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INCIDENT REPORT When Patients Are Treated Without Respect JudyAnn Bigby, HMS associate professor of medicine at Brigham and Women's Hospital, has written the response to the incident below. Incident: A student reported that during team rounds, the resident referred to a black patient by her first name, removed her bedclothes, and examined her abdomen and breasts without drawing the curtains in a two-bed room. The next patient, a white woman who was called Mrs. Jones, underwent the same examination while she was carefully draped, and the curtains around her bed were drawn. Response: In a national survey, the Kaiser Family Foundation found that 16 percent of whites, 30 percent of Latinos, and 35 percent of blacks believe that racism in health care is a major problem. In addition, 15 percent of whites, 35 percent of blacks, and 36 percent of Latinos reported that while receiving medical care they or a family member had experienced unfair treatment because of their race or ethnicity. The Commonwealth Fund reported similar findings: African Americans were twice as likely as whites to say they had been treated with disrespect. While this research reflects people's perceptions of racism and bias in the health care system, there are growing data to suggest that physicians, whether intentionally or not, do exhibit bias when treating patients from racial and ethnic minority groups. In the situation above, the team members should not stand by and allow a woman to be exposed while being examined on rounds. Another team member should immediately close the door and draw the drapes around the patient's bed. The student might also model appropriate behavior by asking the patient how she prefers to be addressed. After rounds, the student also should share his or her concerns about the disrespectful treatment with the resident involved or with the chief resident. The student may also find that it is appropriate to go to the patient to explore the patient's concerns about her experience in the hospital and develop strategies to advocate for the patient to improve her experience. This display of concern would go a long way toward building trust with the patient.