Discriminatory Patient Behavior Towards Minority Healthcare

Volume 5, Number 4, November 2023

Current Concept Review

Discriminatory Patient Behavior Towards

Minority Healthcare Providers: Prevalence,

Consequences, and Coping Strategies

Anthony Yung, MMSc

; Terrence G. Ishmael, MBBS

; Aaron Cedric Llanes, MS

; Mohan V. Belthur, MD, FRCS (Tr & Orth), FAAOS

3,4

Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ;

Shriners Hospital for Children-Philadelphia,

Philadelphia, PA;

University of Arizona, College of Medicine-Phoenix, Phoenix, AZ;

Department of Orthopedics, Phoenix

Children’s Hospital, Phoenix, AZ

Correspondence: Terrence G. Ishmael, MBBS, Shriners Hospital for Children-Philadelphia, PA 3551 N. Broad St,

Philadelphia, PA 19140. E-mail: terr[email protected]

Received: September 24, 2023; Accepted: September 24, 2023; Published: November 15, 2023

DOI: 10.55275/JPOSNA-2023-791

Abstract

In recent years, waves of civil unrest precipitated a national reckoning on the topics of racial injustice, diversity, equity,

inclusion, and belonging. Despite playing an essential role in society, minority healthcare personnel are not immune to

experiencing discriminatory patient behavior in the clinical setting. As the U.S. healthcare workforce becomes more

racially and ethnically diverse, the frequency of negative encounters between patients/families and healthcare providers

of varying social identities will likely increase. For minority healthcare personnel, patients’ discriminatory behavior

can be emotionally challenging, painful, degrading, and could cause feelings of distress, potentially leading to burnout.

Patients/families who demean healthcare providers based on their social identity pose multiple clinical obstacles and

ethical dilemmas to care, which unfortunately can elicit a significant psychological toll on healthcare providers. A

stable therapeutic bond between provider and patient is built on mutual trust, respect, and understanding. This is the

basis of a mutually fulfilling physician-patient relationship and efficacious patient care. In contrast, an incongruous

therapeutic alliance poses challenges to achieve optimal patient and provider outcomes.

We will discuss the prevalence of discriminatory patient behavior against minority health providers and explore the

impact of these potentially distressing experiences. We will present coping strategies and resources for healthcare

providers when directly facing negatively biased patient behavior. Finally, we will offer guidance and a framework that

physicians, bystanders, and institutions that encounter racially motivated behavior from patients and/or their families

can use to respond to these difficult situations.

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Introduction

A constructive relationship between patient and physician

is the cornerstone of healthcare. This relationship is built

on mutual trust, respect, and understanding. However,

this relationship is often strained in today’s diverse

society because of our many differences. This not only

results in decreased quality of healthcare delivery but can

also result in poor patient experience, increase the cost of

healthcare, and harm both the patient and the healthcare

provider. Over the last few decades, much time has

been spent on evaluating the issues of physician bias

against patients that are members of underrepresented

minorities and how this affects outcomes. Additionally,

discrimination against physicians of minority

backgrounds by fellow physicians has also been

reviewed. Yet little attention has been paid to healthcare

providers of minority backgrounds that experience bias

and/or abuse from patients and their families.

It has been found that minority physicians are

significantly more likely to have left at least one job

because of discrimination in the workplace (black, 29%;

Asian, 24%; other race, 21%; Hispanic/Latino, 20%;

White, 9%).

In multivariate models, individuals that

experienced racial/ethnic discrimination at work were

associated with higher job turnover than those who did

not. Among physicians who experienced workplace

discrimination, only 45% of physicians were satisfied

with their careers.

Furthermore, increased physician

turnover puts additional strain on our healthcare

system. For example, the turnover of primary care

physicians (PCP) results in approximately $979 million

in excess healthcare expenditures for public and private

payers annually, with $260 million attributable to PCP

burnout-related turnover.

Increasing physician turnover

due to racial discrimination would only further hinder the

healthcare system.

Living with societal prejudice, in addition to

experiencing micro and macroaggressions in the

workplace, takes its toll. Ungrateful, or even openly

hostile behavior from patients’ families because of

one’s minority status can significantly impact healthcare

provider well-being and fulfillment. In this article, we

seek to explore this painful experience further, discuss

its consequences to patient and provider outcomes, and

provide suggestions as to how we can address, cope, and

thrive in the face of discriminatory patient behavior.

Prevalence

The turn of 21st-century medicine in the U.S. has seen

explosive growth in the diversity of the healthcare

workforce. Through recruitment initiatives, the U.S.

Key Concepts

• Patients’ racially discriminatory behavior towards minority healthcare providers is common, emotionally

challenging, painful, and humiliating.

• When encountering inappropriate patient behavior, individuals and teams should approach patients/families with

compassion and provoke self-affirmation in prejudiced patients to reduce bias.

• After the encounter, a team meeting can offer a supportive environment for affected individuals and team members.

Furthermore, debriefing and reflection can facilitate discussion on future responses and improve morale.

• Institutions and bystanders play an essential role in protecting and intervening in racially prejudiced patients’

behavior against minority physicians.

• Organizations and providers must aim to devise effective policies, develop mandatory anti-discrimination training

for all healthcare team members, and cultivate a culture of safety and belonging in the work environment.

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healthcare workforce has become increasingly racially

and ethnically diverse: 28% of practicing physicians

are foreign-born, 51% are nonwhite, and 10% are

from minority groups underrepresented in medicine.

Consequently, patients are more likely to encounter

physicians whose identity or appearance is different than

their own.

In a retrospective survey study of three academic

medical centers, 98% of residents reported experiencing

or witnessing biased behaviors at least once in the past

year.

A total of 14% of residents experienced belittling

comments at least once a week, and 11% experienced

questioning of credentials or abilities at least once

a week.

Furthermore, 33% of residents reported

experiencing negative patient bias at least once per

month. These included: belittling comments (38%),

assertive inquiries into racial/ethnic origins (33%), and

questioning of credentials or ability (34%).

In recent years, discriminatory patient behavior towards

minority healthcare providers has unfortunately

become quotidian. Patient discriminatory behavior was

disproportionately prevalent for Latino, Black, and Asian

residents in comparison to their White colleagues.

For

example, 45% of Black or Latino residents reported

experiencing refusal of care and requests to change

physicians compared to 28% of White residents.

another national survey, ethnic minority clinicians were

more likely to hear biased remarks than White doctors,

with nearly 70% of Black and Asian doctors reporting

such events.

Minority physicians, including Asian

(43%), Black (30%), and Hispanic (37%), are more

likely to hear inappropriate ethnicity-related remarks

compared to White (11%) physicians.

With regards to medical education, 81% of trainees

reported receiving 2 hours or less of training on

encountering prejudiced patients during residency.

Although 72% of trainees received education on patient

bias in medical school, 74% rated the content of their

prior training as less than adequate.

Finally, 89% of

residents identified the need for biased patient training

and policies as necessary or very necessary. This study

highlights the importance of training and policies to

address biased patient behavior and support for affected

physicians by healthcare systems within the U.S.

Consequences: Increased Physician

Turnover, Burnout, and Poor Patient

Outcomes

According to the American Medical Association’s

(AMA) code of medical ethics, the patient-physician

relationship is based on mutual trust in which the

provider acts as the patient’s advocate.

The goal is

to alleviate suffering without regard to self-interest.

Regarding patient acts of discrimination, the AMA states

that “patients who use derogatory language or otherwise

act in a prejudicial manner toward physicians….such

behavior, if unmodified, may constitute sufficient

justification for the physician to arrange for the transfer

of care…”

There is also a legal limitation on the

extent to which physicians and healthcare organizations

can respond to patient bias. The Emergency Medical

Treatment and Active Labor Act (EMTALA) states that

hospitals cannot refuse patient care in an emergency,

making it difficult to reject a patient’s reassignment

request or ignore discriminatory behavior.

However,

beyond these general principles, physicians and hospitals

have only a modicum of instruction on how to balance

physicians’ employment rights, patients’ interests, and

duty to treat when encountering prejudiced patients.

It is common practice for healthcare institutions to

honor patients’ unreasonable requests, such as race-

based physician reassignment. However, such practices

have established a precedent of indifference towards the

needs of the physicians without assessing whether these

demands were justified or provoked discomfort toward

clinicians.

Supervisors are ill-equipped to respond to

patients’ inappropriate comments and solicitation for

physicians based on nonclinical factors.

This ignorance

propagates a failure to respond to the psychological

toll on the physicians and trainees, leaving them

feeling humiliated, embarrassed, or unsettled.

Much

of the literature on minority physician experiences,

documents acts of bias by patients and illustrate that

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many healthcare organizations provide little guidance

on responding to patient bias, resulting in significant

variability in how physicians respond.

10,12-14

A patient’s

biased behaviors are a pernicious and insidious malady

in medicine because of the harm done to the physician’s

well-being. Physicians often struggle with the internal

conflict between their aversion to the patient and their

professional duty to provide care.

15-18

Some physicians

may ignore the biased remarks due to the potential

consequences of responding (e.g., victim-blaming, poor

evaluations), or some may choose to accommodate

requests for reassignment to avoid confrontation with

biased patients.

A study by Wheeler et al. provides insight into the

painful emotions that patient-biased behaviors elicited.

This study interviewed internal medicine residents who

encountered biased patients and reported that these

residents’ mental health was often affected negatively,

with fear, self-doubt, exhaustion, and cynicism all

reported. Co-residents that observed these events

reported moral distress and were unsure as to how to best

help their colleagues when these situations arise.

Some

residents reported that their focus was often disturbed

and would rather avoid clinical sites where those

encounters were common, which could stymie learning

experiences and opportunities.

A national survey

among general surgery residents revealed that 47%

experienced racial/ethnic discrimination from patients

or patients’ families.

In the same study, residents that

encountered these occurrences were more likely to suffer

from burnout and suicidal ideation.

Although many

physicians believe they can dissociate negative emotions

created by patients’ animosity without compromising

the quality of care, it has been suggested that affected

providers may be reluctant to spend extra time with the

patients.

11,21

This has multiple potential downstream

results. Time spent with patients is positively correlated

with better patient satisfaction, prescribing practices, and

lower risk of malpractice claims.

Furthermore, patient

satisfaction can also influence clinician reimbursement,

career advancement opportunities, and leadership

positions,

which could widen the disparity between

minority physicians and their nonminority colleagues.

As the U.S. physician population becomes more racially

and ethnically diverse, it is likely that the frequency

of racially biased patient encounters with minority

physicians will increase. Therefore, addressing

patient-biased behaviors is essential and should be a top

priority for our healthcare system.

Coping Strategies: Confronting Bias &

Seeking Support

Racial bias is a personal and sometimes unreasonable

judgment made solely on an individual’s race.

Experiencing racial bias from patients can be a

stressful psychological process. Although the burden of

defusing biases should not solely lie on its stigmatized

targets, those targeted by intergroup biases are often

in a unique position to respond effectively to shift the

paradigm. An interpersonal confrontation may result

when an individual brings awareness to an instance

of intergroup bias to the offender, especially when

there is a discrepancy between the offender’s actions

and egalitarian values.

The recognition of these

discrepancies may elicit negative self-directed emotions

and contemplation by the offender while establishing

cues to prevent future occurrences of a value-discrepant

response.

Racial bias studies have shown that both

threatening and nonthreatening confrontation of biased

responses may result in guilt, shame, behavior inhibition,

retrospective reflection, and more importantly, decreased

likelihood of future biased responses by the offender.

25,27

Victims of bias can then be empowered to recognize

biased behaviors and act as a reminder for self-control on

the offender’s behalf.

Physicians should employ bias-reducing strategies while

establishing trust between patients and providers. One such

strategy involves patient education on self-affirmation

which can diminish threat responses in different domains.

Self-affirmation theory focuses on how individuals

adapt to information or experiences that threaten their

self-concept by reflecting on and prioritizing personal

values.

It has shown utility in developing receptiveness

to a conflicting message

and reducing stress from social

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identity threats.

One study demonstrated its utility in

addressing ethnic bias towards Arab-Americans.

This

study showed that prejudiced White participants were not

interested in meeting Arab American individuals again

if they were immediately confronted with the insistence

that they take the perspective of Arab-Americans who

have faced discrimination since the 9/11 attacks.

However, if the Arab-American first asked the prejudiced

White participant questions to promote self-affirmation,

they were more likely to express a desire to meet an

Arab-American again even after the confrontational

perspective-taking message.

In addition to bias-reducing strategies, physicians should

be equipped with appropriate coping strategies to reduce

the detrimental impact on one’s emotional well-being.

Physicians who have experienced biased behaviors

deserve to have their experiences and feelings validated

by an ally, a colleague, or a loved one. Seeking support

from support groups and social networks is an effective

self-healing strategy

that can help one gain perspective,

validate the experiences, and develop protective

mechanisms.

Although social support may involve

colleagues with similar firsthand experience, support

from other empathetic individuals is also valuable

in providing comfort and affirmation.

Aside from

outside support, self-protective strategies should also be

employed. Healthier strategies may involve repression

or sublimation through hobbies.

In sum, as physicians,

the goal should be to temper indignation, maintain

professionalism, and attain satisfaction in our field.

Framework for Responding to Patient or

Visitor Bias Behavior

According to Title VII, clinicians have the right to a

workplace free of discrimination.

However, healthcare

professionals also have a fiduciary responsibility to

address emergent situations in which patients’ lives

are at risk. Physicians must carefully balance their

well-being with patients’ rights and safety.

Clear

policies and procedures are necessary to guide staff when

discriminatory behavior occurs in the healthcare setting.

This section will provide an algorithm (Figure 1) and

scripts (Table 1) for responding to inappropriate patient

or visitor behavior utilizing the previously discussed

coping strategies.

Inappropriate Patient or Visitor Behavior

First, clinician safety must be a top priority. If a

patient is endangering the physician’s well-being,

physicians shall disengage from patients immediately

and request additional assistance, such as a security

team, supervisors, and law enforcement. In addition,

they should report the incident to the organizational

leadership and consider a transfer of care. When

confronting prejudiced patients, providers must

consider patient autonomy with the ethical principle of

justice and nonmaleficence.

Physicians should treat

allformsofdisrespectwithcompassion.ThíchNhất

Hạnh,widelyregardedasa“fatherofmindfulness,”

described the best approach for managing interpersonal

conflict as:

“…If we are sincere in wanting to learn the truth, and

if we know how to use gentle speech and deep listening,

we are much more likely to be able to hear others’

honest perceptions and feelings. In that process, we may

discover that they too have wrong perceptions. After

listening to them fully, we have an opportunity to help

them correct their wrong perceptions. If we approach

our hurts that way, we have the chance to turn our fear

and anger into opportunities for deeper, more honest

relationships…”

The intention of deep listening and loving speech is to

restore communication because once communication

is restored, everything is possible, including peace and

reconciliation. Therefore, mental acuity and the patient’s

health condition must be considered before deciding

on a response to discriminatory patient conduct. If the

patient’s behavior is not hostile, physicians should

assess the patient’s cognitive abilities, such as reduced

decision-making capacity.

Then, the physician should

de-escalate with empathetic language and address the

inappropriate behavior or comments and inform the

patient of their role as physicians: to improve his or her

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Table 1. Examples of Scripted Response to Inappropriate Patient Request

•“Helpmeunderstandyourrequest.”

•“Weareheretohelpyouasateam.Wedonotchangedoctors/nurses/etc.,becauseoftheirrace/ethnicity/religion/etc.”

•“All[NameofYourInstitution]teammembersareveryqualified.Ourtoppriorityisthatyoureceivethebestcare,and

I know that our team members can provide that.”

•“All[NameofYourInstitution]staffarecredentialedandlicensedtopracticeintheStateof__________.Oneof

our core principles is that we treat everyone in our diverse community with respect and dignity. We are confident in

_________’scharacterandclinicalskills.”

•“Iwouldtrustthisphysician/nurse/therapist/etc.,tocareformyownchild/familymember.”

•“Wewanttoprovideyouwithexcellentcareandbelievethat_________istherightpersontodoso.”

•“[NameofYourInstitution]hiresthebestandbrightestpeopletocareforourpatientsregardlessoftheirrace,

ethnicity, gender, sexual orientation, etc.”

Adopted and modied with permission from Mayo Clinic’s 5-Step Policy for Responding to Bias Incidents.

Figure 1. Algorithm for responding to inappropriate patient or visitor behavior.

Adopted with permission from Mayo Clinic’s 5-Step Policy for Responding to Bias Incidents.

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health. Suggested language includes “I am surprised

you thought that would be an appropriate comment/

behavior,” “Let’s keep it professional,” and “I am here

to focus on your health.” Furthermore, physicians

should share their perspectives on how the patient’s

behavior makes them feel. For example, “When you said

[inappropriatecomment]/did[inappropriatebehavior],

I felt uncomfortable.” Next, physicians should inform

the patient that their behavior, if continued, would

undermine the therapeutic alliance. For instance: “Your

care team is made up of many different individuals

who are all working to address your issues. I respect

every member of your team and ask you to do the same

to achieve the best outcome for you.” If the patient’s

inappropriate behavior continues, physicians should

consider temporarily retreating from the setting, with

this suggested response: “We are going to come back

in 30 minutes and hope you will be ready to move

forward.” In addition, bystanders are encouraged to step

in when witnessing inappropriate behavior by affirming

the physician’s ability and addressing the inappropriate

behavior. Physicians should consider that if the patient’s

or visitor’s behavior towards the staff is derogatory or

abusive, it will not be tolerated, and, if persistent, could

result in termination of care depending on its severity

and the setting. This determination should be made by

members of the healthcare team most familiar with that

individual patient’s clinical, cultural, religious, and social

background, in addition to the administration. If the

patient’s behavior is determined to be inappropriate, the

physician may terminate service, offer a transfer of care

to another healthcare institution, and should document

the inappropriate behavior through the reporting

system. In more complicated scenarios where attempts

at dialogue reach an impasse, risk management/ethics

teams should be consulted. Most institutions have such

resources readily available and may have dedicated

multidisciplinary patient experience teams to deal with

potentially contentious situations which can reduce

confrontation and litigation.

The team should apply

policy consistently; clearly communicate expectations to

patients, learners, and staff; and consider each situation

with the aim to resolve conflict as amicably as possible.

Vignette

Dr. Mohammed entered her next patient’s room to see

Amy Smith, a 7-year-old White female. She was present

with her father who looked at the physician suspiciously.

After initial introductions, the patient’s father interrupted

Dr. Mohammed, saying that he would like his daughter

to be seen by a White doctor. Having experienced similar

situations in the past, Dr. Mohammed calmly and clearly

responds: “Mr. Smith, I understand that you want the best

for your daughter. I assure you that I am well-qualified

and fully capable of evaluating her. We will discuss her

symptoms and together, we will figure out what is the

best course of action. I have a little girl that is about the

same age as Amy, and I can understand the concern that

you are feeling. We are in this together. I will have to

inform you that it is not the policy of our institution to

allow patients or their families to decide which physician

they would like to see based on their race or sex. Why

don’t you take a few minutes to think about this, and I

will be right back.” Dr. Mohammed left the patient room.

Upon her return, Mr. Smith apologized and agreed to be

seen.

After the Encounter

Vulnerability of Trainee/Supervisor, Bystander, and

Peer Intervention

Due to medical hierarchy, trainees are particularly

vulnerable to patient mistreatment.

Many trainees may

be concerned with drawing attention to incidents with

the biased patient due to the risk of victim-blaming,

poor evaluation, and being perceived as weak.

In this

situation, supervisors and peers need to intervene on their

behalf, as trainees are generally vulnerable with little

authority to protect themselves.

In situations where the

supervisor fails to address the incident, trainees often

wonder if their supervisors question the validity of the

complaint. This may, unfortunately, result in the decision

to stay silent, as trainees often worry that requesting

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assistance might jeopardize their career.

Therefore,

the attending physician, as the care team leader, should

address inappropriate behaviors as it may place other

staff members in potentially abusive situation.

If a

learner does not wish to participate in a patient’s care

as a result of abusive behavior by the patient or family

members, it is the responsibility of the supervisor to

evaluate the situation and respond appropriately. Lastly,

the supervisor should offer support after the incident.

When encountering abusive patients and/or family

members, bystanders and peers should intervene on

behalf of the victim, as they may be at a loss as to how

to proceed.

A survey of trainees revealed that 50%

of respondents who experienced or witnessed patient

discrimination did not know how to respond while 25%

believed nothing would be done if hospital leadership

were notified.

After the incidents, bystanders might

consult with affected trainees, acknowledge the incidents,

and offer support and empathy. If bystanders wish, they

may share past experiences with biased patients to reduce

the affected trainee’s feelings of self-doubt and build

rapport.

Bystanders and peers can share additional

resources to help trainees process or report the incident.

Reporting events can improve data collection on the

prevalence of discrimination and identify a potential area

of improvement. This data can be implemented in new

strategies to prevent biased incidents from reoccurring.

For example, heat map analysis can detect trends and

identify departments or groups of clinicians at a higher

risk of experiencing patient bias and provide additional

information to revised policies, support, and education

in the future.

Creating this culture of accountability

will allow healthcare professionals—especially staff who

are more vulnerable to discrimination—to better support

those that may encounter such situations in the future.

Debrief/Reflection/Team Meeting/Offer

Support

After the encounter, supervisors should host follow-up

team meetings to acknowledge the event and debrief

the affected individuals in a safe and nonjudgmental

environment. The objective is to reiterate the seriousness

of the experience and allow the trainees and care team to

share and reflect upon the experience with the attending

physician and/or other trusted source of support and

guidance. Research has consistently demonstrated that

the use of critical reflection to process emotionally

challenging clinical encounters helps clinicians cope with

discriminatory experiences.

49-51

It is essential that this

meeting be structured and facilitated in a manner that

promotes inquiry rather than minimize the individual’s

experience. Other team members should be allowed

to empathize with the individuals and others, who

experience of discomfort and vulnerability, so that they

may develop the skills necessary to manage a biased

patient.

Furthermore, this meeting should allow team

members to care for each other, share experiences,

and discuss alternative responses to episodes of

biased behavior by patients and visitors. A supportive

environment is crucial in crafting a meaningful future

response, improving morale, and building camaraderie

among the healthcare team.

In addition to debriefing,

the supervisor needs to ensure that trainees report the

incidents to the proper reporting outlet, which is essential

for the administration to implement or revise policy

relevant to the patient’s biased behavior.

Summary

Medicine is not immune to the prejudice and bias

prevalent in society. It may even come from those whom

physicians are dedicated to serving. In the face of an

ever-shifting demographic landscape, modern medicine

requires a change in the workplace culture to prepare

an ethnically, culturally, and gender-diverse workforce

for the increasing number of biased behaviors from

patients and visitors. Therefore, all healthcare leaders

and institutions should be urged to develop practices

to protect and provide their healthcare personnel

with a safe, supportive, respectful work environment

and to create a sense of belonging where people feel

comfortable, can make meaningful connections, and

contribute to the success of the system.

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Table 2. Resources for Physicians, Bystanders, and Institutions That Experience Patient’s Bias

Resources Description

1. Operating with Respect by The

Royal Australasian College of Surgeons

(RACS)

The Operating with Respect course provides advanced training in recognizing,

managing, and preventing discrimination, bullying and sexual harassment.

The aim of this course is to strengthen patient safety by enabling participants

to develop skills in respectful behavior and practice strategies in responding

to unacceptable behavior. The course follows the release of the RACS Action

Plan on Discrimination, Bullying and Sexual Harassment in the Practice of

Surgery.

Target Audience: Physicians, Trainees, and Other Healthcare Team Members

2. IHI Framework for Improving Joy in

Work

A guide for healthcare organizations to engage in a participative process

where leaders ask colleagues at all levels of the organization, “What matters

to you?”, enabling them to better understand the barriers to joy in work, and

co-create meaningful, high-leverage strategies to address these issues

Target Audience: Healthcare Administrators and Healthcare Team Leaders

3. Mayo Clinic’s 5-Step Policy for

Responding to Bias Incidents

A framework to address bias incidents and to cultivate work environments that

are safe for employees and patients. This guideline created both policies to

support staff and a reporting mechanism for accountability.

Target Audience: Healthcare Administrators

4. Stanford Applied Compassion

Training

An 11-month training program to prepare professionals, including physicians,

who feel a strong need to bring forth and integrate compassionate action into

their occupations, professions, communities, and institutions, as well as into

their personal development.

Target Audience: Healthcare Administrators, Physicians, Trainees, and Other

Healthcare Team Members

5. Stanford SHARE’s Upstander

Intervention Program

A program and guide to promote a culture of community accountability where

bystanders become upstanders that are actively engaged in the prevention

of violence, realizing that all individuals are responsible for each other in

addition to themselves.

Target Audience: Healthcare Administrators, Physicians, Trainees, and Other

Healthcare Team Members

6. The Fearless Organization: Creating

Psychological Safety in the Workplace

for Learning, Innovation, and Growth

A book offers a step-by-step framework for establishing psychological safety

within a team and an organization. It is filled with illustrative scenario-based

examples and provides a clear path forward for implementing a culture that

thrives on the free expression of ideas and nurturing engagement.

Target Audience: Healthcare Administrators and Healthcare Team Leaders

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External Resources for Physicians, Bystanders, and

Institutions to Address Patient’s Bias

All physicians, clinical care team members, and

institutions should behoove creating a comfortable work

environment where all healthcare providers and patients

are treated with equal respect and dignity irrespective

of their social identity. This goal can be achieved by

devising an effective policy that explicitly addresses

patient bias, ensuring mandatory training for all team

members, and cultivating a culture of compassion

within the clinical setting. However, clinicians and

administrators often encounter various barriers, including

a lack of resources, guidance, and support, when

attempting to foster a physically and psychologically

safe workplace.

In Table 2, we describe a few readily

available resources, including frameworks, step-by-

step guides, and training programs, for both individuals

and organizations. We hope these resources will offer

practical recommendations and examples for advancing

diversity, equity, inclusion, justice, and belonging within

the medical community.

Disclaimer

No funding was received. The authors report no conflicts

of interest related to this manuscript.

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