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A Piece of My Mind
June 20, 2017

Speak Up

Author Affiliations
  • 1Executive Vice President, Chief Medical and Academic Officer, Renown Health, Reno, Nevada
JAMA. 2017;317(23):2373-2374. doi:10.1001/jama.2017.2022

When is the last time that your clinic was running behind and you met a patient by apologizing that you were late, only to have her angrily tell you that this delay occurred “because you are not an American”?

Recently I attended Schwartz Center Rounds at our institution, a weekly symposium that affords members of the faculty, house staff, nursing, pharmacy, and technical staff the opportunity to empathize and support one another in discussions of the “social and emotional” and ethical issues encountered in providing care to patients, their families, and each other. The topic was a complaint by a patient who stated she “could not understand” her physician “because of her accent” and that the doctor was late because “she is from Iran” and “doesn’t know the rules of this society.” Further, she demanded she be “assigned to an American doctor” on her next visit. For this presentation, a panel was formed by the physician, a nurse in the clinic who had also been born outside the United States, and a native, white medical assistant—all three women—who had encountered this patient in that clinic visit, in order to discuss that experience and the feelings it generated for them.