The patient-physician relationship is a key component of care. Within these interactions, much of the responsibility is placed on the physician, but what happens when patient bias interferes?
What is patient bias?
In simple terms, Psychology Today defines bias as a tendency, inclination, or prejudice toward or against something or someone. In clinical settings, patient bias can manifest in several ways, including ageism, gender bias and racism.
The Association of American Medical Colleges (AAMC) explains that this issue is widespread and cites the following statistics:
- Nearly one in four gay physicians has received demeaning patient comments.
- More than one in three black physicians experienced racist remarks in 2020, according to AAMC data.
- Nearly 30% of physicians have been rejected by a patient because of their race, religion, gender or other personal feature.
The consequences of patient bias are severe, including erosion of the patient-physician relationship and increased healthcare worker burnout. AAMC says, “Such affronts are particularly worrisome at a time when medicine desperately needs to increase the diversity of the physician workforce.”
Confronting patient bias
On an institutional level, AAMC explains that some healthcare organizations are confronting the issue by establishing anti-bias policies and providing staff training on how to handle patient bias.
On an individual level, MDLinx cites guidance from the American Association for Physician Leadership, recommending that healthcare providers:
- aim to build trust with patients through personalized communication;
- make a good first impression; and
- use eye contact, active listening skills and appropriate touch to communicate clearly and convey a sense of security.
When physicians encounter discrimination, the AMA Code of Medical Ethics advises that physicians:
- recognize the potential psychological harm that can come from disrespectful, derogatory or prejudiced language;
- explore possible reasons for the patient’s behavior and appreciate clinical conditions or experiences that might have an influence;
- take steps to deescalate situations or remove threats when safety is at stake;
- explain to patients that they may seek care from other sources if they continue to oppose treatment from a particular physician; and
- terminate the relationship if the patient continues to display disrespectful behavior.
AMA also offers guidance on deciding whether to accommodate a patient’s request for an alternative physician. It suggests considering care goals and recognizing that a different physician may be clinically useful or improve outcomes.
At MLMIC, we are grateful for the important work that physicians and healthcare workers do, especially during this challenging era. For more information and support, policyholders are encouraged to explore MLMIC’s variety of resources detailing best practices associated with challenging patient interactions: