent situations.

In fact, some studies suggest that newcomers to a country are more likely to obtain potentially life-saving health-care services — from contraception to diabetes prevention — if it is culturally sensitive, said Dr. Pottie.

“The experience of a lot of vulnerable people, marginal people, is they are faced with a lot of discrimination, they have a lot of issues with trust, they may only trust their community,” he said.

Dr. Shelley Ross, a Burnaby, B.C., family physician and past president of the province’s medical association, also said it is not unusual for women to request a female doctor because of cultural or religious reasons, but said she supports the Society’s position.

“We need to stand up and say that our male colleagues are well trained and just as capable as our female colleagues,” she said. “We should be looking at education, knowledge, availability, what’s your training, not whether you are male or female.”