Navigating encounters where patients or their families exhibit biased or disrespectful behavior can be a challenging aspect of medical practice. Dr. Amy Nicole Cowan delves into this complex issue in her essay titled “Inappropriate Behavior by Patients and Their Families—Call It Out,” published in JAMA Internal Medicine. Drawing from her experiences as an associate professor at the University of Utah and a clinician at the George E. Wahlen Department of Veterans Affairs Medical Center, she recounts a poignant end-of-life scenario where a patient’s family members voiced objectionable opinions about the medical team, including discriminatory remarks regarding race, religion, and gender.
Dr. Cowan emphasizes the importance of addressing such behavior promptly and firmly. She outlines three essential strategies derived from her own practice:
Prepare a Response: Dr. Cowan stresses the value of having pre-planned responses to objectionable behavior. She suggests phrases like “We don’t tolerate that kind of speech here” or “Let’s keep it professional” to establish boundaries swiftly and redirect focus to patient care.
Assertiveness: In the face of disrespectful conduct, Dr. Cowan advocates for plain and direct communication without engaging in arguments or negotiations. Later reflection on these encounters allows for further exploration and learning.
Education and Role-Playing: Recognizing the lack of preparedness among medical trainees in handling such situations, Dr. Cowan incorporates role-playing exercises into their training. By simulating scenarios and practicing responses, trainees become better equipped to address inappropriate behavior with confidence.
Dr. Cowan’s insights align with the principles outlined in the AMA Code of Medical Ethics, particularly Opinion 1.2.2, which emphasizes the importance of maintaining professionalism and respect in patient-physician interactions. The code underscores the need for physicians to prioritize patient care while addressing disrespectful behavior, regardless of its origin. It also encourages institutions to foster environments that promote mutual respect and provide support for healthcare personnel who encounter discrimination from patients.
Ultimately, Dr. Cowan’s approach centers on maintaining empathy while firmly upholding professional standards. By confronting unacceptable behavior with compassion and clarity, physicians can prioritize patient well-being while safeguarding the integrity of the healthcare environment.
- : public
