Friday, October 20, 2017

Racist, sexist words by patients, work peers plague hospitals

By Louise Kinross

In the last month, a few studies about racist and sexist comments in medicine crossed my desk. One survey is about bigoted comments made by patients to doctors. Another is about misogynistic remarks from medical staff to female doctors and nurses.

I also learned about a St. Louis University surgical resident who is suing the school and two of its medical school leaders because she claims she was discriminated against as a former nurse. “Stop being a nurse,” “too much of a nurse,” and “too nice” are comments the resident alleges supervisors made.

The studies I received are American. I'd like to know if similar studies in Canada exist. A quick search revealed only this 1996 piece in Studies in Political Economy: Anti-Black Racism in Nursing in Ontario and this position paper on violence, including verbal abuse, against nurses by the Registered Nurses' Association of Ontario.

In the first survey above of over 800 U.S. doctors, 59 per cent had received offensive remarks related to their age, gender, race or ethnicity in the last five years. African-American and Asian-American doctors were more likely to be on the receiving end of these verbal attacks, and female doctors were more often recipients than males.

As a result of these comments, 47 per cent had a patient request a different doctor or ask to be referred to a doctor other than the one recommended. Most physicians in the study, conducted by WebMD and Medscape in collaboration with STAT, said they had no training on how to handle these comments and were unaware of policies to aid them. In this STAT article about the study, eight doctors shared their stories of discrimination.

The second survey focused on bias against female doctors and nurses (the number of survey respondents isn't noted). The survey was conducted online by resident physician Morgan Shier at Providence Hood River Memorial Hospital in Oregon. 

When asked if they had ever been mistaken for someone in a position different from theirs, 71 per cent said "yes." Female physicians said they were most likely to be referred to by patients as “nurse,” even when they introduced themselves as the doctor. When asked if they’ve experienced sexual harassment in the workplace, 44 per cent of respondents said “yes.”

A third said gender played a role in them missing out on a raise, promotion, or key assignment. One participant wrote: “I was in line to do compressions in a code. A resident told me that women were not allowed to do them. When I asked why, [he] said ‘women were weaker and bad at it.’…I was kicked out of the room.”

Of 21 participants who identified as female and an ethnic minority, 67 per cent said “yes” when asked if they had to provide more proof of competence than others at work. Wrote one: 
I've often been told to rely on being a black female to get ahead in life or that my placement in a residency program would fulfill affirmative action quotes. 

When asked if females supported one another in medicine, 39 per cent said “no.” Wrote one: “The environment is so cutthroat that people in general don’t look out for one another.” A third said the role of the U.S. President and Congress played 
an extremely important role in addressing women's issues at work. Said one: “When Trump won, the boldness of racist and sexist healthcare workers instantly surfaced.”

A third study, published in the Journal of Women’s Health in May, found men introduced male speakers as doctors 72 per cent of the time at over 300 Mayo Clinic grand rounds, but only 49 per cent of the time when the speaker was female. In the latter case, they were more likely to call the doctor by her first name. This was interpreted as a lack of respect. 
I wonder if it in any way indicated that the female doctors were more approachable, which, from a patient and work peer perspective, is a good thing?

Which got me thinking about the doctors who criticized the St. Louis University surgical resident for being 
too nice. What patient or family has ever complained about a doctor who cares too much?