The Doctor-Patient Relationship Works Both Ways
October 28, 2016
There has been a lot of attention given in the news lately to discrimination towards physicians. Most often our efforts go towards teaching physicians to avoid biases towards their patients, but a healthy doctor-patient relationship requires mutual respect from both sides.
Like patients, physicians come from a wide range of backgrounds, including race, gender, age, sexual orientation, religion, you name it. Though not a popular topic, much of the bullying physicians face comes from patients and families. In fact, a recent study showed that 40% of discrimination towards first-year residents comes from patients and their families.
Whether or not you’ve yet experienced discrimination as a medical student or resident, chances are you will. Here are a few ways physicians, institutions, and patients work towards eliminating discrimination towards physicians in the workplace.
What can you do?
As hurtful as discrimination can be from your fellow physicians, professors, or co-workers, it especially stings when coming from the very patients you are trying to help. In fact, Dr. Sarah Witgob of Stanford University School of Medicine recently conducted a comprehensive study to help physicians and institutions combat discrimination from patients in the doctor-patient relationship.
Based on interviews she conducted with physicians, the majority found that taking the high road and depersonalizing the event can help diminish the issue rather than perpetuate it. When a hurtful comment is said or a request for another physician is made, start by digging deeper to find the core reason behind the patient’s concern. Showing empathy rather than repute may not only diffuse tension in the moment, but it can help dispel stereotypes and prevent future issues.
Where can you turn?
For a young resident or medical student starting out, dealing with discrimination from patients can be overwhelming. At this stage in their career, they do not yet have the life experience or confidence in their work to be able to fend for themselves. This results in higher rates of depression, suicide, and dropout among students of color. Thus, it’s imperative for both schools and hospitals to have support systems in place, which address both emotional and practical needs in the workplace.
In her study, Dr. Witgob stresses the need for curriculums to equip medical students before these incidences occur, as well as have a place to turn for emotional support and advice. On a practical level, she also states, “Processes must be in place to ensure continuity of care for patients needing transfer when they refuse to be treated by the team.” Last but not least, institutions should lead by example in how they treat their employees, as this will often determine the health of all relationship dynamics within the system.
How else might you be at risk?
In addition to discrimination, physicians are often the victims of unwanted sexual advances or romantic come-ons by their patients. While doctors are usually given the blame because of their position of power, many times it’s the patient who crosses the line of what’s professional. Thus, it behooves physicians be aware of what constitutes professional behavior in the doctor-patient relationship.
Physicians more at risk for getting romantically involved are not what you would think. Typically, they tend to be older (without a supervisor), male (as female professionals are less likely to cross that line), and those in specialties with prolonged relationships with patients, such as primary care doctors. As with discrimination, it’s important to approach the situation calmly, yet resolutely. If a patient expresses a romantic interest, kindly decline the invitation explaining it violates the doctor-patient code of ethics. Then make sure you document the incident and how you handled it to combat any accusations that are made.
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