The COVID-19 pandemic has spurred an alarming jump in racial descrimination and violence against Asian Americans that physicians must address by tailoring their care practices, James Lee, MD, wrote in a commentary published in The New England Journal of Medicine.
Dr. Lee, a psychiatry resident at the University of Washington in Seattle, cited research from Pew showing 58 percent of Asian Americans believe this racism has increased since the pandemic started. Thirty-one percent reported being subjected to racist jokes or slurs, and 26 percent said they've feared being threatened or attacked in the last year. As a result, many Asian Americans have experienced substantial distress amid an already challenging year of social isolation and financial hardship amid the pandemic.
"Physicians can tailor their practices to meet this moment by creating a welcoming environment" for their Asian American patients and "identifying symptoms that stem from living in a racist environment," Dr. Lee wrote.
Below are three ways clinicians can combat anti-Asian sentiments and ensure Asian American patients feel safe.
1. Create a safe physical space for patients and staff. Since hate crimes can occur anywhere, some Asian American patients could feel unsafe or uncomfortable in healthcare settings, according to Dr. Lee. He said healthcare facilities can make simple changes such as displaying information pamphlets in other languages and putting up signs that translators are available to make patients feel more comfortable and welcome.
Creating a safe space for Asian Americans also means protecting Asian-American healthcare workers, Dr. Lee said. Organizations should implement cultural competency training — coupled with bystander intervention and crisis deescalation training — to empower healthcare workers to effectively respond to descrimniation in the workplace.
2. Have open discussions with patients about racism during visits. Creating a safe healthcare environment for Asian Americans can open the door for physicians to speak openly about racism with their patients.
"I believe physicians should become comfortable asking whether patients have experienced racism — a question that could both signal that the physician is open to discussing race and reframe a conversation to permit consideration of the effects of racism on health," Dr. Lee said.
He added that clinicians can gently introduce the topic by asking whether Asian Americans feel safe in their homes or on public transit.
3. Connect patients to treatment and resources to reduce psychological strain. Patients who've experienced a hate crime or display symptoms linked to this racism should be connected to treatment.
"Physicians can prophylactically address harms from anti-Asian sentiment, in part, by connecting patients with resources that might not have been considered if the conversation were not directed toward race," Dr. Lee said.
These small changes will allow clinicians to capture diagnoses they might otherwise miss and to connect Asian American patients with resources essential to their well-being, thereby providing holistic care that accounts for patients’ lived experience of race, Dr. Lee said.
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