Standing up to racism

Handling of a patient’s refusal of care highlights our progress and work ahead

By Drs. Derick Du Vivier, Sharon Anderson and Renee Edwards

Oct. 28, 2019 — Last week, an incident occurred at the Center for Health and Healing 2 that both highlighted our progress in combatting racism and why we must press on to make even more.

A patient who was being cared for by an anesthesiologist who is African American refused the physician’s care because the physician is black, explicitly stating her request and becoming quite vocal in the process. The resident physician, faculty and nurses did an outstanding job of handling the situation, informing the patient that her conduct was unacceptable and, when she persisted, ultimately denying her the procedure.

We want to recognize the physician, nurses and procedure team for their actions and also acknowledge the painfulness and ugliness of this experience and all experiences of racism – overt incidents like this one and those that are less overt yet equally corrosive. This type of behavior is demeaning and emotionally harmful to all members of the team.  It places individuals in a state of tension in which they must balance their dignity and self-worth against their professional responsibilities.  This is untenable and unacceptable.

We are proud that as part of our Respect for All policies, OHSU gives strong and clear direction that we will not reassign providers for reasons related to race, gender or other characteristics unrelated to their professional role.

However, as this incident brought to light, there is also more we can do. We will be working on additional training for care teams, reviewing our policy and making sure the policy is even more visible to patients, highlighting our values and our expectations about OHSU as a safe and respectful space.

Indeed we know that last week’s incident is not rare or unique to OHSU.

In a 2017 national study of physicians, nurses and physician assistants conducted by WebMD/Medscape in collaboration with STAT, 59 percent of physicians (and only a slightly lower proportion of the other health professionals) reported experiencing bias in the last five years from patients on the basis of personal characteristics. Most common: younger age, ethnicity, gender, or race but also religion, weight, political views, accent, or sexual orientation. Differentiating the study results by race, 70 percent of African American or black and 69 percent of Asian physicians reported experiencing bias.

We encourage anyone impacted by last week’s incident or other such incidents to be aware of resources available to you. The steps for reporting discrimination or harassment – or what to do if someone reports such an incident to you – are on the OHSU Affirmative Action and Equal Opportunity website. Mentors, peers and counseling professionals are important resources for residents, faculty, staff and students who are processing this or similar incidents. Wellness resources are posted on the School of Medicine O2 site.

We are grateful to the resident who brought this incident to the attention of leadership so that we could call out and learn from this experience and take additional steps.

By standing up for our values, we model the change that we must see.

Thank you for the care and compassion that you show to each other and for the work you do every day.

Derick Du Vivier, M.D., M.B.A.
Assistant Dean for Diversity and Inclusion
School of Medicine

Sharon Anderson, M.D.
Executive Vice President, OHSU
Dean, School of Medicine

Renee Edwards, M.D., M.B.A.
Vice President and Chief Medical Officer
OHSU Health

Photo caption: OHSU community members joined hands in solidarity in fall 2016 at the Stand Together event outside Mac Hall led by the OHSU Center for Diversity And Inclusion to launch the Gun Violence as a Public Health Issue initiative.

22 responses to “Standing up to racism

  1. This is the best outcome for a bad situation. For too long we have allowed racists (and sexists, and homophobes, etc.) to dictate the terms of their service. No more.

    Kudos to the Care Team for standing strong together. And kudos to OHSU for standing behind them.

  2. “…when she persisted, ultimately denying her the procedure.” Is this the outcome that was desired by OHSU? We can all agree that the patient’s request was not copacetic. However, do not even the racists deserve to receive care?

    1. She received good care. The procedure before the surgery was part of anesthesia, and no, she was not offered another physician. She had the surgery.

    2. You are right that even racists receive care and the beauty about this is that they were offered care from a capable and highly qualified individual, and refused it. So it was their choice to seek care elsewhere.

  3. I noticed that this article states OHSU does not make provider changes requested by patients when they are based on the provider’s gender. I was not aware of this fact. So a female patient can not request to change to a female provider if they are assigned to a male? I know that, in our clinic, when a patient requests to have a female/male medical assistant help them during their visit we are expected to accommodate their request. Which can be difficult as times. So why does this rule not apply to other clinical roles?

    1. Thank you, Danielle. Yes, Dr. Edwards explained to me, there are instances where a patient’s wishes are accommodated. For example, we try to accommodate patients’ wishes out of respect for religious customs or for patients with a history of sexual abuse. We are not always able to accommodate these needs but we do try. View the policy: https://ohsu.ellucid.com/documents/view/4328

      Erin Hoover Barnett
      Director of Communications
      OHSU School of Medicine

  4. Absolutely speechless….this was so sad. I can only hope the Dr. is able to see past the ignorance and continue to help those that are need of service.

    1. Tania, he would not be in the role he/she is in now if he/she would have allowed the many nay-sayers and haters to sway his progress and ambition to help others.

  5. Thanks for highlighting this incident and to the people who did the right thing and said no to racism; you are amazing and you are what makes Oregon and OHSU a good place to be

  6. Thank You For backing the doctor up. Unfortunately this is nothing new, it is too bad that once it happens to a doctor then action is taken to discipline? a patient for their conduct. As a phlebotomist I have had raciest patients and told management was told and nothing was done.

    1. I’m so sorry to hear that you too are suffering from racism here and aren’t feeling heard, Cassie. I hope you find allies in the areas you work who will support you and stand up for your rights. It sounds like the office for diversity and inclusion may be a good resource for you to access if you aren’t feeling like your leadership team is addressing the issues and concerns you have. All the best and please keep standing up, showing up, and help us all become aware of and heal from the embedded racist operations of our society.
      Travis

  7. Thank you, Dr. Du Vivier and to all of you for this important message. We all should feel empowered to speak out against racist, demeaning, or otherwise abusive treatment from anyone. As a nurse and person of color, I appreciate OHSU standing firmly against racist behavior and working to support all that work here. It affects us all.

  8. I am so proud to be a part of a team having the courage to stand up for what is right. Thank you for your commitment to making this a safe place for everyone to work.

  9. I am so proud that OHSU is walking the walk, right down to the point of care. And that can only happen when with strong leaders at the top. Thanks to all.

  10. I was present at CHH the day this event occurred. While the patient did not receive the procedure that the resident was going to perform, the patient did undergo their surgical procedure with a different anesthesia team. Due to some inconsistencies in the policy, this approach was allowable. In retrospect, I think it would have been better if the policy indicated that if the patient refused care from one member of the team then the rest of the anesthesia team would not have to go forth and provide additional services to the patient. Given that this was not an emergent procedure, that was a potential option. However, because a different team was scheduled for the intraoperative part of the procedure, there was no additional accommodation to be made. This loophole made it acceptable for the second anesthesia team to care for this patient even though they may have had objections to caring for this patient based on interactions with their colleague.

    I am proud of our resident for the manner in which he handled this very unfortunate situation as well as for the appropriate and supportive response from my colleagues in the Department of Anesthesiology.

    1. Thank you Dr. Cohen for shedding some more light on what happened behind this article. No matter collogues or community members, we must stand up against anything or anyone that compromises this. Get to know for each other. By understanding another’s struggle or accomplishments, it brings forth potential for a bondable understanding and connection. Be the light in the darkness is my motto.

  11. Thanks for your support. good to know that OHSU IS NOW TAKING A STAND to stand up for racism, I worked there for 22 years and is now retired!!!.

  12. Reading this article makes me proud that our son Josh Andersen is a staff at OHSU. I will share this incident with my American Association of University Women’s Class: Exploring Women’s Culture.
    We just read the book, White Fragility that asked the question, “Why is it so hard for white people to talk about racism?” It was one of the finest quality reads addressing racism that I have read.

    I wish all of you the best as you continue to concretize your values for the common good of all humankind

    Sharon Rezac Andersen
    Green Valley, AZ

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