B.C. college developing cultural safety and humility practice standard

The College of Physicians and Surgeons of British Columbia is developing a new practice standard designed to ensure Indigenous peoples in the province have access to culturally safe healthcare. “This is going to be what is expected of all physicians when they are at the bedside,” said Dr. Heidi Oetter, registrar and CEO of the CPSBC The practice standard is partly in reaction to the findings of an independent review into Indigenous-specific racism in the province’s healthcare system. The review, led by Mary Ellen Turpel-Lafond (Ake-Kwi), was released in November 2020. It was commissioned by the provincial government in response to allegations that emergency department staff were playing a game trying to guess the blood alcohol level of Indigenous patients. While Turpel-Lafond found no proof of those allegations, her research uncovered widespread systemic racism against Indigenous peoples. Read: How expressive writing could help frontline healthcare workers address trauma Dr. Oetter said that Turpel-Lafond’s report “really put a spotlight on the racism that exists that exists in B.C. that targets Indigenous people in a way that we probably hadn’t fully acknowledged." Dr. Oetter also credited the work of Joe Gallagher, former CEO of First Nations Health Authority in B.C., who pledged a commitment to cultural safety in healthcare. Dr. Oetter said that CPSBC has been working on ways to make sure it recognized the impact of colonization on the college and on healthcare in B.C., and the practice standards are part of that initiative. In 2017, CPSBC and other regulators signed a commitment to advancing cultural safety and humility in the regulation of healthcare. She said that conversations around the practice standard are revealing more present-day experiences with discrimination in the healthcare system. “Indigenous people are telling us how they were mistreated, not five years ago, not 10 years ago but last week, or last month.” she said. “We continue to hear stories from our Indigenous physicians who work in the healthcare system about how they continue to be mistreated within the system.” Read: How cultural sensitivities make nursing difficult for men “We certainly have a lot of work to do to change the culture.” When the practice standards will be in place is not certain, as more consultation is needed before a draft is finalized. The principles that will guide the practice standards were recently subject to a month-long public consultation. “It needs to be perfect. It needs to be right,” Dr. Oetter said. “We need to make sure we’re sending a single unified message out to the profession and really get change management in place to make landing the practice standard a success.” The practice standards are being developed in collaboration with the First Nations Health Authority, with extensive consultation with both the profession as well as members of the public. “We have just recently done a number of virtual circles with both Indigenous patients as well as Indigenous physicians,” Dr. Oetter said. She said consultations with First Nations and Métis groups are planned or ongoing. “We still have a lot of work to do to listen deeply to the broad range of people who make up the Indigenous community in British Columbia." There will also be consultations with all the province’s health authorities, the Ministry of Health and other groups. The University of British Columbia will help develop education modules to support the practice standards. Read: Pilot project seeks to boost healthcare provider cultural competence with LGBTQ+ patients “It is not a quick fix. It is going to be a journey,” Dr. Oetter said. The new practice standard is focused on how healthcare delivery is about relationships rather than transactions. The practice standard will outline how a physician needs to be humble when providing care. They must “respect that patients have their own cultural beliefs and values and physicians need to be appreciative and inquiring about what that means,” Dr. Oetter said. CPSBC is also reviewing their complaints process to make sure it is appropriate and safe for Indigenous patients to submit complaints. Dr. Oetter noted that while Turpel-Lafond had hundreds of patients step forward with well-described occurrences or concerns, “as a regulator we have very few of those complaints." “It has become very obvious to the college that our processes are not being accessed by Indigenous patents,” she sai Dr. Oetter said that all medical regulators in Canada are thinking about what it means to be a regulator that promotes equity. “For us, that means really righting the wrongs that have been put upon the Indigenous people in Canada who have suffered the effects of colonization and racism for hundreds of years.” The College of Physicians and Surgeons of Alberta announced that they will form an Indigenous Health Advisory Circle. The circle will guide the CPSA as they examine their processes and focus on how they can better support Indigenous patients. “We are on a journey of increasing our awareness and learning about Truth and Reconciliation in an effort to create culturally-safe care spaces and improve health outcomes for Indigenous peoples,” said Dr. Scott McLeod, CPSA’s registrar, in a press release. “We are fortunate in Alberta to have many influential Indigenous physician and community leaders we can learn from and partner with as we build a framework together to promote culturally-competent care across our province.” Read: Not your typical therapy: culturally sensitive treatments for depression The Yukon Medical Council is making training on First Nations mandatory for holding a medical license from the territory. This requirement comes into effect on March 31, 2022. The training, called Yukon First Nations 101, is offered through Yukon University and was developed with the Yukon Council of First Nations. It takes six hours to complete can be done as a group over Zoom or through an online module. First Nations Health Authority of B.C. has partnered with the Health Standards Organization to develop a cultural safety and humility standard for the healthcare system in B.C. While the standard is designed for B.C., the groups are currently seeking national feedback to investigate if there is a need for a national standard and if so, what it would include. The public review is open until August 23, 2021. The final standard is expected in March 2022. Read: New film highlights Indigenous Canadians' experience with the healthcare system

B.C. college developing cultural safety and humility practice standard

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