Overcoming Disrespect in Medicine: Protecting Physician 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 our profession. While we’ve all had moments when we—or our colleagues—didn’t quite measure up, most of us genuinely aim to make our patients feel safe and respected. But what about the flip side of this dynamic? It’s not talked about nearly enough: physicians are often not treated with the same dignity by their systems or even their patients.
In this article, I’ll dive into the major shifts that have led to this reality and share five practical strategies to help you push back against the disrespect and reclaim your sense of dignity.
The Roots of the Problem: Disrespect and Breakdown in Advocacy
We’ve been conditioned to expect, and even accept, that patients in distress might lash out, but the toll this has taken on physicians in recent years has been enormous. As recently as five years ago there was still a general expectation of respect for the expertise and sacrifices that a physician’s work entails.
But disrespect from patients is currently at an all-time high, sometimes even escalating to physical violence from patients. A recent study found that more than one third of public health workers in the US experience some form of workplace violence. Examples included stigma or discrimination, job-related threats, and bullying or harassment.
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. Their reach extends not only to metrics and billing, but into personal and professional decisions that once would have been completely off limits.
What’s more, employed physicians may have little say into whether threatening patients can be dismissed from their practices.
And 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.
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 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. Younger physicians who lack strong mentorship may be especially vulnerable to these situations.
Unfortunately, these well-meaning attempts to smooth things over often have the opposite effect. They can actually embolden the bully and do nothing to improve the situation.
The status quo is not sustainable, and it is incumbent on healthcare systems to work to create safe and respectful environments. 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 and caring physician doesn’t mean being a friend to your patients or colleagues.
Keep a clear line between work and personal life—avoid interacting with patients or administrators on social media, and be intentional about separating the two spheres. Setting clear expectations for respectful behavior can help prevent issues before they arise.
2. Advocate for a Respectful Work Environment
If you don’t stand up for yourself, who will? Open discussions about mutual respect—at meetings or through anonymous feedback systems—can pave the way for change.
Remember, you’re not asking for anything unreasonable. Advocating for policies that address disrespect and burnout can help create a healthier, more supportive workplace for everyone.
3. Strengthen Doctor-Patient Communication
Good communication is at the heart of the 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 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 addressing patient concerns.
4. Don’t Accept Disrespect
Firmly but politely calling out an incident of disrespect can be a first step towards creating a solution. When an issue persists or escalates, document what’s happening—it’s often more effective than just voicing complaints.
But 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 engaging with and reporting to security or even law enforcement personnel is the best course of action to protect everyone.
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 tools that help you to stay present, focused, and composed during difficult encounters, preventing potential escalation.
Don’t overlook the importance of making time for your family, friends and loved ones. 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 fortitude. While it’s crucial to acknowledge the culpability of our healthcare systems, real change will depend on strong advocacy from physicians like you. By starting with the steps above, 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.
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