I saw your tweet yesterday Jack and spent the day really thinking about this, and how we treat black, brown, first nations, and other marginalized communities. The more I thought, the more came to mind..

In ICU, most of our interaction with patients is through their families 1/n https://twitter.com/iwashyna/status/1266386005847916546

How many times has a family been labelled "difficult" because they have questions, want frequent calls or meetings, and challenge our decisions? Similar actions from white families is often seen as patient advocacy and is promoted.. why? 2/n

Given the privileged positions we have as physicians (including those of us of color), we connect with white families. Maybe we live in the same neighborhoods, our kids go to the same schools, we frequent the same restaurants.. 3/n

Communication with black families happens differently than with white families. There is an understandable level of mistrust and skepticism they have of medicine. The history of this needs to be understood by physicians and acknowledged... 4/n

If a family doesn't speak English, do we put in the effort to ensure effective communication? Are we using translation services for daily updates? Even this week I'm guilty of skipping a couple of calls for patients with COVID because of the obstacle of language.. 5/n

The evidence that medicine is based on doesn't wholly reflect people of color. We know this in large realms like cardiac and renal disease but what else are we missing? How do we identify these misses and work to fix them? 6/n

This is a bit of a word jumble. But racism is prevalent in medicine. As a privileged person of color I'm guilty of lapses as well and I need to be better. Thank you for your tweet @iwashyna which made me think about this a bit more.