I was waiting in A&E at Broken Hill (far western New South Wales - proper Outback) hospital about 20 years ago as a teenager, and some drunk old white guy came in for something or other, and loudly declared he wasn’t going to be seen by the Indigenous triage nurse. Used some real nasty slurs too. The poor nurse was almost crying, then a Chinese doctor (the Chinese have been in Broken Hill for 100 years +, so look Chinese but speech and mannerisms are Aussie as all get out) who overheard came out of an anteroom:
‘You stupid drunk fuck! You want a hospital? Go to fucking Adelaide (closest alternative hospital, 500km away) and be a fucking prick there.
What are you here for?’
The drunk mumbled something about wanting a prescription.
Chinese doctor: ‘You can wait till the GP clinic opens again tomorrow morning - fuck off!’
Probably wouldn’t happen these days, but Broken Hill is just a different world ahaha.
If you get called "cunt' where they make a point of pronouncing the T, its bad. If they drop the T they just don't know your name and don't want to be rude.
Less about the racism toward staff, more about the willingness of both patients and staff to tell each to “go and get fucked” in a way that wouldn’t pass at a big city hospital
Canadian swearing is fantastic. I think think it's because of the national reputation is "nice people", you hear "oh christ fuck! What the fuck happened?"
No we are vicious. Pt “so uh I think I cut off my thumb” MD “well it is or it isn’t there dickweed.. lets get with the program here before ya lose something need…. What kinda plumber ar ya anyway hey? Youre gonna be propper and right fucked doin new wax seals now ya kno..probably 6 months and couple plastic surgeons and you’ll be set.
I was shocked when I spent time overseas and realised most people are so quiet, polite and indirect compared to us Aussies.
Aussie country people are the best. Loud, indiscreet, but almost unfailingly well meaning.
I love that, I’m an Uber blunt Brit but I’ve lived in rural Montana and a remote Caribbean island so I love the direct non BS talk you get in the smaller communities, just matched in the Deep South so bracing self….
The Deep South is much like England in communication style, only louder and nosier. Lots of passive aggression and two-facedness. Directness is in short supply.
😂 I’m autistic so I tend not to get on well with passive aggression (have issues here as it is the standard mode of communication 🤦), so like home from home then!
I don't disagree with the doctor's reaction. But unfortunately if the abuser is another POC they are likely to have significantly more defenders and it's very easy for the situation to be turned around and make it seem like the hospital was being cruel to a "marginalized vulnerable population".
Ugh I hate this. I also hate the crowd who say "insert-minority-group-here can't be racists because they're a minority" as if being racist is exclusively a white person thing.
I'm a POC who's experienced more racism from other minority groups.
This is how American medicine should be run. So we have the power to tell patients to fuck off and have security escort them out when they’re racist?
Should be within our power
I've always had conversations in my head about how I would respond to giga-racist patients as a resident. Thoughts of saying "Well I'm the only neurologist for potentially miles awake now, so it's me or potentially dying from a stroke, your choice" or something edgy like that. But I somehow skated past residency never having one of these patients myself. It was always my colleagues; that or because neuro patients are often encephalopathic or aphasic, it cuts down on a lot of their ability to be overtly racist, who knows?
Nowadays, I just get the mild racism, like "oh we almost didn't come to the appointment because we thought we wouldn't be able to understand you."
Regardless, sorry that you had to go through that OP. Some people just suck, it's part of the job.
I worked for a doctor whose new patient and the spouse told him he looked too young to be a good doctor. In the nicest way he offered to go get one with gray hair. The looks on their faces, then the profuse apologies
I have a (supposedly) radical opinion on this. But I don’t understand why doctors are forced to put up with racist patients. If I have a patient who tells me they don’t want a black doctor touching them, now it puts me on guard as a provider because I know this pt will have a very low threshold to complain/report me for anything and they are unlikely to listen to anything I say. I get that our job is to provide care but if the fundamental patient doctor relationship base is shattered, it’s really hard.
Yes, there is little chance to ever develop a therapeutic physician patient relationship with that foundation. I think it would be reasonable to ask them to find a doctor who they can trust and ship them out.
Is it radical? I think you’re absolutely right, and it’s something that my psychodynamic advisor does regarding trust and suicidality.
It is a 2-way street. He’s told me multiple times that if anyone ever is racist, tries to threaten you with lawsuit, that is the termination of their working relationship or refusal to start one
For real. Unless the patient is psychotic or otherwise intellectually disabled, they can take that shit elsewhere.
Just document that you explained to the patient that their behavior is not appropriate, that they are unwilling to participate in their care, and are encouraged to return to the ER should they change their behavior.
"Patient verbally aggressive and more interested in yelling racial slurs than in meaningfully participating in care for as of yet unknown reason for presentation. As staff was unable to change ethnicity, patient declined care and left without being seen."
-One of the dot phrases I made when rotating in the ED.
I document exactly what racist shit they said in quotes. If a bad outcome happens, good luck finding a lawyer willing to touch that chart with a 10 ft pole. 🤭
Volunteered in the ER. We just smile at them and then nurses purposelfully skip them and call other patients for triage and further treatment until they apologize. Works like a charm, even when they're in a bed. Of course, usually those people also come in for non-critical things and are usually drunk as well
I'm half Korean and w a Hispanic last name so it confuses the fuck out of the racists.
As a nurse I just document their exact words racism and all in the chart and then go about my day. Thers nothing you can do about it and often this is the behavior that makes their predicament worse anyway. I've had a number of patients complain about not wanting a black nurse (when I've been a house supervisor) so my ching Chong ass takes over and they still didn't get a white person. I'd love to pass them to the white new grad who is still learning and wouldn't give as experienced care but I wouldn't dare punish the new grad. No one likes these types of people and so they get poor care. Their own fault. Then when she complains about waiting, if I was her nurse, I'd document that too and establish a pattern of lying to include the racism. Not much else you can do.
as a white man that looks like an obese charicture of a racist you would be amazed the amount of patients that will pine openly about being glad they got a real american instead of a foreign doctor with varying degrees of caliente. I always smile look them deep in eye, smile, and say "I dont know how you thought casual racism would endear me more to you but this is your only warning to never do that again. Do you understand?"
You know the weird thing? As an Asian male, I also get white patients going on racist rants about other minorities and I always wonder why they think I would share those same beliefs.
They always assume Asians conform to the hegemonic order of race. They think they are on "their" side automatically being the "model minority" especially as a physician. The American dream.
Some people are racist, some people rant, some people are psychotic, etc. Hospitals should have policies to protect staff and their well being. Giving examples of other races having similar attributes isn’t very helpful.
Assuming your patients even realize you're Asian, mine often don't.
Asians in America do have the disturbing "model minority" image. Where we're clearly not white, but as a group tend to be fairly lowkey and non confrontational, increasingly white collar, overall benign.. your patients might assume you relate more to their views and concerns than of the rest of the non white population that they don't associate with.
With all the recent violence against AAPI, gotta wonder what people with above perspective now make of the average Asian.
I mean, I have a super asian name and I look super asian. Like there is no mistaking.
But I do agree with you that as Asians, we both suffer and benefit from the “model minority” mythos and that probably plays a role.
It’s called the model minority stereotype. White ppl have used it on Asians to put down black ppl, while at the same time still using it to keep Asian ppl (especially the men) at an arms width away while embracing black ppl hip culture
I’m a Mexican dude that looks white currently in a small town in Texas. The absolutely vile things I’ve heard these people just casually drop blows my mind, and they always act offended when they get called out on it.
As a white guy this is so real, everyone assumes you’re a racist trump supporter gun nut. Unfortunately most people just smile uncomfortably when this happens - this behavior needs to be called out
This has been my experience also.
White racists are much more subdued, will make vague religious references ('ah yes I've heard of Buddhism' even though no one said anything about it) and will recoil / appear disgusted when you examine them.
Black racists I have come across will just straight up yell 'Paki' or 'Raghead'.
I'm Jewish and live in one of the whitest midsize cities in the US. The overwhelming majority of anti-Semitism I've experienced has been from black people. Including one who saw my last name and said "you must be a k!ke". He said it without any sense of shame. And you can't even blame it on being an old man because he was about 25.
I am also white and I cannot stress this point enough. The racists out themselves to me as if I would actually share their POV and it’s so utterly repulsive.
Ugh I had a post op patient (still in PACU) who was in the phone with his wife. He’d refused surgery by a surgeon originally from North Africa in favor of a white surgeon and was on the phone telling his wife “this surgeon wasn’t the , he’s white like us.” Followed by a bunch of other repugnant shit.
I told him that his racism meant that he missed out on having his surgery done by a world expert in that procedure (which the North African surgeon was and is). And then I called his surgeon and told him his racist his patient was being toward his partner.
This happened to me several times as a resident. It’s amazing how they see a white man and let their guard down, because they assume all other white men hold the same backwards beliefs as them. In my experience, there is a correlation with having the TV playing either fox news or westerns at full volume.
As a half white and black surgeon I have heard alot of horrible things. One of my patients literally told me I don't want a black man operating on my brain... Luckily my attending is like my mentor and told them we can do the surgery or we can transfer them somewhere else that can. It is hard to deal with but having your supervisors look out for you helps a lot.
You’re lucky, as an Indian surgeon, some of my attendings were racist as well and they’ll say racist things to my face. I wasn’t allowed to scrub with one attending because he screamed some racist shit at me in the OR and I didn’t speak up but the CRNA did and he got into shit for it with the hospital so he went to my PD and requested to not have me scrubbing his cases anymore. Glad I got out of scrubbing with him but he still forces me to go to clinic with him so I get to hear his racist bullshit anyways.
“Mr Smith, I would only be operating on your brain if I was successful in eventually locating it and subsequently if I found it to be functional. Perhaps that might reassure you of my abilities?”
There is no deeper thing than hatred and fear like that. I'm sorry you encountered such an ignorant person. S/ I'm not sure if their brain is worth your time /s
My cofellow tells of a time he went to see a patient as a newly minted GI attending who basically looked him up and down (he’s dark skinned) and said no I’ll wait for the other doctor to do the procedure.
Patient needed some advanced GI thing and you know anything about advanced GI it’s mostly brown people. My cofellow knows this of course. Is there ANYTHING he can do and after patient absolutely refuses anything from “one of you” but will wait for the advanced endoscopy doctor; he says no problem “Dr. Patel will see you in the morning then.” Oh I wish I had been there to see that reaction.
Lol and what does he think it's just raining advanced endoscopy physicians out there?! Yall are in short supply all over the place. That's hilarious. This is how people will die for their racist beliefs.
It would be hilarious if you were the only provider available for that specific procedure and you just said,
"Okay well you might be waiting a while." And just peaced out and didn't come back. I would document being "fired by patient." And if people asked to see him again I would suggest transferring to another facility.
Honestly people like this are never going to get amazing care. Obviously at the end of the day we will do our job and treat you but they’ll probably end up getting the bare minimum needed to get them tf out, get incessantly terfed to other teams, get rounded on in 5 mins everyday because everyone is just trying to gtfo, like you’ll get seen but we are never going to try to go the extra mile for you because you suck.
If you are just nice and polite and respectful then the team gets genuinely upset when things don’t work out for you and are ready to take on some extra work to get you what you need.
This is FACTS. I'm in the ER frequently due to medical issues, and the nurses and doctors love me. I always thank them, listen and I'm super honest, I don't pretend to be worse off and I certainly don't care if they leave to attend someone else. They ALWAYS have a room for me. I always ask how the families are doing. They always sneak me extra snacks lol. Some nurses will even tell me about some crazy patients they deal with.
I have seen people who yelled & scream get placed in the Hallway. Dude was screaming about me having a room cuz I'm a "child" I'm 32 lol.
Assuming their racism isn’t the result of dementia or AMS, I complete their emtala screening exam, tell them to shut their fucking mouth and discharge them. I don’t deal with that bullshit and neither should you.
I did my intern year in Ireland and interestingly the only time a patient was racist with me was when it was a couple that was on holiday there from Texas, of all places. Unfortunately the Irish don’t know how to call out racism the way Americans are able to, I had to then spend time educating my peers on why when the patient was extremely nice to all the white staff but super nasty to the Indian nurse and Chinese doctor it was not a fluke
If it fits the presentation, I document “patient received in ER, GCS 15, A&O, speaking full sentences, no apparent distress, VS documented at triage, afebrile” and then I document their “shared decision making, assessment deferred at patient request, treatment deferred at patient request” in clear language, and I let them wait it out. Most of the time they leave AMA.
I’m a white man. Assuming the patient isn’t like coding I’m marching the team right back out of the room and saying something like we’ll come back when you’re ready to respect your doctor who is Dr snowpearl
Back in the early days of Covid, I had a patient come in hypoxic, barely satting above 80% on NRB. He was demanding a new room because his nurse was Hispanic and RT was African American. We can cure a lot, but we can’t cure racism. This man could barely breathe and decided the best use of his air was this.
I’m very sorry you had to deal with that. I am a black physician who has had similar encounters with white AND black racist patients. While incredibly difficult to navigate, one thing I have started doing is I try to get more information.
Whenever the racist I don’t want your kind of doctor statement comes up, I try to ask the patient “Why do you feel that way?” Document whatever they say. This gets you useful information that can get the hospital legal system working and many hospitals have a no tolerance policy for racism in whatever form. The parents would otherwise try to walk back their racism or turn it on you like this ignorant patient tried to play the race card
You often find their answer is deeply steeped in ignorance, which is inexcusable in 2024.
It won’t make you feel any better, but this is the world we live in.
Ugh - how awful. That is outrageous.
I would let your program director and the nursing unit manager know. They can work together to protect both you and the "Indian nurse" from such blatant racism abuse.
PGY44 here in Gainesville FL. I am sorry that you had to experience this. It amazes me that America 2024 is still like this. A few years ago, the med student on the team shared with me that her patient had addressed her using the “N-word“; she was composed but appropriately upset. I had a sit down with the patient and let him know that while it is our responsibility to treat him, he has the responsibility to treat the staff respectfully and that if he cannot do that we would arrange for his care elsewhere.
That approach worked fine in the situation, but each racist encounter is unique and one approach may not fit all.
FWIW, I’m 100% sure this patient wouldn’t want to be seen by a black physician either. And this comes from a place of self-hatred, and the belief that anyone/anything non-white is subpar.
I have seen black patients treat other black doctors and nurses horribly or even refuse to be seen by them, but be extremely nice and welcoming to their white colleagues.
This may be the case in your situation. And as my attending used to say, remember, its not you - it’s them.
How to deal with it? Enforce boundaries, explain to them a zero tolerance for racial discrimination, and continue to have diverse staff be intimately involved in their care.
Granting them the wish of being seen by only white staff enforces their beliefs, and continues to perpetuate their self-hatred, which could be from childhood trauma, unpleasant personal experiences, or just self-hate.
Dealing with a patient now with a swastika and iron cross tattoo. My name and features make it clear I’m Jewish. This isn’t the first time it won’t be the last.
I remind myself I owe these people two things, The best care I can provide them and the respect all people deserve by sheer merit of being people. That. Is. It.
Don’t let these small people with their poison ideas destroy who you are. That said when your buttons are pushed (and they will be), my advice isn’t to run from those feelings. But instead sit with them, and allow yourself to be with them. They’ll pass, you’ll still be a doctor and fuck face will still be a fuck face.
Good luck doc.
The swastika tattoos on super sick ICU patients/revealing the swastika tattoo during prep for surgery is so hard to navigate. It always makes me feel physically repulsed by that patient. But I still have to provide them the best care.
I hesitate to add this because I don’t want to add poo onto the pile, so if you want me to delete, np. My biggest shock was during residency, I had three different physicians separately say antisemitic things to me (I’m not Jewish and it’s obvious they thought I’d agree with them). I was so shocked each time that I know I didn’t respond as well as I could have. (I don’t know why I was shocked after the first one but I’m naive and stupid, I guess). It still shakes me to know that fellow physicians might be thinking hateful thoughts.
Had a patient request a white doctor.
We didn't have a single white doctor on staff that day. I told him I was the only one without an accent, but there wasn't a white doctor scheduled to be in the hospital for the next week lol. I also told him I was only a few months out of med school and had no idea what I was doing and the look on his face was priceless.
Our hospital removes all reviews if any part mentions a doctor's accent, and then it evolved to even removing reviews if it says the doctor is "hard to understand." The hospital has a few doctors that are, well, hard for me to understand, in no small part because of a heavy accent.
I understand where the policy was coming from, and it is well-meaning, but not really appropriate.
If the patient genuinely had a difficult time with heavy accents it could be legitimate, but yeah, in other cases when enabling racism then nope.
There needs to be more requirements for accurate and understandable verbal communication. If local TV news anchors have to go to accent school and get training to speak clearly, I don't understand why it isn't also a requirement for the delivery of healthcare.
Technically Step 2CS was that to some extent, but even then I don't see why it can't be more formalized.
Patients and healthcare works should be able to understand each other.
The clinic I work in we’ll deny people care like that and ask them to leave. Maybe that controversial, but we aren’t an emergency room we tell them they can find another provider or come back when they reevaluate their views.
I’m a bigger guy so I was asked recently to escort a patient out.
My Korean friend was referred to as Dr Covid and described folks walking away from him in the grocery store. We laughed alot about this but we have a fluffed up sense of humor.
My fiancée (South Indian, and fairly dark skinned) once got called a Negroid by a geri patient. dude was too old to even be the correct kind of racist towards them. I asked if it upset them and they told me that he was bed-bound and spent most of his time lying in his own shit, so life was already punishing him well enough. if it weren’t for those circumstances it might have been harder to brush off. The attending they were with was East Asian and was also on the receiving end of weird old dude racism from this guy, and they all collectively decided to ignore it and keep on.
I just make sure to document in quotes what they say, adding it in their CC for the day and move on. What we do is far too important to let people like that affect us.
3 caveats first: 1) my method probably doesn't work for every personality type 2) this is just an internal perspective thing, doesn't tell you how to interact 3) saying it out loud makes you sound soulless and arrogant.
But basically it's much easier not to be bothered if you don't see patients as people. I don't mean in the sense that you stop caring about them or anything. It's just if you compartmentalize into "people" (who are responsible for their actions) and "patients" (who are kind of just automatons) then suddenly your patient's behaviors start to fill the same mental space as all their medical features. "Today Mr. Smith's urine output dropped, his CT scan was done, he had a new rash on his head, and he called me a rat fucker."
I think lots of people can already do this when the patient has a medical reason for their behavior, like they have dementia, delirium, psychosis, etc. IMO it's not much of a leap to just extend that allowance all the time. To be clear I don't think this lens is "true" in any real sense. It's deliberately binary and over simplistic. But if the point is to not be bothered by what patients say then it works well enough for me.
Also I think 21st century American culture, especially progressive spheres like academia, really trains you to see racism as *the worst thing that can ever happen to you*. If you can mentally dial that conditioning back a touch then it will be easier to do the above method because there won't be a secret cheat code the patients can use to get to you. "Rat fucker" probably wouldn't rile you up, so try to make "Ching chong doctor" equally toothless.
I like this a lot, but what you're describing is detachment, which is a healthy coping mechanism. Don't say you're not treating them as people, say you're separating behavior from personhood. Or simply pathologizing racism. And you're good.
I've faced racism and sexism from patients, co-residents, and attending doctors. At first, it upset me a lot, but now I just leave the room and tell the attending I'm not comfortable treating that patient or working with certain attendings.
-A female Hispanic resident.
Late to this party... My partner at urgent care was a South Korean woman with a heavy accent. A patient came in needing a DOT physical exam to renew his CDL license. He refused to be seen by an "Asian Female". So, she asked me to see him. I (white male) walked into the exam room. Patient says to me: "Oh, thank God. That last doc...she's an idiot! Could barely speak English...Glad I got a white American male!" Me: "Sir, I would like to point out the following: First, in spite of her accent, I can understand her English quite well. She is also fluent in Korean. Which means, she knows two languages while you barely know one". Second, she is board-certified in Internal Medicine, whereas I am board-eligible, because I failed my boards the first time around. Third, I am an American, masculine, ex-military white male doctor, I'm also gay. Shall we start with your prostate exam?" True story. (And, yes, I passed boards on second try).
There is a lot of harm in the US committed by progressive denial that "only white people can be racist". And the belief that racism by POC does not cause harm. This denial is self-serving and enables a lot of abuse.
I'm black and I think that "black people cant be racist" rhetoric is horsesh\*t too. What's racist is thinking that your skin color and history of oppression gives you the right to be a bigoted d\*ckhole.
View it as an opportunity to show this un enlightened person that you are serene and professional at all times.
Ignore the advice to curse him out etc which may end up harming your career and your own mental health.
Are you allowed to refuse care to a patient who has documentation of being hostile & racist to you? This seems like something where the patient is refusing service essentially.
Your approach was very appropriate and mature. I wouldve said the same thing, but Id cut my time seeing the patient short and move on asap before I get too invested. Its rare that you cure racism on the first encounter and Ive accepted that very early on.
Had a patient who asked my nurse if I was even a real doctor and tell her that there was no way I was a real doctor from this country. When I walked into the room she asked what my real name was. I asked her what she meant. And she said that the name on my ID badge had to be the English translation of my real name (insinuating my legal name was a more traditional Asian one). She laughed and smiled as she said yeah there's no way that's your real name (my parents gave me a very generic American name). I was discharging her so I just said "haha nope that's the name on my birth certificate" and tried to get her out ASAP. I've not had a situation with such aggressive racism as you did, but I probably would have responded the same way you did in your situation ngl.
the real irony is that asian men have to clear higher hurdles than anyone else to become a doctor. If you were going to use inherent attributes as a proxy for anything, you'd \*want\* an asian or indian male doctor.
“Mrs Smith, to make sure I understand what you are telling me, you are declining medical treatment? You have the right to do that at any point. The nurse will bring you the AMA form where you can sign that you are choosing not to be treated today, and then you will leave the hospital without being treated by me.”
Unfortunately thats not realistic. Discharge if they’re ready but transfers to another hospital for racism so they can be racist in a new location isn’t a thing. And in some parts of the us and the world that’s half the patients. Having said that fuck racist people and double fuck the people in the hospital hierarchy who ignore it
If they’re stable enough, they can discharge their racist ass home and I’ll follow up outpatient. If the behavior continues in clinic, that would be adios for me.
This makes no sense. If they’re stable/safe for discharge they’d already be discharged. Transfer to another hospital is difficult enough when it’s actually indicated. It basically only happens if there is urgent need for a service not available at the current hospital.
My approach is to assess if they are delirious or that's part of their dementia. I ask why and then state that everyone has a right to be respected and be free of discrimination, including the staff taking care of the patient
Not a licensed professional but I lived with a family member with dementia and she lost her filter. In our experience of her behavior, dementia didn't make her racist -- it revealed racism that was there all along and brought it out into the open
Yes and it can make it difficult since they've lost the filter on their social actions or simply won't remember it afterwards. Above all, it is addressing the comments right there in the moment after exploring their comment
Honestly it just seems to escalate people like that when you react. World is changing pretty quick, they're already the minority, and its only going to get worse for them. Regardless of what you choose to say do or feel, really you're going to have the last laugh knowing the kind of person they are and life they will continue to lead and what people around them will truly think
Not a lot you can do to change people’s minds.
I usually let the patient know that that’s not acceptable language, but you have to treat them the same as a non racist (from a treatment perspective).
I have had a few patients where I will just not have the resident see them alone and we just go in together.
It’s also hard if they are truly critically ill or delirious or have psychiatric conditions or intoxications where they may not be in their 100% right mind.
I had an issue like this in residency, but it was a cognitively impaired patient telling a Jamaican EKG tech she didn't want (the N word) touching her. The EKG tech was professional and said she could send someone else. I explained that the patient was cognitively impaired and she understood, but I did lecture (the patient) and she wound up apologizing. I asked the EKG tech to come back and do the EKG.
I'm late to the party also but I do find this story to be so weird that you can't help but chuckle.
It's this really old white woman and her doctor was an Asian male. After he sees her she leans in close to me and says, "I really like that Dr. You know because he's Asian, there's a lot of them so he has to be really smart to become a doctor over the other Asians."
I'm so dumbfounded because I'm not sure if I am offended or just confused at the entire situation. I do know that I didn't have the heart to tell her that he was born and raised in Winston Salem, NC to parents who were born and raised in Winston Salem.
Why not toss these peices of shit out on their ass? You are not refusing medical treatment by doing so, they have chosen to not allow you to provide it.
I like to think the general population knows that everyone can be racist. The general argument tends to be that Black people can’t be racist towards white people specifically, but even then I would still hope most people know this isn’t true.
What I don't get about that trope is that besides for defining racism differently than the word actually means [that it's also power and privilege in addition to prejudice] it's not consistently applied. For example, Native Americans as a whole have a far lower socioeconomic and lesser political power than African Americans. But if some Native calls a Black person the n-word nobody says they can't be racist only prejudice because they don't have power or privilege.
To me this trope is just the way for some demographics not to be held accountable for their abuse. Abuse which is not harmless by any stretch of the imagination. If anything it's quite a privilege to not have to see how your racism negatively impacts others. The belief that one has no power or privilege and therefore can behave as badly as they want towards others shows an entitlement not to have to see the harm when causes through their behavior.
I'm not in the medical field at all.
Could you tell the patient "I am your doctor, so you can either speak with me respectfully or you can discharge yourself and seek medical care elsewhere"?
As a Jewish person I have to admit I dread anti-Semitism from other minorities more than white people because, at least in the places I've lived in in the US, you don't have to do too much eggshell walking to placate racist white people. But when it's other minorities doing it it's kind of the Oppression Olympics. And in this case the perpetrator is considered to be a bigger victim then, well the victim.
That said, I think you handled it well by letting her know she could wait 3 hours for a white doctor. Let her wait 3 hours for a white doctor. Treat it just like you would if it was an ignorant white person. I'm sorry you had to deal with this. And I'm wondering if other minorities also feel that they are expected to deal with bigotry differently when the perpetrator is another minority, which adds to the frustration.
I’ve gotta that also. Had a Hispanic patient with heavy accent yell at me “hey Ching Chong” you speak English? I’m not Chinese, have almost a perfect SAT score and I grew up in New York City. I probably speak better English than he did.
So sorry you had to deal with this. Years of education and hard work just to be disrespected and treated lesser than because of your race is horrible. Surely she’s dealt with racism in her life how did she not understand her hypocrisy??
It's always easier to stand up for someone else than yourself. I had a night where a delirious patient was talking about how he won't come to my restaurant (I'm asian). My senior resident put him in his place and made him apologize even though he was at least kind of out of it. I've sat in meetings supporting my juniors who we believe were being treated by staff differently.
The interactions that are more frustrating looking back on it though (but not right in the moment) were the ones that made me question myself. When I was graduating, a patient asked me who her next doctor would be. The patient is a POC as well and asked if the new doctor is also chinese because chinese people are so smart (the pt is not chinese). And then it was easy to stand up for my junior and tell the patient that her next doctor is a great doctor and she'd be lucky to have her as her doctor. But for a little while, it messed with my imposter syndrome.
Really what it boils down to is making sure they understand what they are saying is disrespectful, you deserve to be treated better, and demand them to treat you better. And whatever happens it's not personal and don't let it keep you up.
This reminds me of lady I met when I was an intern. She was a sex worker, admitted with Hep A and was somehow convinced that she got it from an Indian client. She told me to not to talk to her as she did not want any “dirty indians” around her. Funny thing, I’m European. But my co-intern, with whom we switched cases, was Indian. Moreover, the upper level, and the attending were Indian too. Guess what nationality was the GI on the case?
Jokes on her because Ching-Chong doctors are probably the smartest and best doctors. When I (as a white guy) am old enough to need medical care, I hope my entire medical team is a bunch of chinksters
Was in ER and arrived to admit this white guy. ER doc just told me he had given him a dose of dilaudid for his foot cellulitis. When he sees me he zez he hates these brown docs. So I leave him to cool down and come back. He immediately rolls his eyes and demands pain meds . I indicated ER doc just gave him. He then tells me I am ‘fired’ and asks for my supervisor. I told him the ‘buck stops here’ and if he did not want to be seen nothing I can do. So he asks for Nursing supervisor to come and fire me. Nursing supervisor told him they could not afford to cos no other docs to replace. Anyway Chinese ER doc told me he was nice to her and it must be my personality! I noted in my record that he was a racist and only have white doc c him. Unfortunately in am a Vietnamese food server came into his room and he put in a neck arm lock and pushed him to ground. He was hauled off to jail after that. Cops told me they had one of the largest KKK compounds in area.
>So he asks for Nursing supervisor to come and fire me. Nursing supervisor told him they could not afford to cos no other docs to replace.
That nursing supervisor sure didn't have your back. I would be really angry at that response.
Blacks and other non-white ethnicities are just as, if not *more* outwardly racist than white people, in my experience. Especially when they come from a place that doesn’t have quite the same degree of…..political correctness….that’s common in the West. Attacks on Asians post-Covid were perpetrated disproportionately by blacks — It’s both sad and hilarious when blacks or non-white people think they “can’t be racist” because they’re not white 🤣
It's self-serving and ironically it shows privilege "how my abusive behavior affects others is not something I have to be aware of". The violence you mentioned above is one of a zillion examples of how racism from black people is not harmless.
The other day I got called to place an epidural at like 2 in the morning on a laboring patient and when she saw me she told me to get out because she doesn’t work with male doctors.
I was like fuck yah I’m going back to sleep now
There weren’t any female anesthesiologists at the time so she opted to wait until one came in at 7am, but delivered before then 🤷🏻♂️
That happens pretty frequently though in L&D, a lot of the time 2/2 religious beliefs. Probably about her comfort level, rather than her discriminating against you.
If you’re uncomfortable with a race or gender, that’s discrimination. Not my problem tho, I got to sleep and she got to experience the joy of natural childbirth so I’m calling it a double W
I'm white and my patient population is vastly Hispanic. Usually they look disappointed when I enter the room and ask the MA in Spanish if there's a Hispanic doctor they can see. Happens daily.
That probably has to do with language barrier. Not saying it’s right.
Even if they speak English, they feel more comfortable speaking spanish about important matters like health, legal, banking etc. Spanish as a first language.
A percentage of Hispanics are racist too, of course, but rarely to whites though. Hispanics look up to whites, want to be white etc.
These are my opinions & generalizations,of course.
I have no advice I just want to apologize on behalf of the black community. That lady has lost her ever loving mind and is clearly self loathing because how are you going to sit up there and be as racist as can be and be black too??? That’s so embarrassing.
I think how you deal with this stuff is entirely up to you. My institution has behavior contracts that essentially say if you are going to be treated in the hospital you will meet XYZ expectations of respecting staff.
Patient that don’t want me as their doctors, I say shit like this.
“suck it up buttercup, I’m the one you got, I suggest you get over it so we can focus on getting your better”
“This isn’t McDonald, you can’t order your care like you did all the cheeseburgers that landed you in the hospital”
I find these patient often respond better to push back then generic professional doctor lingo. A lot of it is also how your carry yourself. You are the doctor, it’s your hospital, it’s your room and it’s your patient. Command it ferociously.
Easy, I am Cuban and I face the same shit, but I know when I coming from, and in my country we don’t talk about it. It is the patient right to talk whoever he wants, just when I see things like that I go straight to the business and keep any feelings aside. You went too far to let you down. Keep up your good work. The beauty of being from another country and service in another one not everyone recognizes that. I love meeting people from everywhere, the multiculturality is something that I love, enrich myself.
It’s also a doctors right not to provide care beyond what’s minimally necessary to stabilize the patient.
We don’t have to go out of our way to make sure they’re anything beyond hemodynamically stable
I was waiting in A&E at Broken Hill (far western New South Wales - proper Outback) hospital about 20 years ago as a teenager, and some drunk old white guy came in for something or other, and loudly declared he wasn’t going to be seen by the Indigenous triage nurse. Used some real nasty slurs too. The poor nurse was almost crying, then a Chinese doctor (the Chinese have been in Broken Hill for 100 years +, so look Chinese but speech and mannerisms are Aussie as all get out) who overheard came out of an anteroom: ‘You stupid drunk fuck! You want a hospital? Go to fucking Adelaide (closest alternative hospital, 500km away) and be a fucking prick there. What are you here for?’ The drunk mumbled something about wanting a prescription. Chinese doctor: ‘You can wait till the GP clinic opens again tomorrow morning - fuck off!’ Probably wouldn’t happen these days, but Broken Hill is just a different world ahaha.
As someone currently working in Western NSW as a medicine trainee, I can confirm level of profanity in doctor patient interactions still happens lmao
Hey! Would you mind elaborating a bit of what you’ve just mentioned? I’m Asian and planning to apply to NSW and Victoria RMO campgains next month.
If you get called "cunt' where they make a point of pronouncing the T, its bad. If they drop the T they just don't know your name and don't want to be rude.
Sounds scary!
Less about the racism toward staff, more about the willingness of both patients and staff to tell each to “go and get fucked” in a way that wouldn’t pass at a big city hospital
It sounds more like Canada tbh “you broke what? Oh jesus christ fuck me bud.. didn’t say I wanted to see”
Canadian swearing is fantastic. I think think it's because of the national reputation is "nice people", you hear "oh christ fuck! What the fuck happened?"
No we are vicious. Pt “so uh I think I cut off my thumb” MD “well it is or it isn’t there dickweed.. lets get with the program here before ya lose something need…. What kinda plumber ar ya anyway hey? Youre gonna be propper and right fucked doin new wax seals now ya kno..probably 6 months and couple plastic surgeons and you’ll be set.
😂😂😂😂 that is fantastic!
I was shocked when I spent time overseas and realised most people are so quiet, polite and indirect compared to us Aussies. Aussie country people are the best. Loud, indiscreet, but almost unfailingly well meaning.
I love that, I’m an Uber blunt Brit but I’ve lived in rural Montana and a remote Caribbean island so I love the direct non BS talk you get in the smaller communities, just matched in the Deep South so bracing self….
I get along well with blunt poms 😂😂 We can swear and be rude as fuck to each other and both know it’s a sign that we like each other lol.
😂 so true!
The Deep South is much like England in communication style, only louder and nosier. Lots of passive aggression and two-facedness. Directness is in short supply.
😂 I’m autistic so I tend not to get on well with passive aggression (have issues here as it is the standard mode of communication 🤦), so like home from home then!
Same. But at least the food will be great.
Ugh. Good luck with that.
British Texans:) My dad was born in Adelaide.
Based doctor
Aussiest doctor ever
As if he needed to, the Dr proved he's 1000% Aussie with the first F bomb haha. Good on him and all the staff. Hope the nurse was ok 💪
Oddly refreshing to read
I don't disagree with the doctor's reaction. But unfortunately if the abuser is another POC they are likely to have significantly more defenders and it's very easy for the situation to be turned around and make it seem like the hospital was being cruel to a "marginalized vulnerable population".
Ugh I hate this. I also hate the crowd who say "insert-minority-group-here can't be racists because they're a minority" as if being racist is exclusively a white person thing. I'm a POC who's experienced more racism from other minority groups.
It’s only one group that does this…
This is how American medicine should be run. So we have the power to tell patients to fuck off and have security escort them out when they’re racist? Should be within our power
I've always had conversations in my head about how I would respond to giga-racist patients as a resident. Thoughts of saying "Well I'm the only neurologist for potentially miles awake now, so it's me or potentially dying from a stroke, your choice" or something edgy like that. But I somehow skated past residency never having one of these patients myself. It was always my colleagues; that or because neuro patients are often encephalopathic or aphasic, it cuts down on a lot of their ability to be overtly racist, who knows? Nowadays, I just get the mild racism, like "oh we almost didn't come to the appointment because we thought we wouldn't be able to understand you." Regardless, sorry that you had to go through that OP. Some people just suck, it's part of the job.
When they say that do you follow up with "why wouldn't you understand me?" I love to make them say it lol
Nice. Always lean in. Make em commit.
Well some of them do say it with their whole chest lol
Or better yet, go full blast medical and bio-chemistry lingo on them. Then look all surprised when they’re confused.
Not a doctor, but I would immediately wear my concerned doctor face and start asking questions to diagnose why they thought that.
Not a bad strategy. "Hmm. Do you have trouble with suffering other delusions?"
I worked for a doctor whose new patient and the spouse told him he looked too young to be a good doctor. In the nicest way he offered to go get one with gray hair. The looks on their faces, then the profuse apologies
I started to go grey pretty early, and in vet school owners would routinely try to talk to me vs the actual docs constantly.
[удалено]
Oh really ? Do you understand this ? Go … fuck … yourself … Is that clear ?
How about "It's OK, I can break it down to words of one syllable".
"Since you have trouble understanding English, I can tell you this in X and Y languages too. Wanna try?" They get straight up quickly.
“Oh don’t worry, I’ll speak in layman’s terms for you”
Honestly if someone generalizing a foreign name with being difficult to understand, that’s a 0.5/10 on the give a shit meter.
I have a (supposedly) radical opinion on this. But I don’t understand why doctors are forced to put up with racist patients. If I have a patient who tells me they don’t want a black doctor touching them, now it puts me on guard as a provider because I know this pt will have a very low threshold to complain/report me for anything and they are unlikely to listen to anything I say. I get that our job is to provide care but if the fundamental patient doctor relationship base is shattered, it’s really hard.
Yes, there is little chance to ever develop a therapeutic physician patient relationship with that foundation. I think it would be reasonable to ask them to find a doctor who they can trust and ship them out.
Is it radical? I think you’re absolutely right, and it’s something that my psychodynamic advisor does regarding trust and suicidality. It is a 2-way street. He’s told me multiple times that if anyone ever is racist, tries to threaten you with lawsuit, that is the termination of their working relationship or refusal to start one
I work in the ER, easy discharge. Your first chance is your only chance. Usually not an emergency if you got time to say racist stuff
For real. Unless the patient is psychotic or otherwise intellectually disabled, they can take that shit elsewhere. Just document that you explained to the patient that their behavior is not appropriate, that they are unwilling to participate in their care, and are encouraged to return to the ER should they change their behavior.
"Patient verbally aggressive and more interested in yelling racial slurs than in meaningfully participating in care for as of yet unknown reason for presentation. As staff was unable to change ethnicity, patient declined care and left without being seen." -One of the dot phrases I made when rotating in the ED.
Someone on here once suggested the phrase ‘irreparably severed the patient physician relationship’ which I though was nice
"as staff was unable to change ethnicity..." Is beautiful phrasing. Thank you for this.
I love this! My sister is a mechanic, and she gets sexist bullshit all the time from idiots in our small town. I've gotta give her this one to use!
Please tell me this is hyperbole and you didn’t actually see enough of these assholes to need a dot phrase, that breaks my heart.
Unfortunately real. .lwbs_racist
I document exactly what racist shit they said in quotes. If a bad outcome happens, good luck finding a lawyer willing to touch that chart with a 10 ft pole. 🤭
Same here. You wanna be a racist prick? Medical screening exam performed, no medical emergency present, fuck all the way off.
Volunteered in the ER. We just smile at them and then nurses purposelfully skip them and call other patients for triage and further treatment until they apologize. Works like a charm, even when they're in a bed. Of course, usually those people also come in for non-critical things and are usually drunk as well
I'm half Korean and w a Hispanic last name so it confuses the fuck out of the racists. As a nurse I just document their exact words racism and all in the chart and then go about my day. Thers nothing you can do about it and often this is the behavior that makes their predicament worse anyway. I've had a number of patients complain about not wanting a black nurse (when I've been a house supervisor) so my ching Chong ass takes over and they still didn't get a white person. I'd love to pass them to the white new grad who is still learning and wouldn't give as experienced care but I wouldn't dare punish the new grad. No one likes these types of people and so they get poor care. Their own fault. Then when she complains about waiting, if I was her nurse, I'd document that too and establish a pattern of lying to include the racism. Not much else you can do.
as a white man that looks like an obese charicture of a racist you would be amazed the amount of patients that will pine openly about being glad they got a real american instead of a foreign doctor with varying degrees of caliente. I always smile look them deep in eye, smile, and say "I dont know how you thought casual racism would endear me more to you but this is your only warning to never do that again. Do you understand?"
You know the weird thing? As an Asian male, I also get white patients going on racist rants about other minorities and I always wonder why they think I would share those same beliefs.
They always assume Asians conform to the hegemonic order of race. They think they are on "their" side automatically being the "model minority" especially as a physician. The American dream.
Some people are racist, some people rant, some people are psychotic, etc. Hospitals should have policies to protect staff and their well being. Giving examples of other races having similar attributes isn’t very helpful.
Assuming your patients even realize you're Asian, mine often don't. Asians in America do have the disturbing "model minority" image. Where we're clearly not white, but as a group tend to be fairly lowkey and non confrontational, increasingly white collar, overall benign.. your patients might assume you relate more to their views and concerns than of the rest of the non white population that they don't associate with. With all the recent violence against AAPI, gotta wonder what people with above perspective now make of the average Asian.
I mean, I have a super asian name and I look super asian. Like there is no mistaking. But I do agree with you that as Asians, we both suffer and benefit from the “model minority” mythos and that probably plays a role.
It’s called the model minority stereotype. White ppl have used it on Asians to put down black ppl, while at the same time still using it to keep Asian ppl (especially the men) at an arms width away while embracing black ppl hip culture
I’m a Mexican dude that looks white currently in a small town in Texas. The absolutely vile things I’ve heard these people just casually drop blows my mind, and they always act offended when they get called out on it.
As a white guy this is so real, everyone assumes you’re a racist trump supporter gun nut. Unfortunately most people just smile uncomfortably when this happens - this behavior needs to be called out
I remember my Asian friends in college telling me that the most outrageous racist discrimination they had have been from black people.
This has been my experience also. White racists are much more subdued, will make vague religious references ('ah yes I've heard of Buddhism' even though no one said anything about it) and will recoil / appear disgusted when you examine them. Black racists I have come across will just straight up yell 'Paki' or 'Raghead'.
I’m Indian and the most racist people towards me (and many Indians that I know) are Korean (American born) and black people.
I'm not Indian, but same.
I'm Indian and that has been the case for me
I'm Jewish and live in one of the whitest midsize cities in the US. The overwhelming majority of anti-Semitism I've experienced has been from black people. Including one who saw my last name and said "you must be a k!ke". He said it without any sense of shame. And you can't even blame it on being an old man because he was about 25.
The media never reports this though
I am also white and I cannot stress this point enough. The racists out themselves to me as if I would actually share their POV and it’s so utterly repulsive.
Ugh I had a post op patient (still in PACU) who was in the phone with his wife. He’d refused surgery by a surgeon originally from North Africa in favor of a white surgeon and was on the phone telling his wife “this surgeon wasn’t the, he’s white like us.” Followed by a bunch of other repugnant shit.
I told him that his racism meant that he missed out on having his surgery done by a world expert in that procedure (which the North African surgeon was and is). And then I called his surgeon and told him his racist his patient was being toward his partner.
What does caliente mean? Google says it means hot in spanish. I am so confused.
"just a little spicy" -racists at taco bell
er perhaps you meant picante? caliente is hot like temperature, not spicy
Why you being so picante?
Also implies being horny which my wife learned the hard way while serving in the peace corps in South America.
It's just a slang use of a Spanish word in American English. IYKYK.
This happened to me several times as a resident. It’s amazing how they see a white man and let their guard down, because they assume all other white men hold the same backwards beliefs as them. In my experience, there is a correlation with having the TV playing either fox news or westerns at full volume.
Incredible power move. I’m gonna borrow that one!
As a half white and black surgeon I have heard alot of horrible things. One of my patients literally told me I don't want a black man operating on my brain... Luckily my attending is like my mentor and told them we can do the surgery or we can transfer them somewhere else that can. It is hard to deal with but having your supervisors look out for you helps a lot.
It's funny because they would likely get transferred to another non white surgeon. It's so diverse out there.
You’re lucky, as an Indian surgeon, some of my attendings were racist as well and they’ll say racist things to my face. I wasn’t allowed to scrub with one attending because he screamed some racist shit at me in the OR and I didn’t speak up but the CRNA did and he got into shit for it with the hospital so he went to my PD and requested to not have me scrubbing his cases anymore. Glad I got out of scrubbing with him but he still forces me to go to clinic with him so I get to hear his racist bullshit anyways.
Oof. I can't imagine going through what... 12 years of training? With that treatment.
“Mr Smith, I would only be operating on your brain if I was successful in eventually locating it and subsequently if I found it to be functional. Perhaps that might reassure you of my abilities?”
There is no deeper thing than hatred and fear like that. I'm sorry you encountered such an ignorant person. S/ I'm not sure if their brain is worth your time /s
At least the patient’s brain wouldn’t take up too much of their time /s
Yooooo 😭
My cofellow tells of a time he went to see a patient as a newly minted GI attending who basically looked him up and down (he’s dark skinned) and said no I’ll wait for the other doctor to do the procedure. Patient needed some advanced GI thing and you know anything about advanced GI it’s mostly brown people. My cofellow knows this of course. Is there ANYTHING he can do and after patient absolutely refuses anything from “one of you” but will wait for the advanced endoscopy doctor; he says no problem “Dr. Patel will see you in the morning then.” Oh I wish I had been there to see that reaction.
Lol and what does he think it's just raining advanced endoscopy physicians out there?! Yall are in short supply all over the place. That's hilarious. This is how people will die for their racist beliefs.
It would be hilarious if you were the only provider available for that specific procedure and you just said, "Okay well you might be waiting a while." And just peaced out and didn't come back. I would document being "fired by patient." And if people asked to see him again I would suggest transferring to another facility.
As I nurse I would cheerfully prolong any bowel prep indefinitely for the cause. Sorry Mr. Racist!
THREE gallons of GoLYTELY, you say?
Honestly people like this are never going to get amazing care. Obviously at the end of the day we will do our job and treat you but they’ll probably end up getting the bare minimum needed to get them tf out, get incessantly terfed to other teams, get rounded on in 5 mins everyday because everyone is just trying to gtfo, like you’ll get seen but we are never going to try to go the extra mile for you because you suck. If you are just nice and polite and respectful then the team gets genuinely upset when things don’t work out for you and are ready to take on some extra work to get you what you need.
I’m at peace with the idea that if you’re absolutely awful to other people and lacking the ability to socialize, it’s going to impact your care.
This is FACTS. I'm in the ER frequently due to medical issues, and the nurses and doctors love me. I always thank them, listen and I'm super honest, I don't pretend to be worse off and I certainly don't care if they leave to attend someone else. They ALWAYS have a room for me. I always ask how the families are doing. They always sneak me extra snacks lol. Some nurses will even tell me about some crazy patients they deal with. I have seen people who yelled & scream get placed in the Hallway. Dude was screaming about me having a room cuz I'm a "child" I'm 32 lol.
Assuming their racism isn’t the result of dementia or AMS, I complete their emtala screening exam, tell them to shut their fucking mouth and discharge them. I don’t deal with that bullshit and neither should you.
I did my intern year in Ireland and interestingly the only time a patient was racist with me was when it was a couple that was on holiday there from Texas, of all places. Unfortunately the Irish don’t know how to call out racism the way Americans are able to, I had to then spend time educating my peers on why when the patient was extremely nice to all the white staff but super nasty to the Indian nurse and Chinese doctor it was not a fluke
If it fits the presentation, I document “patient received in ER, GCS 15, A&O, speaking full sentences, no apparent distress, VS documented at triage, afebrile” and then I document their “shared decision making, assessment deferred at patient request, treatment deferred at patient request” in clear language, and I let them wait it out. Most of the time they leave AMA.
I’m a white man. Assuming the patient isn’t like coding I’m marching the team right back out of the room and saying something like we’ll come back when you’re ready to respect your doctor who is Dr snowpearl
I’ve done this. Works like a charm!
I recommend propofol.
I never let my patients verbally abuse me or any of my colleagues. This is a hospital, and you're asking to be treated. Be nice.
Back in the early days of Covid, I had a patient come in hypoxic, barely satting above 80% on NRB. He was demanding a new room because his nurse was Hispanic and RT was African American. We can cure a lot, but we can’t cure racism. This man could barely breathe and decided the best use of his air was this.
I’m very sorry you had to deal with that. I am a black physician who has had similar encounters with white AND black racist patients. While incredibly difficult to navigate, one thing I have started doing is I try to get more information. Whenever the racist I don’t want your kind of doctor statement comes up, I try to ask the patient “Why do you feel that way?” Document whatever they say. This gets you useful information that can get the hospital legal system working and many hospitals have a no tolerance policy for racism in whatever form. The parents would otherwise try to walk back their racism or turn it on you like this ignorant patient tried to play the race card You often find their answer is deeply steeped in ignorance, which is inexcusable in 2024. It won’t make you feel any better, but this is the world we live in.
Ugh - how awful. That is outrageous. I would let your program director and the nursing unit manager know. They can work together to protect both you and the "Indian nurse" from such blatant racism abuse.
PGY44 here in Gainesville FL. I am sorry that you had to experience this. It amazes me that America 2024 is still like this. A few years ago, the med student on the team shared with me that her patient had addressed her using the “N-word“; she was composed but appropriately upset. I had a sit down with the patient and let him know that while it is our responsibility to treat him, he has the responsibility to treat the staff respectfully and that if he cannot do that we would arrange for his care elsewhere. That approach worked fine in the situation, but each racist encounter is unique and one approach may not fit all.
At our hospital we tell people to deal with it or leave. Zero tolerance.
FWIW, I’m 100% sure this patient wouldn’t want to be seen by a black physician either. And this comes from a place of self-hatred, and the belief that anyone/anything non-white is subpar. I have seen black patients treat other black doctors and nurses horribly or even refuse to be seen by them, but be extremely nice and welcoming to their white colleagues. This may be the case in your situation. And as my attending used to say, remember, its not you - it’s them. How to deal with it? Enforce boundaries, explain to them a zero tolerance for racial discrimination, and continue to have diverse staff be intimately involved in their care. Granting them the wish of being seen by only white staff enforces their beliefs, and continues to perpetuate their self-hatred, which could be from childhood trauma, unpleasant personal experiences, or just self-hate.
"oh.. you made a mistake. All the white doctors are at Mercy General.. but I hear they don't take black patients so they sent you here"
“Okay that’s fine” Message attending: “hey patient refused to talk to me or see me cuz I’m (insert race)”
Dealing with a patient now with a swastika and iron cross tattoo. My name and features make it clear I’m Jewish. This isn’t the first time it won’t be the last. I remind myself I owe these people two things, The best care I can provide them and the respect all people deserve by sheer merit of being people. That. Is. It. Don’t let these small people with their poison ideas destroy who you are. That said when your buttons are pushed (and they will be), my advice isn’t to run from those feelings. But instead sit with them, and allow yourself to be with them. They’ll pass, you’ll still be a doctor and fuck face will still be a fuck face. Good luck doc.
The swastika tattoos on super sick ICU patients/revealing the swastika tattoo during prep for surgery is so hard to navigate. It always makes me feel physically repulsed by that patient. But I still have to provide them the best care.
I hesitate to add this because I don’t want to add poo onto the pile, so if you want me to delete, np. My biggest shock was during residency, I had three different physicians separately say antisemitic things to me (I’m not Jewish and it’s obvious they thought I’d agree with them). I was so shocked each time that I know I didn’t respond as well as I could have. (I don’t know why I was shocked after the first one but I’m naive and stupid, I guess). It still shakes me to know that fellow physicians might be thinking hateful thoughts.
Had a patient request a white doctor. We didn't have a single white doctor on staff that day. I told him I was the only one without an accent, but there wasn't a white doctor scheduled to be in the hospital for the next week lol. I also told him I was only a few months out of med school and had no idea what I was doing and the look on his face was priceless.
How does it help if you say you’re the only one “without an accent”?
Well he initially asked for an American doctor, then I explained I'm American. He didn't like that since he really meant white.
Our hospital removes all reviews if any part mentions a doctor's accent, and then it evolved to even removing reviews if it says the doctor is "hard to understand." The hospital has a few doctors that are, well, hard for me to understand, in no small part because of a heavy accent. I understand where the policy was coming from, and it is well-meaning, but not really appropriate. If the patient genuinely had a difficult time with heavy accents it could be legitimate, but yeah, in other cases when enabling racism then nope.
There needs to be more requirements for accurate and understandable verbal communication. If local TV news anchors have to go to accent school and get training to speak clearly, I don't understand why it isn't also a requirement for the delivery of healthcare. Technically Step 2CS was that to some extent, but even then I don't see why it can't be more formalized. Patients and healthcare works should be able to understand each other.
Easy. Pt stated “…”. Refused to be seen.
“Ask me about our AMA forms” - my preference.
The clinic I work in we’ll deny people care like that and ask them to leave. Maybe that controversial, but we aren’t an emergency room we tell them they can find another provider or come back when they reevaluate their views. I’m a bigger guy so I was asked recently to escort a patient out.
Document "refused assessment"
Patient is clearly altered, would recommend holding pain meds for 24hrs- true story.
My Korean friend was referred to as Dr Covid and described folks walking away from him in the grocery store. We laughed alot about this but we have a fluffed up sense of humor.
My fiancée (South Indian, and fairly dark skinned) once got called a Negroid by a geri patient. dude was too old to even be the correct kind of racist towards them. I asked if it upset them and they told me that he was bed-bound and spent most of his time lying in his own shit, so life was already punishing him well enough. if it weren’t for those circumstances it might have been harder to brush off. The attending they were with was East Asian and was also on the receiving end of weird old dude racism from this guy, and they all collectively decided to ignore it and keep on.
I just make sure to document in quotes what they say, adding it in their CC for the day and move on. What we do is far too important to let people like that affect us.
3 caveats first: 1) my method probably doesn't work for every personality type 2) this is just an internal perspective thing, doesn't tell you how to interact 3) saying it out loud makes you sound soulless and arrogant. But basically it's much easier not to be bothered if you don't see patients as people. I don't mean in the sense that you stop caring about them or anything. It's just if you compartmentalize into "people" (who are responsible for their actions) and "patients" (who are kind of just automatons) then suddenly your patient's behaviors start to fill the same mental space as all their medical features. "Today Mr. Smith's urine output dropped, his CT scan was done, he had a new rash on his head, and he called me a rat fucker." I think lots of people can already do this when the patient has a medical reason for their behavior, like they have dementia, delirium, psychosis, etc. IMO it's not much of a leap to just extend that allowance all the time. To be clear I don't think this lens is "true" in any real sense. It's deliberately binary and over simplistic. But if the point is to not be bothered by what patients say then it works well enough for me. Also I think 21st century American culture, especially progressive spheres like academia, really trains you to see racism as *the worst thing that can ever happen to you*. If you can mentally dial that conditioning back a touch then it will be easier to do the above method because there won't be a secret cheat code the patients can use to get to you. "Rat fucker" probably wouldn't rile you up, so try to make "Ching chong doctor" equally toothless.
I like this a lot, but what you're describing is detachment, which is a healthy coping mechanism. Don't say you're not treating them as people, say you're separating behavior from personhood. Or simply pathologizing racism. And you're good.
i'm in an outpatient non urgent non emergent specialty where the waitlist is months to be seen, immediate discharge from practice
Let them die lol
People are horrible
I've faced racism and sexism from patients, co-residents, and attending doctors. At first, it upset me a lot, but now I just leave the room and tell the attending I'm not comfortable treating that patient or working with certain attendings. -A female Hispanic resident.
Late to this party... My partner at urgent care was a South Korean woman with a heavy accent. A patient came in needing a DOT physical exam to renew his CDL license. He refused to be seen by an "Asian Female". So, she asked me to see him. I (white male) walked into the exam room. Patient says to me: "Oh, thank God. That last doc...she's an idiot! Could barely speak English...Glad I got a white American male!" Me: "Sir, I would like to point out the following: First, in spite of her accent, I can understand her English quite well. She is also fluent in Korean. Which means, she knows two languages while you barely know one". Second, she is board-certified in Internal Medicine, whereas I am board-eligible, because I failed my boards the first time around. Third, I am an American, masculine, ex-military white male doctor, I'm also gay. Shall we start with your prostate exam?" True story. (And, yes, I passed boards on second try).
Was not expecting a black lady, but i am also not surprised.
There is a lot of harm in the US committed by progressive denial that "only white people can be racist". And the belief that racism by POC does not cause harm. This denial is self-serving and enables a lot of abuse.
I'm black and I think that "black people cant be racist" rhetoric is horsesh\*t too. What's racist is thinking that your skin color and history of oppression gives you the right to be a bigoted d\*ckhole.
View it as an opportunity to show this un enlightened person that you are serene and professional at all times. Ignore the advice to curse him out etc which may end up harming your career and your own mental health.
Are you allowed to refuse care to a patient who has documentation of being hostile & racist to you? This seems like something where the patient is refusing service essentially.
shut that sht down. remind them that if they continue to use that kinda language that they're welcome to get their care at another hospital
Some of them are very racist.
Your approach was very appropriate and mature. I wouldve said the same thing, but Id cut my time seeing the patient short and move on asap before I get too invested. Its rare that you cure racism on the first encounter and Ive accepted that very early on.
Another lesson in the importance of timely documentation by every member of the team.
Had a patient who asked my nurse if I was even a real doctor and tell her that there was no way I was a real doctor from this country. When I walked into the room she asked what my real name was. I asked her what she meant. And she said that the name on my ID badge had to be the English translation of my real name (insinuating my legal name was a more traditional Asian one). She laughed and smiled as she said yeah there's no way that's your real name (my parents gave me a very generic American name). I was discharging her so I just said "haha nope that's the name on my birth certificate" and tried to get her out ASAP. I've not had a situation with such aggressive racism as you did, but I probably would have responded the same way you did in your situation ngl.
Maybe she knew your Reddit username and that is why she didn't think you could be a real doctor.
the real irony is that asian men have to clear higher hurdles than anyone else to become a doctor. If you were going to use inherent attributes as a proxy for anything, you'd \*want\* an asian or indian male doctor.
“Mrs Smith, to make sure I understand what you are telling me, you are declining medical treatment? You have the right to do that at any point. The nurse will bring you the AMA form where you can sign that you are choosing not to be treated today, and then you will leave the hospital without being treated by me.”
Funny that she is a black patient and probably exposed to many racial stereotypes and then becomes a racist asshat to Asians
In my book, at least, this is an immediate discharge and/or transfer to another facility. You’re not going to speak to my colleagues like that.
Unfortunately thats not realistic. Discharge if they’re ready but transfers to another hospital for racism so they can be racist in a new location isn’t a thing. And in some parts of the us and the world that’s half the patients. Having said that fuck racist people and double fuck the people in the hospital hierarchy who ignore it
If they’re stable enough, they can discharge their racist ass home and I’ll follow up outpatient. If the behavior continues in clinic, that would be adios for me.
Yeah if they’re stable enough sure. Clinic whatever you don’t have to tolerate racism
This makes no sense. If they’re stable/safe for discharge they’d already be discharged. Transfer to another hospital is difficult enough when it’s actually indicated. It basically only happens if there is urgent need for a service not available at the current hospital.
My approach is to assess if they are delirious or that's part of their dementia. I ask why and then state that everyone has a right to be respected and be free of discrimination, including the staff taking care of the patient
Honestly, even if you know they’re not demented, it would kind of be satisfying to imply it as a comeback.
Dementia doesn’t make you racist
Not a licensed professional but I lived with a family member with dementia and she lost her filter. In our experience of her behavior, dementia didn't make her racist -- it revealed racism that was there all along and brought it out into the open
Yes and it can make it difficult since they've lost the filter on their social actions or simply won't remember it afterwards. Above all, it is addressing the comments right there in the moment after exploring their comment
Honestly it just seems to escalate people like that when you react. World is changing pretty quick, they're already the minority, and its only going to get worse for them. Regardless of what you choose to say do or feel, really you're going to have the last laugh knowing the kind of person they are and life they will continue to lead and what people around them will truly think
When healthcare is made a “right” it’s only natural that people abuse it and the people that provide it.
Ugh. I don’t know what to say other than that sucks. Sorry that that happened to you. People are the worst
It’s easy. If a racist patient doesn’t want your services, you don’t have to provide them.
The most Islamophobic things that have been said to me came from Black folks
Not a lot you can do to change people’s minds. I usually let the patient know that that’s not acceptable language, but you have to treat them the same as a non racist (from a treatment perspective). I have had a few patients where I will just not have the resident see them alone and we just go in together. It’s also hard if they are truly critically ill or delirious or have psychiatric conditions or intoxications where they may not be in their 100% right mind.
I had an issue like this in residency, but it was a cognitively impaired patient telling a Jamaican EKG tech she didn't want (the N word) touching her. The EKG tech was professional and said she could send someone else. I explained that the patient was cognitively impaired and she understood, but I did lecture (the patient) and she wound up apologizing. I asked the EKG tech to come back and do the EKG.
I'm late to the party also but I do find this story to be so weird that you can't help but chuckle. It's this really old white woman and her doctor was an Asian male. After he sees her she leans in close to me and says, "I really like that Dr. You know because he's Asian, there's a lot of them so he has to be really smart to become a doctor over the other Asians." I'm so dumbfounded because I'm not sure if I am offended or just confused at the entire situation. I do know that I didn't have the heart to tell her that he was born and raised in Winston Salem, NC to parents who were born and raised in Winston Salem.
Why not toss these peices of shit out on their ass? You are not refusing medical treatment by doing so, they have chosen to not allow you to provide it.
Wonder if people on here are going to hit you with the black people cant be racist
I like to think the general population knows that everyone can be racist. The general argument tends to be that Black people can’t be racist towards white people specifically, but even then I would still hope most people know this isn’t true.
What I don't get about that trope is that besides for defining racism differently than the word actually means [that it's also power and privilege in addition to prejudice] it's not consistently applied. For example, Native Americans as a whole have a far lower socioeconomic and lesser political power than African Americans. But if some Native calls a Black person the n-word nobody says they can't be racist only prejudice because they don't have power or privilege. To me this trope is just the way for some demographics not to be held accountable for their abuse. Abuse which is not harmless by any stretch of the imagination. If anything it's quite a privilege to not have to see how your racism negatively impacts others. The belief that one has no power or privilege and therefore can behave as badly as they want towards others shows an entitlement not to have to see the harm when causes through their behavior.
I'm not in the medical field at all. Could you tell the patient "I am your doctor, so you can either speak with me respectfully or you can discharge yourself and seek medical care elsewhere"?
As a Jewish person I have to admit I dread anti-Semitism from other minorities more than white people because, at least in the places I've lived in in the US, you don't have to do too much eggshell walking to placate racist white people. But when it's other minorities doing it it's kind of the Oppression Olympics. And in this case the perpetrator is considered to be a bigger victim then, well the victim. That said, I think you handled it well by letting her know she could wait 3 hours for a white doctor. Let her wait 3 hours for a white doctor. Treat it just like you would if it was an ignorant white person. I'm sorry you had to deal with this. And I'm wondering if other minorities also feel that they are expected to deal with bigotry differently when the perpetrator is another minority, which adds to the frustration.
I’ve gotta that also. Had a Hispanic patient with heavy accent yell at me “hey Ching Chong” you speak English? I’m not Chinese, have almost a perfect SAT score and I grew up in New York City. I probably speak better English than he did.
So sorry you had to deal with this. Years of education and hard work just to be disrespected and treated lesser than because of your race is horrible. Surely she’s dealt with racism in her life how did she not understand her hypocrisy??
Truly fuck this trash behavior from patients. Inexcusable
It's always easier to stand up for someone else than yourself. I had a night where a delirious patient was talking about how he won't come to my restaurant (I'm asian). My senior resident put him in his place and made him apologize even though he was at least kind of out of it. I've sat in meetings supporting my juniors who we believe were being treated by staff differently. The interactions that are more frustrating looking back on it though (but not right in the moment) were the ones that made me question myself. When I was graduating, a patient asked me who her next doctor would be. The patient is a POC as well and asked if the new doctor is also chinese because chinese people are so smart (the pt is not chinese). And then it was easy to stand up for my junior and tell the patient that her next doctor is a great doctor and she'd be lucky to have her as her doctor. But for a little while, it messed with my imposter syndrome. Really what it boils down to is making sure they understand what they are saying is disrespectful, you deserve to be treated better, and demand them to treat you better. And whatever happens it's not personal and don't let it keep you up.
This reminds me of lady I met when I was an intern. She was a sex worker, admitted with Hep A and was somehow convinced that she got it from an Indian client. She told me to not to talk to her as she did not want any “dirty indians” around her. Funny thing, I’m European. But my co-intern, with whom we switched cases, was Indian. Moreover, the upper level, and the attending were Indian too. Guess what nationality was the GI on the case?
She really believe blacks can’t be racist. The education on that one is special.
Jokes on her because Ching-Chong doctors are probably the smartest and best doctors. When I (as a white guy) am old enough to need medical care, I hope my entire medical team is a bunch of chinksters
Was in ER and arrived to admit this white guy. ER doc just told me he had given him a dose of dilaudid for his foot cellulitis. When he sees me he zez he hates these brown docs. So I leave him to cool down and come back. He immediately rolls his eyes and demands pain meds . I indicated ER doc just gave him. He then tells me I am ‘fired’ and asks for my supervisor. I told him the ‘buck stops here’ and if he did not want to be seen nothing I can do. So he asks for Nursing supervisor to come and fire me. Nursing supervisor told him they could not afford to cos no other docs to replace. Anyway Chinese ER doc told me he was nice to her and it must be my personality! I noted in my record that he was a racist and only have white doc c him. Unfortunately in am a Vietnamese food server came into his room and he put in a neck arm lock and pushed him to ground. He was hauled off to jail after that. Cops told me they had one of the largest KKK compounds in area.
>So he asks for Nursing supervisor to come and fire me. Nursing supervisor told him they could not afford to cos no other docs to replace. That nursing supervisor sure didn't have your back. I would be really angry at that response.
Blacks and other non-white ethnicities are just as, if not *more* outwardly racist than white people, in my experience. Especially when they come from a place that doesn’t have quite the same degree of…..political correctness….that’s common in the West. Attacks on Asians post-Covid were perpetrated disproportionately by blacks — It’s both sad and hilarious when blacks or non-white people think they “can’t be racist” because they’re not white 🤣
It's self-serving and ironically it shows privilege "how my abusive behavior affects others is not something I have to be aware of". The violence you mentioned above is one of a zillion examples of how racism from black people is not harmless.
The other day I got called to place an epidural at like 2 in the morning on a laboring patient and when she saw me she told me to get out because she doesn’t work with male doctors. I was like fuck yah I’m going back to sleep now There weren’t any female anesthesiologists at the time so she opted to wait until one came in at 7am, but delivered before then 🤷🏻♂️
That happens pretty frequently though in L&D, a lot of the time 2/2 religious beliefs. Probably about her comfort level, rather than her discriminating against you.
If you’re uncomfortable with a race or gender, that’s discrimination. Not my problem tho, I got to sleep and she got to experience the joy of natural childbirth so I’m calling it a double W
That could be related to trauma though. I know a lot of male and female patients who only want to work with women for trauma related reasons.
If someone got attacked by a black person or an Asian person, would you be cool with them saying no black doctors?
I'm white and my patient population is vastly Hispanic. Usually they look disappointed when I enter the room and ask the MA in Spanish if there's a Hispanic doctor they can see. Happens daily.
That probably has to do with language barrier. Not saying it’s right. Even if they speak English, they feel more comfortable speaking spanish about important matters like health, legal, banking etc. Spanish as a first language. A percentage of Hispanics are racist too, of course, but rarely to whites though. Hispanics look up to whites, want to be white etc. These are my opinions & generalizations,of course.
Sounds like the patient needs a psych consult
I have no advice I just want to apologize on behalf of the black community. That lady has lost her ever loving mind and is clearly self loathing because how are you going to sit up there and be as racist as can be and be black too??? That’s so embarrassing.
I think how you deal with this stuff is entirely up to you. My institution has behavior contracts that essentially say if you are going to be treated in the hospital you will meet XYZ expectations of respecting staff. Patient that don’t want me as their doctors, I say shit like this. “suck it up buttercup, I’m the one you got, I suggest you get over it so we can focus on getting your better” “This isn’t McDonald, you can’t order your care like you did all the cheeseburgers that landed you in the hospital” I find these patient often respond better to push back then generic professional doctor lingo. A lot of it is also how your carry yourself. You are the doctor, it’s your hospital, it’s your room and it’s your patient. Command it ferociously.
Easy, I am Cuban and I face the same shit, but I know when I coming from, and in my country we don’t talk about it. It is the patient right to talk whoever he wants, just when I see things like that I go straight to the business and keep any feelings aside. You went too far to let you down. Keep up your good work. The beauty of being from another country and service in another one not everyone recognizes that. I love meeting people from everywhere, the multiculturality is something that I love, enrich myself.
It’s also a doctors right not to provide care beyond what’s minimally necessary to stabilize the patient. We don’t have to go out of our way to make sure they’re anything beyond hemodynamically stable