It’s time for doctors—from medical students to attending physicians—to no longer ignore racist, sexist and other inappropriate behavior from patients and family members.
The answer to such inappropriate behavior is simple: Call it out, writes Amy Nicole Cowan, M.D., an internal medicine doctor at the University of Utah in a perspective piece in JAMA Internal Medicine.
She recalls a recent incident when she was the attending physician, overseeing a team caring for an elderly patient who was just admitted to the hospital. The family made unrealistic demands, were disrespectful and at times outright hostile, she writes. They did not want to work with the medical student, who was a Muslim; with the intern, who they did not consider a real physician; with the senior resident, whose skin color was too dark; or with Cowan, who is a woman. Yet, no one did anything in response to the disrespectful behavior from the family, she says.
Doctors are too often stunned into inaction when they encounter a patient or family that behaves in an unexpected or outrageous manner, she says. Too often they smooth over interactions with excuses, such as a patient is from a different generation, is ignorant or stressed out being in the hospital.
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But Cowan says no longer. “After years of personal paralysis and of recognizing the same paralysis in my team members, I have started to teach boundary setting. On rounds, when others in the room are frozen by a patient’s or a family’s offensive behavior, I serve as a model by calling out the behavior,” she writes.
A recent survey found more than 1 in 4 doctors say they have been sexually harassed by a patient.
It's not always easy, but she is practicing the standard language she uses to confront such behavior with trainees and medical students.
“When we all practice on a regular basis by speaking up to the racial slurs, lewd comments and hate directed toward a person for their faith, skin tone or sexual orientation, only then will cultural change happen,” she says.
It’s not so unusual for doctors to take abuse at the hands of patients, including offensive remarks about gender, age, race and ethnicity, according to a 2017 study. Some 59% of doctors said they confront bias from patients.