The Embarassed GP

The incident takes place in the GP´s waiting room and partly in the GP´s consulting room at the narrator´s GP. The narrator is consulting her GP because of a general health issue, which is not particularly related to her physical disability. This particular day, it turns out that the permanent GP is on vacation, and therefore another GP is taking care of the patients as a temporary/substitute.

The narrator´s emotional reaction would be:

In the very moment she feels very embarrassed and confused by the GP´s reaction.

She also feels rejected and somehow even excluded.

She really feels exhibited and exposed to all other patients in the waiting room. Likewise affected by the GP´s strange reaction, most of them are looking up and apparently confused by the situation. Thus, the situation actually affects the narrator´s usual self-confidence in the downward direction.

She feels completely caught off guard. Even though she is prepared to meet various reactions on disability, this is a new experience that she never expected from a professional. In this light, her astonishment and embarrassment is gradually replaced by anger and indignation.

The incident collides with several of the narrator’s attitudes, principles and values:

The value of equal treatment and equal opportunities

The narrator is deeply involved in events, activities and debates to combat discrimination, prejudice and lack of equal opportunities. Having Cerebral Palsy, she is the chairman and board member of a major youth organisation for young people with disabilities. Thus, she is generally strictly aware of situations and incidents where either she herself or other people are treated in a discriminatory and exclusionary way because of disability or due to other illegal discrimination areas (like ethnicity, race, colour, gender, age etc).

The value of equality, equal opportunities and anti-discrimination implies in this case that people with physical disabilities should have equal opportunities to take part in society on equal terms with other people – and have a right to be treated equally and with equal respect as other people.

In this incident, the narrator experiences that her basic value of equality and respect for other people regardless of their background, resources and skills, is violated. Indeed, this is not a first time experience for the narrator. But the shock occurs specifically because she expects these values to be a basic part of the professional attitude in the healthcare system with the primary task to deal with patients with all kinds of physical and mental challenges.

The value of safe and equal access to professional care and treatment

Even though the narrator is generally aware of lack of equality and discrimination in society and everyday life – she still has a strong expectation of a fair distribution of benefits and requirements as the basic value of the welfare state. She expects that she is equally as entitled as other citizens to ask for a decent medical care and treatment whenever she needs it. She expects to meet a professional and objective approach in the healthcare system, whether her GP consultation is about her disability or other health issues.

In this incident, her general expectations are frustrated when she learns that the GP is unable to comply with these professional requirements. The shock occurs because the response to her physical disability comes from a doctor who is supposed to have a professional insight into physical disabilities and all other kinds for physical disorders.

The narrator´s image of the temporary GP can be assembled in the word: lack of professionalism on various levels:

Firstly, the GP is sloppy – she didn’t read the narrator´s file properly. That may have had serious consequences in matters of proper medical treatment etc.

Secondly, the GP is indiscreet – by her reaction she is exposing the narrator to all other patients in the waiting room. By creating awareness about the narrator, the GP exposes the narrator´s otherness as a disabled person.

Thirdly, the GP is close to discriminatory and exclusive behaviour – she seems unable to relate naturally and inclusive to patients with physical disabilities.

The cultural approach:

From an intercultural perspective, this incident seems quite subtle. On one hand, the temporary GP appears to be raised and integrated in a Danish tradition, be it in the existing professional healthcare culture as well as a wider culture of inclusiveness and respect for citizens with visible disabilities.

Thus, it remains puzzling, whether the GP´s reaction comes from cultural attitudes and feelings towards physical disability. It is well known that people in some cultures tend to “hide” relatives with disabilities to the world – actually in order to protect them. But it seems inexplicable that the GP with her Danish cultural background has similar cultural preferences.

The diversity approach:

However, there may be a reason to interpret the situation as an expression of the GP´s lack of understanding of – or insight into – a wide diversity concept. Thus, the GP´s disorientation in the situation may be a reflection of her personal and private embarrassment to people with physical disabilities. In the situation, the GP transmits her lack of personal experience to the professional contact with a patient with a walker and a visible physical disability, in this case the narrator.

Thus, the GP´s remarkable reaction may suggest that she – despite her profession – is unfamiliar with diversity in practice. She seems to have a preconception about people and patients with physical disabilities: you have to treat them in a special way, because they are, in fact, different. Perhaps you also have to talk to them in a special way, do they perceive things in the same way as normal people, do they suffer from declining mental faculties etc.

Such considerations may in a split second have gone through the GP´s head. She doesn’t want to act in a discriminatory way, but she may feel helpless, due to the lack of insight in a diversity discourse and, as part of this, a disability discourse. In summary, from the diversity perspective, the GP may react from lack of insight and thereby from a stereotyping, which may also be viewed as a specific variation of culturalisation.

A double shock

This incident represents, in fact a kind of double shock:

On the one hand, the shock is triggered by the lack of equal treatment and unpleasant exposure of the narrator´s disabilities and otherness. This seems all the stronger because disability is not at all relevant to the narrator´s consultation.

On the other hand, the shock is triggered by the lack of professionalism as well as the lack of professional empathy and perspective which makes the narrator uncomfortable, insecure and vulnerable as a patient. By her attitude, the GP brings the narrator out of her comfort and safety zone as a human being and as a patient. Probably, the GP´s reaction is an expression of her own insecurity and disorientation. However, this only reinforces the image of her lack of professionalism in the situation.

This would leave the narrator with the principle question: how can you trust a healthcare system where the professionals are unable to comply with basic professional principles and values in terms of professional medical attitudes and in terms of general human rights and equality requirements.

In summary:

It is obviously that no matter what may underly the GP´s behaviour, in the situation she doesn’t meet the professional requirements for medical practice in a diverse society, where the concept of diversity  is closely related to the concepts of equality and discrimination. Thus, the concept of diversity embraces a range of illegal discrimination areas, including disability.

The situation is also an illustrative example that we cannot limit our intercultural conceptual framework for intercultural misunderstandings to ethnicity. Culture in this context is a broader term that rather goes hand in hand with discrimination against people who are different from the so called normativity of the majority population.

Consequently, intercultural training must include and articulate the broad concept of diversity, referring to a wide range of exclusion mechanisms.