Ashley Denmark, DO, was on a Hawaii-bound flight with her husband when the Delta flight crew asked if a doctor was on board. But when Dr. Denmark, a second-year family medicine resident in Florence, South Carolina, volunteered to assist, she says the flight crew was skeptical that she was really a physician. Ultimately, Dr. Denmark, who is African-American, was directed to sit down while two nurses, who were white, attended to the sick passenger.
In a blog post shared by the New York Times and the Washington Post, Dr. Denmark explained it wasn’t the first time she’d encountered discriminatory assumptions. “As an African-American female physician, I am too familiar with this scenario,” she wrote. “Commonly, I’m mistaken for an assistant, janitor, secretary, nurse, student, etc., even when I have my white coat on.”
Dr. Denmark’s experience followed a widely publicized incident this fall in which Tamika Cross, MD, an African-American physician, was denied the chance to help a sick passenger on a Delta flight. The incident prompted outrage and thousands of tweets using hashtags like #whatadoctorlookslike and #PhysiciansToday, which was created by the AOA’s Bureau of Emerging Leaders to highlight diversity among physicians.
Perla del Pino-White, DO, a family medicine physician in Fort Lauderdale, Florida, has also encountered discriminatory comments on the job. “Sometimes patients make comments to me about Hispanic people, not realizing I’m Hispanic, or about African-American people, not realizing I’m Afro-Cuban,” says Dr. del Pino-White.
In other cases, patients have told Dr. del Pino-White about encounters with health care professionals who made disparaging remarks about their ability to speak English. Whether discriminatory language comes from a patient or a health care professional, Dr. del Pino-White says, physicians can react by pointing out the importance of respecting diverse cultures and not judging others based on appearances.
Other physicians have had patients refuse treatment or ask for a different clinician because they don’t want to be seen by a physician of a certain ethnic background, religion or gender. A recent study from the journal Academic Medicine offered tips for resident physicians on dealing with this situation and patients’ discriminatory comments. Here’s a sampling:
- Reflect on your values as a medical professional: The first priority is to care for the patient.
- If the patient isn’t in immediate danger, try to learn what’s at the root of the fear. Doctors can use language such as, “What are the things you’re really concerned about? Tell me what you’re afraid of. All members of our medical staff are highly qualified.”
- If medical residents face discrimination in a nonemergency case and attempts to de-escalate the situation are unsuccessful, it’s OK to have a colleague care for the patient instead.
- Being open with colleagues about discrimination. “When these things occur, it’s important to share so you can open up dialogue and bring positive outcomes from a negative situation,” says Dr. Denmark. After she blogged about her Delta experience, for example, the airline apologized to her and is working to improve training for flight crews.
- Drawing on your DO training to model openness and inclusivity.
The study’s recommendations are a good starting point, say Drs. Denmark and del Pino-White, who also suggest:
It’s important for all physicians to be aware of the problem and support colleagues who experience discrimination, Dr. del Pino-White says: “Regardless of your own race, religion, age or gender, discrimination affects us all.”