COMMENTARY

Racist Patients in Medical Training: How to Respond

Ashley M. McMullen, MD; Coauthor: Rosalyn E. Plotzker, MD, MPH

Disclosures

May 14, 2019

You are a newly minted first-year resident. You worked arduously through 4 years of college, 4 years of medical school, and maybe even more in between. This probably involved observing established physicians deftly navigate the patient-physician relationship. You learned the importance of truly earning a patient's trust, not just identifying their diagnosis. You learned that this trust is contingent on your ability to empathically communicate and connect with the individuals under your care.

Now, you are the physician, and it's time to meet your new patient. After introducing yourself, you hear something like the following:

  • "Oh. I saw your last name and wasn't expecting, well, you know…"

  • "Where are you really from?"

  • "Did you go to a good school?"

  • "When can I speak to the doctor?"

  • "I don't want you touching me!"

How Racist Patients Affect Trainees

If you are a trainee with a racial or ethnic minority background, you may know all too well the harsh sting of these comments from the very patients you swore an oath to help. If you are an ally, perhaps you have witnessed or heard about similar instances and grappled with how to be supportive. This problem is not unique to residents or physicians: Encounters with racist patients can occur with any healthcare provider. However, these experiences have a distinctive effect on medical trainee performance and self-esteem.

Residents and medical students face an intense pressure to perform. The perception is that we must demonstrate an air of confidence and competence relative to colleagues at the same level of training. Racially motivated questioning of your ability early in your career can sow long-lasting seeds of self-doubt and feelings of inadequacy. It is not unlike starting a race with your shoes tied together. Whether overt or implied, racism does not care whether you went to an Ivy League school, published in a high-impact journal, or can recite the latest iteration of hypertension guidelines by heart. No matter how much you prepare, these hurtful interactions reinforce stereotypes that suggest that the possibility for your success in medicine stops at the color of your skin.

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