STOCKHOLM— A Swedish healthcare reform more than a
decade ago allowing patients to choose their own doctor has unexpectedly led to
widespread discrimination against medics with foreign-sounding names.
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"When I was working in psychiatry, a patient cancelled
his appointment with me three times because he didn't want to be treated by a
'foreign doctor'," 30-year-old practitioner Navid Ghan told AFP.
"In the end he didn't have any choice, I was the only
doctor available. During the appointment, even though he saw that I spoke
Swedish without an accent, he told me 'you foreigners, you don't understand
anything'," Ghan said.
Ghan, whose name has been changed at his request to protect
his identity, is not even a 'foreigner': He was raised and earned his medical
degree in Sweden.
"Now my colleagues and I joke about it in the lunch
room. The nurses arrive and say 'they cancelled again when they saw your
name'."
Since 2010, as part of a broader reform to Sweden's
universal healthcare system that opened up primary healthcare to private
actors, patients have been allowed to choose their own doctor and clinic.
Prior to the reform, Swedes were assigned a clinic based on
where they lived.
But as tensions smolder over rising immigration in
traditionally homogeneous Sweden, the reform has made it possible for patients
to refuse to be treated by non-ethnic Swedes.
Sweden has seen its
immigrant population double in the past
two decades, statistics show, and support for the far-right Sweden Democrats
has surged to 20 percent to make it the third-biggest party.
'Fair-skinned'
Lars Arrhenius is the head of Sweden's Equality Ombudsman, a
government agency that promotes equal rights and combats discrimination.
He said that choosing a doctor based on ethnicity is a
"worrying development".
At the end of March, 1,011 doctors and medical students
signed an appeal in daily newspaper Expressen calling on "the responsible
authorities to act against racism" in their field.
In July, the country's largest broadsheet Dagens Nyheter
published an investigative series exposing the scope of the problem.
Journalists posing as patients who had recently moved to a
new city or town called 120 healthcare clinics and asked that their new doctor
be an ethnic Swede.
A total of 51 clinics agreed to the request, 40 refused.
Only a handful explicitly said the request was unacceptable.
"We have Maria, Sanna, and Elsa. Three fair-skinned
women," one medical secretary told a journalist.
Gender Equality Minister Marta Stenevi, whose brief includes
the fight against discrimination, told AFP the practice was "totally
unacceptable", after meeting various actors in the healthcare sector to
address the issue.
The head of the Swedish Junior Doctors' Association,
Madeleine Liljegren, said clinics often consented to the requests because of
"competition between healthcare clinics over patients."
The more patients a clinic has, the more state funding it
gets.
Lack of support
"The nurses likely think 'I'll agree to their request'
— as shocking and horrible as it is — just to keep the patient," said
Liljegren, noting that some clinics do not have enough patients to stay afloat
financially.
Makih Fatelahi, a hospital doctor in the southern Swedish
county of Kronoberg whose name has also been changed, says some patients are
concerned about communication issues.
"The problem is that they only see your name when the
appointment is made. You don't get a chance to establish an in-person contact
before you get rejected," the 28-year-old tells told AFP.
The number of cases of discrimination against doctors of
foreign origin is not known.
In 2020, more than 3,500 general discrimination complaints
were filed to the Equality Ombudsman, 1,146 of which concerned "ethnicity".
Sweden's health care system relies heavily on immigrant
workers, who are often employed as nursing assistants. In 2020, 2,401 doctors
received medical licenses in Sweden, almost half of whom earned their degrees
abroad.
Navid Ghan said he does not feel supported by his superiors,
even though they have seen the discrimination he has faced.
Many doctors with foreign names complain about a lack of
internal procedures at their workplaces for how to respond in such
situations.
"You end up not paying any attention to (the
discrimination). I use an algorithm to not let my emotions get the better of
me: Does this patient really need my help? If yes, I take care of the patient
and ignore the comments. If not, I ask a colleague to take my place," Ghan
said.
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