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Approaches to diversity in family medicine

"I have always tried to be colour blind"

Zofia Kumas-Tan, MSc
Registered occupational therapist in Gatineau, Que

Correspondence: Dr Brenda Beagan, Dalhousie University, School of Occupational Therapy, 5869 University Ave, Forrest Bldg, Room 215, Halifax, NS B3J 3H5; e-mailbbeagan{at}dal.ca

OBJECTIVE To explore family physicians’ perceptions of and experiences with patient diversity, including differences in sex, race, ethnicity, social class, sexual orientation, and abilities or disabilities.

DESIGN Semistructured, in-depth, qualitative interviews.

SETTING Halifax metropolitan region, Nova Scotia.

PARTICIPANTS Twenty-two family physicians who ranged in age (25 to 65 years) and in years of practice (< 5 to > 20). Participants included both sexes, members of racialized minority groups, and those who self-identified as gay, lesbian, or bisexual.

METHODS Physicians were recruited through information letters distributed by mail and through professional networks. Interviews and field notes were recorded, transcribed verbatim, and coded using data analysis software. Weekly team discussions enhanced interpretation and analysis.

MAIN FINDINGS Family physicians employed 5 main approaches to diversity: maintaining that differences do not matter, accommodating sociocultural differences, seeking to better understand differences, seeking to avoid discrimination, and challenging inequities. Quotes from interviews illustrate these themes.

CONCLUSION Most approaches assume that both medicine (as a profession) and physicians are and should be socially and culturally neutral; some acknowledge that the sociocultural background of patients can raise tensions. Most participants in our study seek to treat patients as individuals in order to not stereotype, which hinders recognition of the ways in which sociocultural factors—both patients’ and physicians’—influence health and health care. Critical reflexivity demands that physicians understand social relations of power and where they fit within those relations.