Doctor Monica Peek was the attending physician for a patient with a serious condition.
The patient refused care from Dr. Peek and her team and issued a written request for
a "white" physician.
"... that the primary thing on his mind was not his health and the well-being of himself
and his family, but his racial prejudices towards persons of color who are caring for
him."
It's an open secret.
Credentials don't protect physicians of color from experiencing racism, and there isn't
an official national policy to help doctors deal with patient prejudice.
"Did it catch you by surprise?"
"It did not catch me by surprise because again, I had experiences like this throughout my
life and throughout my career in medicine, starting as a medical student but it was disappointing."
A recent study found that 6 in 10 doctors surveyed had experienced some sort of biased
remarks from their patients about their gender, ethnicity, race, age or weight.
About 16% or 160,000 physicians in the U.S. are black or Asian and yet the study found
the majority of them are targets of patient prejudice when compared to other physicians.
"You can't go to a restaurant and say I don't want to be served by any Latino waiters.
That would violate Title II of the Civil Rights Act.
I thought it was odd that here we have in a medical context this happening all the time."
It's called informed consent when patients learn of their condition and give consent
to a doctor for treatment.
Patients have the right to refuse care by a physician, but what if a patient refuses
care due to bigotry?
"I've been an African-American woman my entire life.
And so the experiences that I've had as a physician with racism are not entirely different
than experience I've had as a regular person with racism."
The patient was transferred to the intensive care unit (ICU), not because of his complaint
but because of the severity of his illness.
"The white coat, the hospital walls, they don't protect someone from racism.
How does it impact physicians, or more specifically, how does it impact you?"
"It has been one of my greatest joys of my life being a physician.
Can we pause of a second?"
The New England Journal of Medicine says for minority health care workers, patient expressions
of racial preferences are "painful and degrading" and can "contribute to moral distress and
burnout."
"Have you ever wanted to stop being a physician?"
"It has never occurred to me to stop what I'm doing.
Life is full of challenges.
I know the road that is behind me that my foremothers and fathers sort of fought to
pave the way for me.
So my road has most certainly been easier than people who came before me.
My road hopefully will be more difficult than those who come behind me."
The article co-authored by Paul- Emile aims to help physicians deal with discriminatory
patients.
Its flowchart offers options for moving forward with care.
For example, if a patient request is bigoted, the chart suggests options to accommodate,
transfer, negotiate or limit unacceptable conduct from that patient.
Paul-Emile admits that a request to be reassigned to another physician isn't always discriminatory
or racist.
"Even if they claim it's based on the assigned physician's race or ethnicity, it might look
like bigotry, but it could be something else.
For example, it could be that the patient is a war veteran and the physician reminds
them of a former enemy combatant.
In situations like this, it could be biased, but it could also be PTSD."
"The bigger, more important issue is what happens when patients are the target of racism.
Structural racism.
Interpersonal racism.
Because they are the ones who are sick and vulnerable entering the system and really
need help.
And the problem is not going to be solved unless we all roll up our sleeves and get
to work.
So that's every person.
That's every white person.
That's every straight person.
Every person."