How to handle a racist patient?

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Unfortunately, most doctors will encounter patients who make racist comments. Ingrid Torjesen discovers how to manage them

Everyone has a role to play in the fight against racist behavior

Mark Swindells, deputy director, standards and ethics, at the General Medical Council, says: The GMC condemns racism against staff in healthcare settings. It’s not acceptable, but we know it still happens: 76% of respondents to this year’s BMA Racism in Medicine survey said they had experienced it in the past two years.

We have created a resource dedicated to addressing racism in the workplace as part of our Ethics Hub web pages. Its goal is to support people who experience discrimination, as well as bystanders, employers and medical leaders.

You don’t have to be the object of racist behavior to deal with it. In non-emergency situations, you can speak up and tackle the person exhibiting the behavior. Alternatively, if you don’t think you can take action right now, log the incident as soon as possible.

In an emergency context, it was clear that patients need to be treated, but their behavior can be monitored afterwards.

If possible, talking to the patient’s context is vitally important. Sometimes they may not know that certain words and actions can be offensive. If this is not possible, work with colleagues on how to proceed, such as ensuring that you are not responsible for the continued care of the patient.

If a patient refuses to be seen by you or a colleague because of their ethnic origin, this may amount to them refusing to be seen by your service. We advise you to discuss with the patient the possible consequences of refusing treatment and familiarize yourself with the policies for transferring care to other providers.

Above all, it is important to recognize that everyone has a role to play in combating racist behavior in the workplace.

Employers must take all reasonable steps to protect you

Phoebe Owens, East Midlands Co-Chair of the BMA Forum for Racial and Ethnic Equality and Specialist Registrar for Rehabilitation Medicine, says: For many of us, how to deal with a racist patient is not an academic question. Two in five doctors (41%) who responded to this year’s BMA Racism in Medicine survey said they had received derogatory comments from patients about their ethnicity, country of origin, heritage, their name or accent.

I remember one particular incident while I was on a night shift as a patient clerk who said, I don’t believe him at all. The doctors a bloody black bastard. I was 18 weeks pregnant with twins and felt completely helpless.

We shouldn’t tolerate racial abuse at work and the BMA has published some fantastic advice on dealing with discrimination in the workplace. I want to emphasize two things:

Your Employer’s Responsibility Our workplaces have a duty to take all reasonable steps to protect employees from harassment or abuse. Failure to do so could put them in breach of the Equality Act 2010

Your response as an employee record all racism events and discuss them with your elders. Think about how you would like your employer to handle the situation and let them know. If no changes are made, contact the BMA for advice regarding a formal complaint.

If a patient is verbally or physically abusive, your safety is paramount. You can ask them to leave or let them know that they may need to change their behavior if they want to stay. Seek backup from on-site security if necessary.

You are not alone and we should not rest until workplace racism is an event. You can contact the BMA with your concerns by calling 0300 123 123 or emailing [email protected].

Be clear, factual and specific

Hannah Chandisingh, Head of Inclusion and Engagement at University Hospitals of Morecambe Bay NHS Foundation Trust, says: If you are asked to support a colleague who has experienced racist behavior from a patient, start with a statement that the patient cannot disagree with, I can see you feeling uncomfortable and would like to make sure that we help you this morning so that you can go home with your family.

Be factual and specific about the incident. Rather than describing the behavior with a judgmental word like offensive or racist, repeat their words back to them. Mr. Smith, you yelled at Dr. Patil not to touch you, and you say you want a white doctor. This can help avoid hostility or escalation, especially in healthcare settings where security is critical.

Explain what you think of the incident. I am upset to hear this because Dr. Patil deserves to be treated with respect.

Talk about the consequences If you insist on a white doctor, you could have a long wait and you may have to go elsewhere for specialist care. Many of our best clinicians come from all over the world. Some providers will also refuse care after a second incident of racist behavior.

Set your expectations and use their name “Mr. Smith, in order for you to receive the care you need today, you will need to be respectful of hospital staff.

Explain the positive effects “That means we can give you the best care, from the most skilled clinicians, and we can get you home and healthy as quickly as possible.

Always be sure to report the incident afterwards and get help for yourself if you need it.

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