Researchers: Yael Keshet¹, Ariela Popper-Giveon²

Background: The ethos of neutrality in medicine promotes professional integration of ethnic minorities and thus reduces disparities in health care, although it also masks and represses tensions and racist acts that ought to be addressed.

Objectives: Evaluating strategies for coping with ethnic tensions and the relevant policies from the point of view of Jewish and Arab administrators, physicians and nurses at public hospitals in Israel; determining patients’ opinions and feelings concerning this issue.

Method: Fifty in-depth interviews were held with medical staff members at 11 public hospitals and a survey was conducted (N=760) to determine patients’ opinions.

Findings: The interviews showed that alongside integration and professional work relations, tension and racism between Jews and Arabs were detected in ethnically mixed staffs, in relations with the administration and in patient-practitioner relations. Lacking clear policies, professionals apply ad hoc solutions. The survey revealed that most patients appreciate physicians and nurses of the other ethnic group, although 30% preferred a doctor from their own group. Certain factors were found to be associated with and predict such preference.

Conclusions: The lack of official policy on the part of the Ministry of Health and most hospital administrations delegates coping to professionals in the departments. This situation exacerbates pressure on the lower-echelon teams and cannot always ensure appropriate response to tension-laden incidents.

Recommendations: Clear, uniform and written policies are required regarding issues such as refusal to be treated by professionals of the other ethnic group, separate wards for different ethnic groups, language of communication in the organization and staff political opinions expressed in social media. Proposed recommendations include establishment of a special commission at each hospital to deal with manifestations of racism.

Research end date: 11/2018