Focus on Physicians:
Insights, Ideas, and Strategies
Overcoming Disrespect in Medicine: Protecting Physician Dignity
Treating patients with dignity is one of the cornerstones of the medical profession. Most physicians genuinely want their patients to feel safe, heard, and respected. But what happens when physicians are not treated with the same dignity by their colleagues, their healthcare systems or even their patients? It’s a growing problem, and one that often goes unacknowledged.
In this article, I’ll dive into the major shifts that have led to this reality and I’ll share five practical strategies to help you push back against disrespect and reclaim your sense of dignity.
An earlier version of this article appeared on the KevinMD website in August, 2023.
Treating patients with dignity is one of the cornerstones of the medical profession. Most physicians genuinely want their patients to feel safe, heard, and respected. But what happens when physicians are not treated with the same dignity by their colleagues, their healthcare systems or even their patients? It’s a growing problem, and one that often goes unacknowledged.
In this article, I’ll explore the major shifts that have led to this reality and I’ll share five practical strategies to help you push back against disrespect and reclaim your sense of dignity.
The roots of the problem: Disrespect and breakdown in advocacy
In medical school, you may have been taught to expect, and even accept, that patients in distress might occasionally lash out. Years ago, this wasn’t something that happened every day, so it was easier to shake it off, remind yourself it wasn’t personal, and move on. Norms have shifted drastically over the past decade, and today the toll of daily disrespect has an enormous impact on physicians’ wellbeing and sense of agency.
In the worst cases, disrespect can escalate to physical violence. In fact, a recent study found that more than one third of public health workers in the US experience some form of workplace violence. Minority healthcare professionals are frequent targets, but any physician is at risk.
Adding fuel to the fire is the rise of administrative oversight of physicians and their practices by people who may have little experience in direct patient care. These administrators’ reach extends not only to metrics and billing, but into personal and professional decisions that once would have been completely off limits. Stigma, discrimination, job-related threats, and bullying or harassment are aspects of institutional disrespect that may be swept under the carpet by management personnel who work at a distance from patient care.
Of course, when physicians own their practices, they can refuse to engage with patients who are habitually disrespectful. And if staff members fail to maintain civility, they can be dismissed with cause. But employed physicians may have little say as to whether threatening patients can be dismissed from their practices, or disruptive staff terminated.
At the intersection of patient and administrative stress are the widely published patient satisfaction scores. While these scores often have no relevance to patient outcomes, they’ve become yet another pressure point, pushing physicians to prioritize arbitrary expectations over doing their best work.
When coping strategies backfire
Although physicians are tasked with regular training in sensitivity and respect for patients and employees, they get little instruction in how to protect their own dignity. Often, defaulting to earlier norms, physicians are advised to just let it go.
It’s not unusual for doctors, especially women, to attempt to deal with these situations with passivity and even self-deprecation, in a misguided attempt to get along. And regardless of gender, younger physicians who lack strong mentorship may be especially vulnerable to these situations.
Unfortunately, these well-meaning attempts to smooth things over typically have the opposite effect. They can actually embolden the transgressor and do nothing to improve the situation.
This status quo is not sustainable. It leads to burned out physicians, and can hinder patient care. It is incumbent on healthcare systems to work to create safe and respectful environments. But this is not something that can wait for a committee to decide what to do. As a physician, you have more power than you may realize. Here are five ideas that you can implement right now:
How to reclaim your dignity
1. Establish boundaries
Boundaries are essential for maintaining professional relationships and protecting your sense of self. Being a compassionate physician is not the same thing as being a personal friend.
Keep a clear line between work and personal life. This means avoiding interacting with patients or administrators on social media, and being intentional about keeping the two spheres separate.
2. Advocate for a respectful work environment
If you don’t stand up for yourself, who will? Open discussions about mutual respect, whether at meetings or through anonymous feedback systems, can pave the way for change.
Keep in mind that you’re not asking for anything unreasonable. Advocating for policies that address disrespect and burnout can help create a healthier, safer, and more supportive workplace for everyone.
3. Strengthen doctor-patient communication
Good communication is at the heart of any physician-patient relationship. By being empathetic and respectful in your interactions, you can set the tone for civility with both patients and staff.
Stay calm during difficult conversations. Pause, take a deep breath, and step away if needed. Active listening, showing genuine interest in your patients' concerns, and involving them in decision-making can help build trust and respect.
And although the EHR is great tool for communication, keeping EHR messages brief and focused can help to maintain your professional boundaries while still addressing patient concerns. If a message requires more than a couple of minutes of your time, it may be an indication that the patient needs an office visit for more focused care.
4. Don’t accept disrespect
Firmly but politely calling out an incident of disrespect can be a first step towards creating a solution. This can mean simply repeating someone’s words out loud, asking if they meant to say what you heard. If an issue persists or escalates, begin by documenting what’s happening. This is often more effective than simply voicing complaints.
If you feel that your safety or that of your staff is at risk, don’t allow yourself to be talked into accepting a dangerous situation. If you’re employed, your healthcare system bears responsibility. If your concerns are not addressed, sometimes reporting to security or even law enforcement personnel is the best course of action to protect everyone. And don’t overlook the option of engaging an attorney if workplace safety issues are routinely ignored.
5. Take care of yourself
Prioritize your own well-being. Make time for self-care, whether it’s through exercise, meditation, or hobbies to help you recharge emotionally and mentally. Mindfulness practices can give you practical tools that help you to stay present, focused, and composed during difficult encounters, preventing potential escalation.
Make time for your family, friends and loved ones. Don’t take them for granted. By nurturing these ties, you will stay connected to the world outside of your practice.
Reclaiming your dignity as a physician will require commitment and some courage. While it’s crucial to acknowledge the culpability of our healthcare systems, real change depends on strong and consistent advocacy from physicians. Fair or not, no one else is likely to do this work for you. By starting with the steps I’ve outlined, you can begin to build a workplace that’s not only more respectful but also more sustainable. And ultimately everyone, including the patients you care for, will benefit.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary coaching discovery session, click the button below.
References