CHS webinar discussion: How to deal with racist patients

By Ryan Clark

CHS Communications Director

“Why don’t you go back to India?”

Sachin Jane, MD, MBA, was shocked. His patient, a person who was not suffering from any kind of neurological problem, was belligerent, and acting out in a racist way. Jane was immediately transported back in time, to when he was a child on the playground and classmates made similar comments.

Jane did not know how to respond to the patient, as he was not trained for the situation. Jane became angry, and told the patient that he could leave the hospital if he wanted.

“I regretted it,” said Jane, an American physician who held leadership positions in the Center for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology. Jane then went about learning how he could have handled the situation better. It led to him writing a journal paper, and leading a series of talks to help educate physicians and physician assistants on how to handle racist patients.



On Monday, more than 50 faculty, staff, students and members of the community participated in the first of two CHS webinars presented by the Diversity, Equity, and Inclusion Committee and sponsored by the Josiah Macy Jr. Foundation, entitled “Racist Patients: Taking Action on Harmful Bias and Discrimination in Clinical Learning Environments.”

The hour-long webinar featured topics like: How do you respond to a racist patient? And, Addressing Patient Bias at the Institutional Level.

Along the way, CHS faculty, students and alumni shared their own stories about patient bias, while offering advice on how to deal with it.

A few suggestions included: engage in conversation, treat the patient if unstable, or transfer the care.

Janice Kuperstein, PhD, PT, MSEd, Associate Dean for Faculty Advancement & Clinical Engagement, Professor and College Diversity Officer, said these are topics that are not commonly talked about.

Jane said that after the publication of his paper, many physicians wrote to thank him, saying they’d wished they would have learned how to handle such a situation. “Well, better late than never,” he said.

But the experiences with racist patients have not stopped. 

“Unfortunately, I have had experiences,” said Kara Wade, an occupational therapist at Cardinal Hill, and a panelist for Monday's webinar. Wade said she’d heard patients say they do not want medical personnel who aren’t white.

Vrushali Angadi, PhD, CCC-SLP, assistant professor and speech-language pathologist, agreed.

She told the story of a wealthy, well-educated gentleman who — after meeting her — requested another pathologist. A white one.

At the time, Angadi did not respond to the man, because she said she was afraid she might lose her student visa. “I was definitely not prepared to handle that situation,” she said.

But, she reminded the students to remember one thing: “You’re a student today,” she told them, “but you’re going to be a supervisor tomorrow.”

The trick is how to balance standing up for yourself while still respecting the patient.

On the UK neurology website, listed under Patient Responsibilities, it clearly states, “Patients, as well as their family members, representatives and visitors, are expected to recognize and respect the rights of our other patients, visitors, and staff.”

Further down, it notes: “In addition, patient or family requests for changes of nurses or other non-physician staff based solely on the nurse’s or other non-physician staff member’s race, ethnicity, religion, sexual orientation, or gender identity are not honored, except in rare circumstances.”

One student wondered how to report an incident, and Wade suggested to document everything that happens. Another student noted that these topics were not covered in their health and ethics course. Several of the professors in the webinar noted they should be taught, possibly with role playing activities.

Angadi did note that her situation had a happy ending. The patient who requested a white pathologist got one — but he then realized Angadi actually gave him better care.

From then on, he would only see her. “He was very apologetic,” she said. “Don’t give up on the patient. People are willing to change, which is why this has to be an ongoing conversation.”