How Doctors Deal with Racist Patients

Sumathi Reddy, Wall Street Journal, January 23, 2018

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“I’ve had patients request reassignments since I was an intern,” Dr. Sutton-Ramsey says. He says he’s been called the N-word way more at work than out in the world. Patients have handed him trays when he walks into the room, assuming he’s there to clean it.

Patient discrimination against physicians and other health-care providers is an oft-ignored topic in a high-stress job where care always comes first. Experts say patients request another physician based on race, religion, gender, age and sexual orientation.

No government entity keeps track of such incidents. Neither do most hospitals. But more trainees and physicians are coming forward with stories and more hospitals and academic institutions are trying to address the issue with new guidelines and policies.

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Penn State College of Medicine adopted language into its patient rights policy in May that says patient requests for providers based on gender, race, ethnicity or sexual orientation won’t be honored. It adds that some requests based on gender will be evaluated on a case-by-case basis.

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At the University of Chicago Medicine, Elizabeth Blair, a professor of surgery, is working on a simulation program that would help train medical professionals on how to respond to scenarios where patients discriminate.

And at Stanford, a pediatrician published a paper in 2016 in the journal Academic Medicine that outlined strategies to address patient and family discrimination toward trainees.

The four-step process includes assessing the illness of the patient, developing a rapport with the patient and family, depersonalizing the event and maintaining a safe learning environment.

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Dr. Paul-Emile, an associate professor at Fordham University School of Law, published a piece that appeared in the New England Journal of Medicine in 2016 called “Dealing with Racist Patients.”

Dr. Paul-Emile calls patient requests for a doctor of a different race or ethnicity “one of medicine’s open secrets,” but says hospitals are starting to pay more attention to the problem.

Patients have the legal right to informed consent, which includes the right to refuse medical treatment. That does not include the right to be treated by a particular physician.

Physicians face the moral and ethical obligation to treat all patients, but the 1964 Civil Rights Act also protects employees from experiencing overt discrimination. That physicians aren’t being discriminated against by their institutions complicates matters. “So it manifests more as a hostile work environment claim if it were to be brought,” Dr. Paul-Emile says.

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