Racial bias goes much deeper than medical aids, say black specialists

Apparent racial bias in private medicine, similar to that exposed in the medical aid industry recently, is hitting black medical specialists in the pocket by forcing them out of the suburbs and affluent areas.

Three specialists spoke to The Citizen about supposedly being blackballed by hospital groups, which are allegedly reserving practice opportunities for white specialists when it comes to facilities in affluent areas, relegating black specialists to scant growth opportunities in far-flung areas, away from their homes.

Recently, Dr Coceka Mfundisi – a specialist neurosurgeon in Johannesburg – said for the longest time she struggled to find opportunities for admittance rights closer to Johannesburg’s northern suburbs where she resides. This, not because of space not being available, but because those opportunities would almost always end up being given to a white specialist.

Mfundisi took to Twitter to call out the three major hospital groups – Netcare, Life Hospitals, and Mediclinic – for perpetuating and allowing this practice.

I have told you about a hospital on my doorstep where I have been denied admitting rights despite the fact that they need a neurosurgeon.

I have also told you that as black specialists-especially those of us who are known to be vocal against discrimination are denied practice

— Coceka Mfundisi (@Cmfundisi) January 19, 2021

“What you will find is that these hospital groups will only let you practise in any of their peripheral hospitals. I was once offered opportunities in Randfontein or Vereeniging, which is quite far from where I live and is an area that I’m not interested in.

“They had also approached us, sending their recruiters and we would tell them where we wanted to practise. That is the area in which we live currently or where we look to live in the future. But if you look at where there is a high LSM group, where the practice growth prospects are very high, they will not give you any opportunity there,” she said.

A widespread problem

Two other doctors have since spoken to The Citizen, but requested anonymity, stating that they, like many other black specialists, were afraid of ruining the little opportunity they felt they had for a successful career.

A specialist surgeon practising in Port Elizabeth was one of only three black specialists in town in his field. He said he was disappointed when he was told by the manager of a busy Life Hospital facility that there was no space, only for two vacancies to open up which were later to be filled by two male, white specialists.

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He believes there is little desire or business incentive for private hospital groups to commit to transformation and give equal opportunities to black doctors. These hospital groups appeared to see nothing wrong with a hospital almost entirely manned by white specialists and managers, he lamented.

His gripe, however, is not just with hospital groups that are failing to transform, but with anti-black attitudes even adopted by black colleagues and patients.

“We can understand that hospital groups should be cognisant and make sure that different people are represented and they should be held to account for that. I know that in these hospital groups there are even black hospital managers who are refusing to allow black specialists to come and join them, purely on a business agenda.

“You will meet a patient that will exclaim when they see you in a suburban hospital, because they are surprised that you work there. It shows you that this attitude is right across the board. These people I am talking about are the same ones who refuse to go to ‘black’ hospitals in the outskirts because they hold the same attitude.”

Things are beginning to change

A 35-year-old ear, nose and throat (ENT) specialist in Johannesburg said though people tend to question the credentials of black specialists, things were beginning to change, at least on the part of the patients.

“There is an interesting phenomenon taking place in the urban areas now, where patients are specifically asking to see black doctors. That is encouraging for us. In terms of the managers, what happens with black managers most of the time is they are entering into a system of white dominance and they are entering a boardroom of people who are not really receptive to conversations about transformation.

“What they end up doing is falling in with the agenda. It’s not like there is a force behind them. There is a certain individuality that goes with being able to get into those positions and you really don’t want to jeopardise your executive salary over an attempt to get another black doctor into the system.”

Long before she qualified as an ENT specialist, she anticipated difficulties getting into the private sector purely because the field was relatively small and low in demand.

Asking around for opportunities, she found that not only was it “tough to get in”, but it was even harder if you were not white. Access to social capital is paramount in such professions, from where one was trained to where one ended up setting up practice.

“You would mostly find that our white colleagues would already have someone perhaps in management speaking on their behalf. There is always some form of network that if you’re not in, then you can’t access these opportunities.”

From 2015, when she qualified, she, like Mfundisi, was constantly turned away only to be told to try somewhere in the outskirts of the city. These areas, however, not only hold little growth prospects and earning potential for specialists, but most patients do not have medical aid, can’t afford market-related rates charged in the suburbs, and black specialists feel compelled to join medical aid networks. Outside of these networks, it is difficult to survive, but inside of them, black specialists are also being blackballed, according to a recent report.

‘Zero tolerance for racism’

The three hospital groups were queried on these concerns, but only Netcare responded after several days. The group’s head of human resources and transformation, Nceba Ndzwayiba, said the group distanced itself from any behaviour perpetuating racial bias at its hospitals.

“At Netcare we view ourselves as an integral part of transforming South Africa. We are fully committed to playing a pivotal role in helping to normalise our society, our economy as well as ensuring diversity and inclusivity in our staff complement, procurement and associated service providers and specialists. We at all times support human dignity, equality and fairness.

“We distance ourselves from and condemn any form of racial discrimination. We expect our colleagues to uphold our values and the highest standards of behaviour where the dignity of all individuals is respected and safeguarded at all times,” said Ndzwayiba, who pointed out that the Netcare Group had a zero-tolerance approach to any form of unfair discrimination and took a firm stance against racism.

“As at the end of 2020, 48% of doctors with admission privileges within Netcare hospitals were African, Indian and Coloured (ACI). This figure has risen steadily in recent years from 24% in 2011 to 46% in 2019. Of the 107 doctors granted admission privileges in 2020, 72% are ACI doctors.

“Our hospitals continue to provide enterprise development support to many newly qualified doctors. In addition, we sponsor 10 to 15 registrars every year and 60% of the individuals sponsored are of colour.”

simnikiweh@citizen.co.za

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