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
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.