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November 2018

Inappropriate Behavior by Patients and Their Families—Call It Out

Author Affiliations
  • 1Department of Internal Medicine, University of Utah, Salt Lake City, Utah
  • 2George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
JAMA Intern Med. 2018;178(11):1441. doi:10.1001/jamainternmed.2018.4348

Recently, I was the hospital attending physician on service when the team admitted an elderly patient. Despite the obvious end-of-life status, the family wanted everything done to keep the patient alive. They made unrealistic demands, were disrespectful, and at times were outright hostile. They did not want to work with the medical student, who was Muslim. They also did not want to work with the intern, whom they felt was not a real physician. The senior resident, despite being from a neighboring US state, was not allowed to touch the patient because the family believed that the resident’s skin was too dark for an American. To say that this family was disappointed when they learned that I, the attending physician, was a woman would be an understatement. After a brief introduction, I let the family know that we work as a team, and they would be working with all of us. Later when I discussed this out-of-the-ordinary behavior with the team, I asked, “What did you do when you recognized the disrespectful behavior from this family?”

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2 Comments for this article
Thank you
Gina Gotsill, Masters in Journalism |
I appreciate your point of view and the specific examples you shared. Required reading for anyone who wants to work in the medical field.
You get no support from higher ups
Ramakant Sharma, MD |
It is easy to write that one should call out such behavior. But it is easier said than done. These behaviors are encountered by all workers in health systems, day in and day out. An individual worker may lack  rights in the current system.

A  physician can not decline to take care of an abusive patient, as it will be called abandonment. There is a fear of retribution in the form of law suit. Third, And there is no support or policies to tackle such patients.

Until we change the law, the situation will continue.