Bringing an anti-oppression and inclusion lens to work
When Dr. Gaynor Watson-Creed stands in front of a group of physicians to talk about oppression within the healthcare system, the room is silent. They’re not just listening to her speak, they’re absorbing her words as they begin to question their own experiences and wonder if they have been a part of the problem without realizing it.
She’s so used to that reaction that she deliberately builds time into her sessions to allow people to digest what she’s saying. Dr. Watson-Creed recently facilitated one such session for PEI physicians on behalf of the Medical Society of PEI about bringing an anti-oppression and inclusion lens to work.
“We are waking up to the ways in which we have been constructed as an instrument of oppression, particularly in the North American context against Black and Indigenous communities, and the ways in which that has fed some non-evidence-based approaches to medical practice,” Dr. Watson-Creed said. “In most cases, we just didn’t know better. We’re waking up to the ways in which medicine has— maybe unintentionally—been fully complicit with forms of oppression. And now, we need to look at what needs to be done to undo that.”
After 18 years as a public health specialist physician and a wealth of experience with national population health councils and boards, Dr. Watson-Creed has talked to many people about oppression. In fact, she held her first anti-racism rally while still a student at the University of Prince Edward Island. Growing up as a minority on PEI in the household of two Black social scientists, she began questioning inequities and disparities at an early age. Now, as the Associate Dean of Serving and Engaging Society for Dalhousie University’s Faculty of Medicine, Dr. Watson-Creed makes it her mission to shed light on these complexities and help others tackle oppression within their own environments.
Dr. Nicole Green, an emergency medicine physician at the Queen Elizabeth Hospital in Charlottetown, was not only a participant at Dr. Watson-Creed’s recent session, but an event organizer. Dr. Green said she and her colleagues were motivated to learn how to be more inclusive and contacted Dr. Watson-Creed after discussing how best to support members of the community who struggle with oppression based on race, religion, gender, disability or otherwise.
“I have considered these issues for a long time, and thought that I was aware of the complexities, but came away from this session with an awareness that they are in fact even more deeply entrenched and convoluted than I realized,” Dr. Green said.“I left the session realizing that before we can ever hope to foster equity and diversity within our system, we must first become aware of where oppression lives in the intersections of people’s identities and roles, and thoughtfully engage in anti-oppression.”
It’s that enlightened reaction Dr. Watson-Creed hopes for after her sessions. She said the system-wide changes needed to really address oppression are going to require many people to feel a bit vulnerable, but also engaged with an open mind.
“We could focus on oppression of minorities or of women in the traditionally male dominated medical environment, but regardless of what area you want to focus anti-oppression work, the same questions apply: who has the power in this situation, who is at a relative disadvantage , and how do we create a structure that allows other voices to share in that power,” Dr. Watson-Creed said. “One of the larger, complex issues is looking across our health authorities in this country to see who sits around the table, who holds the power, whose voices are missing, and how do we share that power and include those voices. This can be applied at our colleges, licensing bodies, and professional associations, for example. Who represents the decision makers there and are we sure they actually represent all the people who need to be a part of the conversation? That’s just one of the things we need to work on.”
It’s not just large, system-wide issues that need to be tackled, Dr. Watson-Creed said there are little things that add up and contribute to oppression in health care.
“We talk a good game about being patient-centered in medicine, but we do things, even little things, in our environments that are actually so system centric that we don’t even realize it’s there,” she said. “A classic one is the signage in our waiting rooms. We have signs that talk about behaviours that will not be tolerated and the consequences that will result, but often that signage has harsh language and tone and is in all caps, but we’re speaking to people who are sick and vulnerable. So right away, as our patients come into the room at their worst, looking for help, we’re in their face speaking to them in a way that we’re asking them not to do to us. It can be something as small as that, or as egregious as using an outdated clinical practice algorithm that is inherently racist. Anti-oppression work challenges us to be critical about every single one of our environments.”
Like all of her sessions, Dr. Watson-Creed leaves a lot for the participants to think about and she believes the reactions she’s getting as she addresses various groups about tackling oppression are genuine. Professional associations are starting to do internal examinations and there’s even been a recent full revision using an anti-oppression lens to a widely used medical pathology textbook.
“There’s always so much more we can do, but we’re going in the right direction, and I’m so pleased it’s becoming an international conversation,” said Dr. Watson-Creed. “I recognize this current generation of physicians is not responsible for constructing these falsehoods that have permeated medical practice, and I never go into a session looking to hold anyone responsible in that way, but I do think we have an accountability to not pass it along to the next generation.”
Dr. Green is already looking for ways to continue the conversation and get involved in anti-oppression work on PEI. She currently leads the MSPEI Peer-to-Peer program which is a structured peer support program that aims to be a driver of cultural change in the medical community. She encourages her colleagues to reach out if they want to discuss Dr. Watson-Creed’s session or ways to get involved.
“We need to engage regularly and in earnest about how we can create safe spaces for racialized and oppressed groups within our community so that opportunities exist to connect and identify needs, and how as individuals who experience privilege, we can be honest about where we have power over others, and instead work to use that power in support of those experiencing oppression,” Dr. Green said. “In all honesty, I think that we are not doing enough within the medical community in PEI and opportunities to explore topics like this with colleagues are invaluable in our ongoing efforts to shift culture.”
To learn more about Dr. Watson-Creed and her work as the Associate Dean of Serving and Engaging Society for Dalhousie University’s Faculty of Medicine, visit: https://medicine.dal.ca/community.html
View Dr. Watson-Creed’s biography here
Dr. Gaynor Watson-Creed’s session was MSPEI’s first CME course offering of 2024. To learn more about programs and educational opportunities available to PEI physicians, contact MSPEI or visit https://www.mspei.org/