Based on her article, How Should Organizations Support Trainees in the Face of Patient Bias?, published in the AMA Journal of Ethics®, Professor Kimani Paul-Emile provides her recommendations on how to assist colleagues during a real-time discrimination incident and to address discrimination organization-wide.
“Despite the startling statistics regarding patients’ treatment of trainees, data and overwhelming anecdotal evidence show that organizations are not adequately supporting their trainees in dealing with these abusive patient encounters. Indeed, 50% of surveyed residents who experienced or witnessed patient discrimination didn’t know how to respond, while 25% believed that nothing would be done if hospital leadership were notified,” Paul-Emile wrote, citing a 2016 study.
She suggests five protocols that together “constitute a clinically, ethically and legally appropriate means of supporting trainees while protecting the interests of patients and health care organizations.”
Assessment. When an incident occurs, a supervisor should immediately acknowledge the patient’s misconduct and determine whether the resident wishes to handle the situation on her own.
“If the trainee doesn’t, then the supervisor must intervene to inform the patient that the trainee is qualified to treat patients and that bigoted conduct will not be tolerated,” Paul-Emile wrote. “After conferencing with the trainee, it is imperative that, whatever is decided, the supervisor model appropriate behavior and not force the trainee to accede to the patient’s biased demands, as this may violate both employment and education anti-discrimination laws.”