Patient discrimination: 4 ways docs can respond

Women doctors

An incident in the emergency department led a group of Stanford University School of Medicine doctors to identify strategies for residents and physicians to respond to discrimination from patients and families.

An intern on rotation in the ER was asked by the father of a little boy whether her last name was Jewish. When she told him it was not and asked why it mattered, the man said if she was Jewish, he did not want her treating his son.

When she learned about the incident, Emily Whitgob, M.D., was appalled and after hearing other stories of bias and discrimination from patients directed at residents because of gender, religion and race, she decided to explore ways to prepare doctors-in-training to handle such incidents, according to Scope, a Stanford Medicine blog.

Results were published in a study in Academic Medicine that concluded physicians must be prepared to deal with discrimination. “We can’t prevent it, but we have to be prepared for it. That’s the big goal: Start talking about it and let trainees know this will very likely happen. Here’s who you talk to when it happens. Please don’t keep it to yourself,” Whitgob told Scope.

The study advises medical trainees to focus on their role as doctors by not taking hostile comments personally and countering patients’ anxieties with empathy. In interviews with 13 faculty members who participated in the study, they recommended doctors take four actions:

  • Assess the medical needs of the patient. If an immediate medical intervention is necessary, doctors should ignore or avoid responding to the discriminatory remark.
  • Cultivate a therapeutic alliance. Discrimination is often motivated by a patient’s fears and doctors can empathize with the patient and draw attention to the shared goal of addressing immediate health needs.
  • Depersonalize the event. Don’t take comments personally and keep in mind you are there to provide medical care.
  • Ensure a safe learning environment for medical trainees. The medical team can provide support to trainees to counteract the potential harmful effects of discrimination.