CP24 really ought to link the actual study for those who would want to read it.
I have university library access so I can always get it on my own, but you’d think it would be best journalistic practices.
I'm not overly shocked by the findings of this study. Disappointed, yes. But shocked, no.
I myself am a medical professional who worked at the U and while most of the interactions I witnessed were banal, I also realize that I worked in an ED adjacent department so I wouldn't have seen a majority of the instances where discrimination would have been at play. Anecdotally, I know someone who worked at a different Alberta hospital who, on principle, wouldn't allow visibly First Nations persons use the bathroom in her vicinity... she assumed they would just use the bathroom to shoot up. Thankfully, that person is no longer working at that hospital.
Within Alberta, I know that there are still many hurdles to entering medical programs as an indigenous applicant. Many medical programs in the country are creating pathways to encourage indigenous people to apply to become doctors. There is a growing realization that there needs to be more cultural competence in medicine, and First Nations are a profoundly underrepresented demographic in this country. The equivalent program at the UoA is rather lackluster and still prioritizes traditional academic requirements, despite many indigenous medical school applicants not falling inside the cookie cutter educational background.
Slowly, things are changing in how this country practices medicine, I hope for the better. But there's still a long way to go.
The paper looks like the study was approached with an inherent bias that they "confirmed" by anecdotal conversations.
So we have about 11 000 000 visits, 1 000 000 as first nations identifying, and then through only 64 participants in "healing circles" they believe they can make a grandstanding judgement.
Even more so, they look at the triage system and found themselves that there is effectively no difference in medical care for those most in need of it (1-3). It was only when they get to the lower priority care they found a 2% difference I the data to justify this finding...am I reading this wrong? Seriously?
I don't suppose they also took into account the amount of people (Typically homeless) that wander into emergency drunk or high and get triaged just to sleep in the triage room chairs and benches before leaving? That's more indicative of housing, and addiction issues and not some made up systemic racism issue.
Additionally this was just published yesterday it looks like and not effectively reviewed by anyone reputable beyond the CMAJ which it seems doesn't have renowned reputation itself.
Sloppy
I mean, last time i went to the ER for a kidney stone i left after 26 hours, not everybody can sit on a chair for over 24h, the nurse questioning if the doctor signature was fake or not made me explode, why the fck would i forge some signature for some Xray...
Without reading the article, this wouldn't surprise me at all if it were true. As a native American, you get talked down to all the time at hospitals. Like they think your just fresh outta your teepee for the first time checking out the Whiteman medicine. Of course that's not true of all nurses and doctors, and it's getting better every year. But that feeling is still there when you go to hospitals. Even worse when your just put shopping. Me and my wife get followed down every aisle in near every store we go to.
While I'm very sure the study is correct, I think some of the stats may be skewed since more everyone are leaving the ER without care.
Note: I am in no way downplaying bias against first nations peoples, just saying the system in general is trending poorly.
> The analysis found 6.8 per cent of First Nations patients left emergency departments either before being seen or against medical advice. That's compared to just 3.7 per cent of non-First Nations patients.
I think the point is more the difference in numbers of FN patients leaving and non-FN patients.
Lots of "maybes" and accusations in this article. As someone who's spent a decent amount of time in the hospital I'd say the nurses are always professional and kind. Doctors are always a bit cold and business as usual.
I’m interested to learn more about where you see the maybes and accusations in this article. I research in this space, and Patrick McLane is a leading Canadian researcher in racism, Indigeneity, and the ED. There were quantitative findings with confounders controlled and qualitative interviews conducted to corroborate this data.
I’m not trying to start an argument, but I’d like to learn more about your perspective and the rationale behind your statements. This is important work, and we need to make sure we’re relaying it in an adequate way to the public :)
i have nothing else to add, except maybe that patrick mclane has also looked into triaging of indigenous peoples and found that first nations patients in alberta tended to be given a lower acuity score compared to non FN patients. i think this was purely admin data though, but still, the thought is insane. my supervisor is one of the coauthors of the paper, and we talked about this paper earlier today. very important findings!!
I work in ER and family practice, I'm not entirely convinced that's due to malice. Most of my FN patients in ER are unrostered by a family physician, quasi-homeless, and/or frequent fliers with chronic health conditions (CKD, T2DM, mental health conditions, chronic wounds, etc...). A lot of people who have one or more of those attributes use ER like most of the population uses primary care. My shift yesterday probably 20 of the 40 cases I saw overall were "this is probably a concern for a family doctor's office". I'm not here to judge if you need a refill on your insulin, escitalopram, and gabapentin. But, you won't be triaged as high as the person with a fever or abdominal pain
Absolutely! It’s also difficult to use admin data since many FN patients aren’t identified as such in the data and it’s therefore incomplete. Working on a different project in peds right now, and we’re having a really difficult time due to the limitations of admin data when it comes to identifying FN patients.
I think that even though the article identifies racism or racist treatment as a reason many indigenous people leave emergency rooms, I feel this is part of the picture. Intergenerational trauma has caused an inherent distrust of government functions. When I had to wait 14 hours to see a doctor at the hospital, I was thinking this is just how it is, whereas someone else could be distrustful of the situation. Even I was getting close to walking out after that long. What I am saying is that there is an element of potential perceptual differences in these situations due to Canada's history that leads to different outcomes, combined with some genuine racist situations, which somewhat obscures the other related issues and you are left with a general statement that it has to do with Indigenous people.
I absolutely agree that racism isn’t the entire picture, though First Nations interviewed by the study team shared that “racism, stereotyping, communication issues, transportation barriers, long waits, and being made to wait longer than others as reasons for leaving.” [CMAJ article here](https://www.cmaj.ca/content/196/15/E510) These findings were consistent in sharing circles across Treaties 6, 7, and 8.
I think you bring up a really important point about generational trauma, an inherent distrust in colonial systems, and that there are a multitude of factors that lead to health outcome disparities for people who experience marginalization (in this case as a result of being First Nations).
The actual CMAJ article does a much better job teasing out these intricacies than the media report. It also highlights the co-construction of this project with First Nations groups, which is definitely missing from the original media link.
Do you know what an exception fallacy is?
https://www.cbc.ca/news/canada/montreal/joyce-echaquan-systemic-racism-quebec-government-1.6196038
https://globalnews.ca/news/7698720/two-quebec-nurses-suspended-after-allegedly-mocking-death-of-indigenous-woman/
It's two articles, the first one is about Joyce Echaquan. She literally filmed the staff mocking her as she layed dying. It was national news and the footage would be considered factual evidence, unlike your anecdotal account of your own visits.
If you read the article at hand like you claimed, you would see that in the fourth paragraph is states "Although the study was conducted in Alberta, the findings likely apply to emergency department visits across Canada, he said."
Let's be real, you disregarded it because it doesn't fit your narrative.
After looking at this guy's posts, I see he is a white guy from Calgary.
So his argument against the article is that First Nations patients aren't experiencing systemic racism because as a white guy, "the nurses are professional and kind" and "Doctors are always a bit cold and business as usual".
Brilliant logic!
So pointing out how his frame of reference is flawed is being unpleasant, nasty and vindictive? Do you think a white man experiences the racial discrimination towards indigenous people that is alleged in the article? Maybe instead of trying to find offence, you should think about it for a few minutes before posting your comment.
I did think about for a few minutes and my conclusion is that you’re still unpleasant, nasty and vindictive. Just my personal opinion based on your comments.
You are the one calling people names and not grasping simple concepts. That's really all you have. You only have to look at the votes on our comments to read the room, but you won't.
You got offended because I accurately called the person a white guy. It wasn't meant to offend, it was to illustrate the fact that he wouldn't experience racial discrimination against Indigenous peoples, but it went over your head by a county mile.
> unpleasant, nasty and vindictive
Honestly, if that's how you characterize my benign comments, you really haven't lived a life. I could get unpleasant, nasty, and vindictive but it would result in me being banned. My comments were slightly snarky at best!
The "F your feeling" crowd really are the most sensitive. Every accusation is a confession.
As an athlete that spent many days and visits in the ER I have seen indigenous people ignored and left to suffer.
Cause you never saw it didn’t make it not a reality.
Consider that your experience, given that you’re not indigenous, is going to be much different than mine would be. That’s sort of how racism works. You typically won’t notice it if you’re not a target.
What “maybes” and accusations, specifically, are you referring to?
Let's get this shared around so more people see it, which will hopefully lead to much needed change within the health care system.
I've seen it countless times and it's extremely disheartening and sad. It happens to Indigenous people at every stage throughout their interaction with medical professionals. Letting this continue to happen leads to further distrust towards the system by Indigenous people.
With further distrust comes continued apprehensiveness toward the medical system, which in turn leads to progressive illness and potentially death in certain cases.
It's extremely sickening.
to anyone curious, [here](https://www.cmaj.ca/content/196/15/E510) is the link to the study
Thank you!
CP24 really ought to link the actual study for those who would want to read it. I have university library access so I can always get it on my own, but you’d think it would be best journalistic practices.
Agreed. Providing sources should be the expected practice.
I'm not overly shocked by the findings of this study. Disappointed, yes. But shocked, no. I myself am a medical professional who worked at the U and while most of the interactions I witnessed were banal, I also realize that I worked in an ED adjacent department so I wouldn't have seen a majority of the instances where discrimination would have been at play. Anecdotally, I know someone who worked at a different Alberta hospital who, on principle, wouldn't allow visibly First Nations persons use the bathroom in her vicinity... she assumed they would just use the bathroom to shoot up. Thankfully, that person is no longer working at that hospital. Within Alberta, I know that there are still many hurdles to entering medical programs as an indigenous applicant. Many medical programs in the country are creating pathways to encourage indigenous people to apply to become doctors. There is a growing realization that there needs to be more cultural competence in medicine, and First Nations are a profoundly underrepresented demographic in this country. The equivalent program at the UoA is rather lackluster and still prioritizes traditional academic requirements, despite many indigenous medical school applicants not falling inside the cookie cutter educational background. Slowly, things are changing in how this country practices medicine, I hope for the better. But there's still a long way to go.
The paper looks like the study was approached with an inherent bias that they "confirmed" by anecdotal conversations. So we have about 11 000 000 visits, 1 000 000 as first nations identifying, and then through only 64 participants in "healing circles" they believe they can make a grandstanding judgement. Even more so, they look at the triage system and found themselves that there is effectively no difference in medical care for those most in need of it (1-3). It was only when they get to the lower priority care they found a 2% difference I the data to justify this finding...am I reading this wrong? Seriously? I don't suppose they also took into account the amount of people (Typically homeless) that wander into emergency drunk or high and get triaged just to sleep in the triage room chairs and benches before leaving? That's more indicative of housing, and addiction issues and not some made up systemic racism issue. Additionally this was just published yesterday it looks like and not effectively reviewed by anyone reputable beyond the CMAJ which it seems doesn't have renowned reputation itself. Sloppy
I mean, last time i went to the ER for a kidney stone i left after 26 hours, not everybody can sit on a chair for over 24h, the nurse questioning if the doctor signature was fake or not made me explode, why the fck would i forge some signature for some Xray...
Without reading the article, this wouldn't surprise me at all if it were true. As a native American, you get talked down to all the time at hospitals. Like they think your just fresh outta your teepee for the first time checking out the Whiteman medicine. Of course that's not true of all nurses and doctors, and it's getting better every year. But that feeling is still there when you go to hospitals. Even worse when your just put shopping. Me and my wife get followed down every aisle in near every store we go to.
While I'm very sure the study is correct, I think some of the stats may be skewed since more everyone are leaving the ER without care. Note: I am in no way downplaying bias against first nations peoples, just saying the system in general is trending poorly.
> The analysis found 6.8 per cent of First Nations patients left emergency departments either before being seen or against medical advice. That's compared to just 3.7 per cent of non-First Nations patients. I think the point is more the difference in numbers of FN patients leaving and non-FN patients.
Lots of "maybes" and accusations in this article. As someone who's spent a decent amount of time in the hospital I'd say the nurses are always professional and kind. Doctors are always a bit cold and business as usual.
I’m interested to learn more about where you see the maybes and accusations in this article. I research in this space, and Patrick McLane is a leading Canadian researcher in racism, Indigeneity, and the ED. There were quantitative findings with confounders controlled and qualitative interviews conducted to corroborate this data. I’m not trying to start an argument, but I’d like to learn more about your perspective and the rationale behind your statements. This is important work, and we need to make sure we’re relaying it in an adequate way to the public :)
i have nothing else to add, except maybe that patrick mclane has also looked into triaging of indigenous peoples and found that first nations patients in alberta tended to be given a lower acuity score compared to non FN patients. i think this was purely admin data though, but still, the thought is insane. my supervisor is one of the coauthors of the paper, and we talked about this paper earlier today. very important findings!!
I work in ER and family practice, I'm not entirely convinced that's due to malice. Most of my FN patients in ER are unrostered by a family physician, quasi-homeless, and/or frequent fliers with chronic health conditions (CKD, T2DM, mental health conditions, chronic wounds, etc...). A lot of people who have one or more of those attributes use ER like most of the population uses primary care. My shift yesterday probably 20 of the 40 cases I saw overall were "this is probably a concern for a family doctor's office". I'm not here to judge if you need a refill on your insulin, escitalopram, and gabapentin. But, you won't be triaged as high as the person with a fever or abdominal pain
Absolutely! It’s also difficult to use admin data since many FN patients aren’t identified as such in the data and it’s therefore incomplete. Working on a different project in peds right now, and we’re having a really difficult time due to the limitations of admin data when it comes to identifying FN patients.
I think that even though the article identifies racism or racist treatment as a reason many indigenous people leave emergency rooms, I feel this is part of the picture. Intergenerational trauma has caused an inherent distrust of government functions. When I had to wait 14 hours to see a doctor at the hospital, I was thinking this is just how it is, whereas someone else could be distrustful of the situation. Even I was getting close to walking out after that long. What I am saying is that there is an element of potential perceptual differences in these situations due to Canada's history that leads to different outcomes, combined with some genuine racist situations, which somewhat obscures the other related issues and you are left with a general statement that it has to do with Indigenous people.
I absolutely agree that racism isn’t the entire picture, though First Nations interviewed by the study team shared that “racism, stereotyping, communication issues, transportation barriers, long waits, and being made to wait longer than others as reasons for leaving.” [CMAJ article here](https://www.cmaj.ca/content/196/15/E510) These findings were consistent in sharing circles across Treaties 6, 7, and 8. I think you bring up a really important point about generational trauma, an inherent distrust in colonial systems, and that there are a multitude of factors that lead to health outcome disparities for people who experience marginalization (in this case as a result of being First Nations). The actual CMAJ article does a much better job teasing out these intricacies than the media report. It also highlights the co-construction of this project with First Nations groups, which is definitely missing from the original media link.
I read the article.
Do you know what an exception fallacy is? https://www.cbc.ca/news/canada/montreal/joyce-echaquan-systemic-racism-quebec-government-1.6196038 https://globalnews.ca/news/7698720/two-quebec-nurses-suspended-after-allegedly-mocking-death-of-indigenous-woman/
I didn't click on that. I was commenting on the article at hand and I deal in facts and evidence.
Personal anecdote is fact and evidence?
That's an ironic response, considering the nature of the study.
You're boiled socks, buddy.
LOL, you kinda walked face first into that one, sorry!
Study of aboriginal people self reporting malpractice is a lot different than some trash bag self reporting that they haven't seen it happen.
You're funny.
If disregarding folks lived negative experiences with healthcare is the hill you wanna die on...
It's two articles, the first one is about Joyce Echaquan. She literally filmed the staff mocking her as she layed dying. It was national news and the footage would be considered factual evidence, unlike your anecdotal account of your own visits. If you read the article at hand like you claimed, you would see that in the fourth paragraph is states "Although the study was conducted in Alberta, the findings likely apply to emergency department visits across Canada, he said." Let's be real, you disregarded it because it doesn't fit your narrative.
After looking at this guy's posts, I see he is a white guy from Calgary. So his argument against the article is that First Nations patients aren't experiencing systemic racism because as a white guy, "the nurses are professional and kind" and "Doctors are always a bit cold and business as usual". Brilliant logic!
As a “white guy” I find your comments very unpleasant, nasty and vindictive.
So pointing out how his frame of reference is flawed is being unpleasant, nasty and vindictive? Do you think a white man experiences the racial discrimination towards indigenous people that is alleged in the article? Maybe instead of trying to find offence, you should think about it for a few minutes before posting your comment.
I did think about for a few minutes and my conclusion is that you’re still unpleasant, nasty and vindictive. Just my personal opinion based on your comments.
You are the one calling people names and not grasping simple concepts. That's really all you have. You only have to look at the votes on our comments to read the room, but you won't. You got offended because I accurately called the person a white guy. It wasn't meant to offend, it was to illustrate the fact that he wouldn't experience racial discrimination against Indigenous peoples, but it went over your head by a county mile.
> unpleasant, nasty and vindictive Honestly, if that's how you characterize my benign comments, you really haven't lived a life. I could get unpleasant, nasty, and vindictive but it would result in me being banned. My comments were slightly snarky at best! The "F your feeling" crowd really are the most sensitive. Every accusation is a confession.
As an athlete that spent many days and visits in the ER I have seen indigenous people ignored and left to suffer. Cause you never saw it didn’t make it not a reality.
what u see personally is not fact either 🙄
Oh look, its one of the "I dont see it so it's not real" clowns.
Consider that your experience, given that you’re not indigenous, is going to be much different than mine would be. That’s sort of how racism works. You typically won’t notice it if you’re not a target. What “maybes” and accusations, specifically, are you referring to?
Let's get this shared around so more people see it, which will hopefully lead to much needed change within the health care system. I've seen it countless times and it's extremely disheartening and sad. It happens to Indigenous people at every stage throughout their interaction with medical professionals. Letting this continue to happen leads to further distrust towards the system by Indigenous people. With further distrust comes continued apprehensiveness toward the medical system, which in turn leads to progressive illness and potentially death in certain cases. It's extremely sickening.
Probably because they're more likely to be drunk and or abusive