A lesbian couple in Winnipeg say a local doctor refused to treat them because of their sexual orientation.
Andrea Markowski and her partner Ginette recently moved to Winnipeg from Yellowknife and used a provincial hotline to find a physician who was accepting new patients. But when the couple went to the Lakewood Medical Centre to see Kamelia Elias, a doctor trained in Egypt, they ran into problems.
“My partner and I went together,” says Markowski. “I introduced myself. Then I introduced Ginette as my partner. From Dr Elias, first there was confusion, then there was discomfort.
“I don’t know why she would be confused. I was very open with the clinic when I spoke to them to book the appointment.”
Markowski says Elias seemed increasingly ill at ease.
“She tried to take my history but she was having a hard time,” says Markowski. “She couldn’t look at me. She started to ask me about my partner, about how long we’d been together, but I could tell from the way she was asking she didn’t want to ask. I asked her, ‘Do you have a problem with seeing us because of our sexual orientation?’
“She said, ‘Yes.’ She said, ‘It’s against my religion.’ At that point I was feeling very much as if I had been kicked in the stomach. I’ve never had any problems with doctors before.
“She also told us she’d never treated lesbians or gay people before. I told her she certainly had, they just wouldn’t have felt comfortable enough to be open with her. I told her she needed to get some help, that she needed to educate herself.”
Markowski says she and her partner were unable to speak to the clinic’s administrators. They decided to file complaints with the Manitoba College of Physicians and Surgeons (MCPS) and the Manitoba Human Rights Commission, as well as call the Winnipeg Free Press, to try to save other patients from going through the same experience.
“I became concerned for others, maybe young people, maybe a family in crisis,” she says. “She [Elias] could really damage somebody.”
Markowski says the couple also faxed a copy of the complaints to the Lakewood clinic after which they received a call from an administrator.
“She apologized on two counts,” she says. “First that the receptionist didn’t help us to contact her at the time. And then for us being assigned to Dr Elias. She said they knew Dr Elias had certain limitations and some patients might not be comfortable.
“They had this notion that they could vet out potential problems for Dr Elias.”
Elias told the Free Press that she had no experience with lesbians and that gays and lesbians sometimes have “sexual problems” and were more susceptible to disease.
“They get a lot of diseases and infections,” Elias told the paper. “I didn’t refuse to treat them, I said it’s better to find someone who has experience and will take this type of patients. There [are] some doctors who can treat them.”
A request from Xtra for an interview with Elias was referred to Thor Hansell, the lawyer for the Lakewood Medical Centre. Hansell sent Xtra a statement released by Terry Gwozdecki, the medical director of Lakewood.
“Dr Elias at no time refused to accept these women into her practice,” states Gwozdecki. “In fact, she interviewed them, collecting a long medical history for the sole purpose of accepting them into her practice. She was already aware, early into the interview, of their sexual orientation…. It was only when one of the two women became defensive when asked about their relationship and Dr Elias was pointedly asked if she had a problem with their relationship that Dr Elias felt it necessary to be up-front with regards to her own religious beliefs and inexperience in treating homosexual patients.
“Please understand that her inexperience stems not from unwillingness to treat these patients, but solely due to lack of exposure to them in her practices in Cairo, Egypt and Steinbach, Manitoba. Her religious beliefs do not prevent her from treating anyone in the gay or lesbian community, and her disclosure of her religious background was in the interest of being as honest and transparent as possible so that the patients themselves could decide if they wanted her as their physician.”
Gwozdecki also stressed that Elias was Christian.
Markowski says the couple has an appointment to see a doctor at another clinic, but felt it necessary to ask about possible homophobia beforehand.
“We asked if he would be receptive to seeing us,” she says. “They said he has other gay and lesbian patients. I don’t like to do that. I don’t think I should have to. I should be able to feel safe whichever doctor I see.”
Shelly Smith, the executive director of Winnipeg’s Rainbow Resource Centre, says such situations probably happen fairly regularly.
“I don’t think it’s an unusual occurrence,” she says. “I don’t think it’s reported very often but I had a call from another couple, two gay men, who said they’re going through the same thing with another doctor.”
Bill Pope, the registrar of the MCPS, says the complaint is new to the college.
“It’s the first time we’ve had a complaint about this issue,” he says. “I’m saddened by it but it might also be an opportunity.”
Pope says orientation training for international medical graduates has recently increased from one week to four.
Pope says the program is run by the University of Manitoba but that representatives of the MCPS are involved. He says Elias did not go through the training because she arrived in Manitoba five years ago.
“It’s unfair to an individual to expect them to fit right when the cultural mores are so different,” he says.
But Smith says she worries that such concerns allow Canadian-trained doctors to escape blame for their own ignorance.
“I think they’re scapegoating the immigrant/refugee/newcomer aspect of this,” she says. “This isn’t just a cultural issue.”
Smith says medical students at Manitoba’s one medical school at the University of Manitoba receive one session at the Resource Centre in their first year.
“We do one two-hour session for medical students and that’s it,” she says.
Gens Hellquist, the executive director of the Canadian Rainbow Health Coalition (CRHC), says the problem is Canada-wide.
“Unfortunately it’s very common across the country,” he says. “The medical profession gets very little training on our health issues.”
Hellquist says CRHC did a national survey on education in medical schools on queer health issues.
“We found many medical colleges didn’t even want to talk to us.”
Hellquist says the federal government has no national policy in place.
“Part of the problem is that Health Canada absolutely refuses to take a leadership position on queer health,” he says.
Pope says Manitoba’s medical school sets its own curriculum but that the MCPS has one of its policies that physicians cannot discriminate against patients on the basis on sexual orientation.
Similarly in Ontario the College of Physicians and Surgeons says that it has no requirements for doctors — either graduates of Ontario medical schools or immigrants — to take any sort of sensitivity training.
“We don’t set training requirements at all,” says Kathryn Clarke, the college’s senior communications coordinator. “The requirements are set by the medical schools.”
For international immigrants Clarke says the province has what she calls “bridging programs.”
“There are also programs that have been developed by the provincial government to familiarize doctors with the different cultures,” she says.
Clarke says the college does require doctors to follow the Ontario Human Rights Code and would investigate any complaints it received.
Smith says the lack of a proper educational system for queer health issues leaves many patients afraid.
“It’s very fear-based,” she says. “A lot of people are afraid of even disclosing their orientation. Without having proper education a lot of lesbians find the doctors feel their gynecological health isn’t as important. And when a gay men reveals his orientation almost inevitably the first question is about STIs [sexually transmitted infections].”
Hellquist says the problem is life-threatening.
“We get burned by the healthcare system so we avoid it, usually at the cost of our lives,” he says.