Equity, diversity, and inclusivity do not exist for all.

The College is working to improve its understanding of these issues by learning about equity, diversity, and inclusivity (EDI) and by critical self reflection of our processes. Our governing Council is comprised of elected physician members and has the addition of five government appointed public members. While we can encourage diversity and inclusivity our system does not allow for specific selection of physician Councilors. Despite this we are fortunate that our Councilors (physician and public) are diverse in age, gender, and ethnicity. We benefit from this diversity.

Anti-Indigenous Racism

Council and College staff have been learning about anti-Indigenous racism through the excellent resources from the Office of the Treaty Commissioner. Mr. Burton O’Soup is an appointed public member of the Council, and he is the Chair of the CPSS Truth and Reconciliation Committee.  Mr. O’Soup is also a member of The Key First Nation.

We have adopted as foundational documents the Truth and Reconciliation: Calls to Action, the United Nations Declaration on the Rights of Indigenous Peoples, and Joyce’s Principle. A land acknowledgement is part of Council and committee meetings and we have developed a commitment statement that has been approved to send out for feedback from our Indigenous partners.

The College is aware of the work completed in British Columbia with the In Plain Sight report that casts a critical eye on the state of anti-Indigenous racism in Healthcare in British Columbia. We do not think the experiences of Indigenous people is any different in Saskatchewan. Systemic racism exists here as it does elsewhere in Canada, and physicians are part of this system. We are exploring what we, as a regulator, can do to support the changes that are needed.

We have set the course to look at our processes to examine how they may discriminate so that we may make improvements to counter this. There are criticisms of a racist healthcare system, yet we do not often receive formal complaints from Indigenous persons. Anecdotally, we know they are not happy with their healthcare. Why do they not inform us of their concerns? Is it because of the requirement to register a written complaint? Is it because they do not know where to register a concern? Is it because they feel we will do nothing with their concern? We are taking a critical look at the barriers that may be faced by an Indigenous person in registering a concern/complaint. We are also building relationships so that Indigenous knowledge from the knowledge keepers and the Elders can help guide us in transforming our processes to be more culturally aware and welcoming. You will find another excellent article from Elder Willie Ermine in this issue of Doctalk.

Anti-Black Racism

Discrimination and racism are widespread. We know discrimination and racism affects Indigenous people, but Black physicians in Saskatchewan have raised their concerns as well. In response to these concerns, Council has constituted the Diversity and Bias Committee. Dr. Oladapo Mabadeje, a physician Councilor, chairs this group. We are also working with the SMA’s EDI committee to develop a survey that will hopefully lead to a clearer understanding of the specifics of the racism that exists, so the actions taken to combat racism can be specific and appropriately directed. As a protector of the public, we are aware of the reports of racism against patients. However, we know our providers are subject to racist and discriminatory behaviour as well. We hope we might have the survey completed and distributed late this year. When it becomes available, please take the time to inform us with your answers, as it will assist in directing our efforts to combat racism and/or discriminatory practices.

We hope that, as we gain knowledge in anti-Indigenous and anti-Black racism, we can use the lessons learned to address other forms of racism or discrimination that patients and providers might experience. We recommend that physicians learn as much as possible about anti-Indigenous racism and anti-Black racism, starting with understanding your own biases. There are many excellent resources to help you in your journey of understanding. The Harvard reference for Implicit Bias is a good start to understanding your inherent or unconscious biases.

Resources

There are excellent courses offered through the U of S College of Medicine CME Department and the College of Nursing on anti-Indigenous racism specific to the Saskatchewan Indigenous population. The following foundational documents, Truth and Reconciliation Commission of Canada: Calls to Action, United Nations Declaration of Indigenous Rights (UNDRIP), Joyce’s Principle and the In Plain Sight report are all helpful to gaining knowledge and perspective in understanding the challenges. The Office of the Treaty Commissioner also has highly informative videos.

Resources to assist your understanding of anti-Black racism can be accessed at Black Health Alliance. A reading list issued by the University of Toronto Scarborough (UTSC) library for its students provides basic anti-Black racism reading.

Act with a Trauma-informed Approach

Self reflect and take the initiative to challenge the current state. Stop and think about your words, your body language, and your actions. Remember inaction is an action.

Taking a trauma-informed approach to care ensures the patient’s physical and emotional safety. Do not ask “What is wrong with the patient;” rather ask, “What has happened to this patient?” This trauma-informed approach will keep the patient emotionally and physically safe and it will also decrease the risk of the provider unknowingly re-traumatizing the patient.

The Saskatchewan Health Authority has been offering trauma-informed training to its staff and to physicians. We applaud their efforts and encourage physicians to seek additional resources on trauma-informed care at the Institute on Trauma and Trauma-Informed Care.

Rebranding

We are aware that elements of our current College seal that serves as a logo on our letterhead and other documents are of historic significance, but several of the elements of the seal are constant reminders of colonialism, which is offensive to many. Part of the College’s work over the past few months has been to engage with a graphic designer to rebrand the CPSS and modernize the College logo. We have partnered with the designer to develop something that will identify the College as a medical regulator in Saskatchewan. We look forward to sharing this fresh look with you soon.

What we have accomplished so far feel like small steps – however we hope that they are steps towards a better future of equity, diversity, and inclusivity for all of us. If you would like to assist with these efforts, please do not hesitate to contact the College by emailing us at OfficeoftheRegistrar@cps.sk.ca.

Respectfully submitted,

Karen Shaw