Archive for July, 2013

Bigoted Patients and the Obligation to Serve

A counterpoint to this article: while i have no doubt whatsoever that some fraction of patients are racist, and that this is of course bad and a trial for clinicians, to what degree is Chen’s blog post special pleading on behalf of a very, very high-social-status service occupation? In other words, it’s funny how nobody ever writes a piece called “When The Diner on Whose Table I Have to Wait is Racist” or “When The Guy Who Calls into My Call Center is Racist” or “When The Person Renewing His Driver’s License at my DMV Office is Racist.” Anyone who has ever worked in any service job that deals with the general public knows that you are occasionally going to have to suck it up and serve some flagrantly racist asshat who goes out of his way to abuse a minority employee. Except that 1) those businesses usually have much less of an ability to fight back than a doctor does – or at least choose not to, because this is America, after all, where the customer’s dollar is the most important thing of all; 2) the amount of contact those businesses have with the racist person is arguably more limited than some doctors have; 3) if the guy at the DMV loses his composure, the worst thing that happens is that some racist doesn’t walk out with a driver’s license, whereas if a doctor loses his composure, the patient could wind up dead.

Ultimately it seems to me that it’s going to be easier to thoroughly train doctors how to best handle these incidents than it is for the medical profession to try to coerce difficult, disturbed, and even racist patients to behave differently.