Stereotypes of different cultures can be pervasive in health care. David Shimizu, MD, Program Director for the Pathology Residency Program at the University of Hawaii, and pathologist at the Queen’s Medical Center in Honolulu, Hawaii, has seen firsthand the stereotypes used by physicians and other health care workers to target/label Asian Americans (quiet, non-confrontational, not wanting to be actively involved in health care decisions, non-English speaking, a preference for non-Western medicine) and Pacific Islanders (non-compliant, not taking care of themselves when it comes to exercise and diet, unwillingness to seek Western medical care, non-English speaking). Here he shares his thoughts on how race impacts care, and what we need to overcome biases.
How does race affect health care?
Race, ethnicity, culture, gender and socioeconomic status affect all aspects of health care including access, delivery, etc. It seems that much of our health care processes have centered around white males of higher socioeconomic status.
How can healthcare providers in the U.S. get a better understanding of cultural needs or differences for Asian Americans/Pacific Islanders in order to better provide earlier screening and prevention, and better health care overall? How can the laboratory play a role in this?
It requires education on these issues, education on the effects of race, ethnicity, culture, gender on health and health care. We need resources to provide better access for disadvantaged populations. Laboratories can try to provide better access and outreach for phlebotomy and testing, financial assistance, interpreters/translators when necessary, etc. For laboratory testing, reporting, and interpretation we should look at the reference ranges for different populations.
Tell us about your own experiences with racism in health care and how has it affected your career/your education. What should we focus on in to teach and practice respect and open-mindedness for one another?
I don't recall any specific personal experiences. I am fortunate because I trained and practice in Hawaii and the Queen's Medical Center (founded by Queen Emma and King Kamehameha IV in 1859, our mission is to provide health care to Native Hawaiians and all of the people of Hawaii). When I attended university on the East coast many years ago, I was teased about being from Hawaii and Asian. Sometimes this made me feel like an imposter and outsider.
We have been getting education on implicit bias (including our own implicit biases) and microaggressions. We should call these out when we observe them. We should strive for diversity (race, gender, etc) in our organizations, at all levels, examining our job descriptions and processes for hiring, evaluation and promotion.
This Q&A has been edited for clarity and length.
To read more Q&As with Asian American and Pacific Islander members of the laboratory, click
here.
