Physicians Are Talking About…

Dealing With Racist or Sexist Patients

Brandon Cohen

Disclosures

February 02, 2018

Many doctors face racism and sexism from patients. A recent article by Dr Seema Yasmin, "When Patients Discriminate Against Doctors: A Muslim Physician Weighs In," highlighted this problem and prompted a spate of observations and recollections from a variety of medical professionals.

Quite a few doctors reported personal experience with prejudice from patients.

Many advocated forbearance. A plastic surgeon wrote:

It is an everyday situation for me as a Muslim Arab doctor working in the emergency department . . . I do my job with a smile, trying to ignore the offensive language and swearing. The only relief is that you're a better person: a doctor with a big heart.

A primary care physician added, "You learn to deal with it . . . just move on to the next patient who might be so pleasant that the sun shines again."

Some sought to understand these ugly attitudes. One healthcare professional wrote:

Many times the unreasonable demands of patients (and colleagues) can result from fear and anxiety . . . Firmness, respect and a sense of humor can overcome those fears and patients' apparent sexism and racism.

A family therapist also tried to put the bigotry of patients in context, saying, "Try to understand that when people come to seek medical help from you, they bring their prejudices with them, but they also bring fear."

A surgeon was optimistic that bigotry could be conquered by competence:

The blackness of my skin and my accent became a moot subject. If [patients] had prejudices, and I am sure some did, those prejudices became irrelevant in the great scheme of things and I did not go looking for them or shove them in their faces. Give people a chance, whether they are doctors or patients. Before you decide in your own mind that they are racists, despicables, liberals, Trumpists or whatever, give them a chance.

But a registered nurse was less forgiving:

This entitled behavior by those who seek that help should not be tolerated. You don't want to see our doctor due to race, gender, or any other trait that he or she cannot help, that is your choice. Most times you can go home and wait to see your regular provider anyway.

A psychiatrist agreed and added:

Unless their capacity to make decisions is diminished by their illness (and even that doesn't necessarily give a person a free ride to say just anything), then a useful thing about hospitals is that they are full of exit signs.

Many others shared this take-it-or-leave-it attitude. One pediatrician explained her usual policy:

If the situation is not urgent, then sure, you can completely reschedule your appointment. It may or may not be within the same hour or day (depending on the season) but that is up to you. I move on to the next patient . . . If it is urgent, then my first responsibility is to the care of the child.

A radiologist used much the same method but then discussed another surprising source of trouble:

Unless their mental faculties are gone, I simply call them on it and give them a choice: you are free to stay and be treated, or you are free to leave. Simple! But should you stay, you must cooperate. The patient has duties too, not only rights! In any case, prejudice from colleagues is worse, since they are supposed to have your back.

A psychiatrist described racism from colleagues: "I have sat next to colleagues at medical conferences only to have them abruptly and dramatically remove their electronic devices or purses from my reach."

Another psychiatrist feared that these accounts were a harbinger of destructive forces in general, saying, "Such stories are becoming more, rather than less, common. Where are we—not just the medical profession but humanity—heading? Back to tribalism writ large, I'm afraid."

And a primary care practitioner felt that proactive steps needed to be taken:

We need to model, teach and require appropriate respect for people of all demographic groups by visibly and vocally supporting our health providers when they are the focus of discrimination or any other form of ill treatment or abuse . . . We need to make it clear to our patients that healthcare providers of varied colors and ethnicities are valued members of the healthcare community who can count on their colleagues and supervisors to have their backs!

But there were some who saw all discussion of prejudice as simply political posturing. An administrator wrote:

The idea that a medical professional would need a safe space to deal with patient bias is reflective of either having led a very sheltered life and/or being a recent product of one of the many leftist-controlled institutions of higher education, with their emphasis on all things deemed to be racially and ethnically insensitive.

A physician assistant agreed and wielded the authority of aggressive punctuation: "Liberal propaganda!! Your little chance to assert your passive aggressive statements . . . Boo hoo for you."

But the last word goes to a psychiatrist:

I am an African American woman. When I was a resident, a patient asked me if I knew anyone I could recommend as a housekeeper . . . Racism is something I encounter on a daily basis. There is a tendency to minimize the impact of these events on people who experience them from those who rarely if ever face this kind of discrimination. In many cases there is a learned helplessness that occurs to anesthetize oneself from the bitterness that follows such encounters.

The full discussion of this topic is available here.

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