Some healthcare systems are addressing patient biases with zero-tolerance policies, but not all physicians are on board.
Cleveland Francis, MD, diversity, equity and inclusion adviser at Falls Church, Va.-based Inova Heart and Vascular Institute, shared his experience with racial bias in a Medscape blog post published in December. During his second year of medical school, Dr. Francis, who is Black, had an experience where his patient requested a white physician. Dr. Francis wrote that he remembers feeling hurt and embarrassed, and that every patient encounter from then on was tainted by a fear of rejection based on patient bias.
Some hospitals, including Boston-based Mass General Brigham and Rochester, Minn.-based Mayo Clinic, have created patient codes of conduct that aim to help curb patient bias based on race, gender, body size, accent, age or other such factors. But Dr. Francis argued that policies are not enough. He called for procedures that discourage and mitigate the effects of patient bias on clinicians, starting with a clear definition of what a bias incident is.
However, not all physicians agree with Dr. Francis' approach. Clinicians shared their thoughts on patient bias and choice of medical professionals in the comment section of his piece.
Note: Comments have been lightly edited for length and clarity. Names listed are the usernames appearing in the comment section, which is an open forum on Medscape.
Dr. Denis Franklin: It makes me sad that Doctor Francis has had to suffer such indignities. However, I suggest that [the article's] main defect is that it defines a problem that has at least a thousand variations, many extremely valid, and suggests a one-size-fits-all solution based upon the narrow circumstances of his own experience. Except in the case of an emergency, no physician was required to accept any patient he or she did not, for ANY reason, wish to treat. It was also true that no patient was required to accept treatment from a physician he or she did not wish to engage. These were good and useful rules and to discard them would, in my view, be a big mistake.
Dr. Mark Jackson: We could outlaw ignorance or being a jerk and if we could do that, we could also outlaw my favorite...stupidity. Having said that, I agree that we shouldn't have to stand for blatant abuse from people who decided to become a patient that day. I require those patients, no matter how sick they are to, at minimum, conduct themselves with mutual respect.
Anne Turner: In my charge nurse days, I rarely saw overt racism but frequently had to deal with sexism; patients who had no issue with a male physician who got all up in their personal business, but no one else on the healthcare team could be male. So "strange men can't touch me, unless it's a physician." I've also had it happen twice that a male patient asked for their female doctor to be changed to a male, but they had no problem with female nurses touching them. My point is...is there no line to be drawn on this nonsense? And their demands affect the rights of others. What about the patient who adores the nurse they've had for the last several shifts, but must lose her because she has to trade with the male nurse to meet another patient's gender stereotypes? Don't others have rights, too? Now, if a request for change was substantive (poor communication, perceived incompetence, trauma history, etc.), I would move mountains to accommodate it, but the belief in honoring patient preference doesn't necessarily need to include rearranging the world in order to accommodate racism, sexism, etc.