Hospice: 10 Things Patients and Families Need to Know

Hospice is a care philosophy that focuses on maximizing the quality of life as opposed to the quantity of life. Hospice may incl...

Tuesday, August 8, 2017

Racial Profiling of Patients By Healthcare Providers

I hate having to write yet another post on discrimination against patient by healthcare providers, but I think it's important.

Recently, I was called to investigate an abuse incident. The only evidence based on chart review and talking to the staff was "the nurse heard the family member yelling at the patient". As a result, this family member was essentially banned from seeing the patient, who was confused at the time.

To avoid violating HIPAA, here is a super abridged version of what happened next:
-The family member returned to the hospital asking for the patient's location and an explanation for the ban. I received a phone call from the nurses station, claiming that the family member was on the verge of aggression.
-I was with the family member in minutes, and the person was completely appropriate with me. The family member acknowledged speaking loudly due to the patient's confused behavior and seemed apologetic. The explanation was sound, and added details not included in the nurse's report. I sent the family member home to await my call.
-I spoke to the administrative team gathered at the nurses station, who reiterated that the family member nearly became aggressive. When asked how the family member was approached, staff members stated that they were non-confrontation, but that there was also a group of them for security reasons.
-Despite no record of abuse in the patient's chart and my personal opposition, I was ordered under the guise of "due diligence" to call the local police station to request abuse history. As expected, "yelling at the patient" was not enough evidence to get information from the police.

By this point, I had noticed that the nursing and administrative staff was predominantly one ethnicity, while the family member was another. I brought this up to my boss, along with my suspicion that the family member was being racially profiled.

Later, I received a phone call from my boss telling me to call the family member to let them come back and to apologize on behalf of the hospital. The family member was gracious enough, but expressed embarrassment at being treated like a criminal.

The longer I'm in the first, the more I notice blatant discrimination against patients by healthcare workers. While I've already posted this in a previous blog post, I think it's worth reiterating the findings of a study by the Agency of Healthcare Research and Quality:
  • Blacks and AI/ANs received worse care than Whites for about 40% of measures.
  • Asians received worse care than Whites for about 20% of measures.
  • Hispanics received worse care than non-Hispanic Whites for about 60% of core measures.
  • Poor people received worse care than high-income people for about 80% of core measures.
As healthcare providers, we are mandated to provide non-biased care to all our patients. Being a member of a disenfranchised or minority group (like the staff at my hospital) does not excuse discriminatory behavior. Imagine being provided subpar care because of your race, gender, religion, illness, sexual orientation, etc. The thought makes me ill and makes me terrified to be hospitalized.

In the case of this family member, I was the last line of defense against an organization too eager to use the "abuser" label. As long as I am a social worker, I plan on advocating for my patients to ensure they get the best care possible regardless of circumstance.