Table 3. Commonly Reported Responses.
| Response | Illustrative Quotation [Participant] |
|---|---|
| Individual/Team | |
| Setting limits | “I’ve been coached on saying statements like, ‘Well, that’s flattering, sir. I would like to focus on how I can help you with your medical problems right now, as your doctor.’” [Second-year resident, woman, Latina] |
| Team plan | “What was really great about the situation was that then we as a team sort of figured out how to address the patient, and I wanted to take a very active role in how we addressed him. I started off, ‘We want to maintain a respectful environment for all of our patients and provider relationships. And this is something that crosses a boundary.’ And allowed him to say what he needed.” [First-year resident, woman, white] |
| Avoiding confrontation | “My response has been to retreat into the background and let the intern do most of the face to face and I’m just going to take a step back unless something really goes down.” [Third-year resident, woman, black] |
| Explain clinical consequences of behavior | “I was under the service where the chief resident was certainly the most skilled surgeon on the floor and someone needed a C-section, and that chief was a man, and he had a very frank conversation with a patient who was saying, ‘You can refuse my care but you’ll get worse care or you’ll have to wait 90 minutes. This is what is here and those are the options.’” [Fourth-year medical student, gender nonconforming, white] |
| Institutional | |
| Reassigning staff or patients | “What ended up happening is that they talked to the chief residents, and they ended up switching this patient...to a team of all male residents who were not minorities.” [Third-year resident, woman, black] |
| Behavioral teams | “So we told my attending the next day. Then we got the BEST [behavioral contract] team involved to try to see if that could help with [the patient’s] behavior.” [Second-year resident, woman, Latina] |
| Training | “We are now getting training, if you’re at the right site, on how to deal with racist patients. There are things in motion at least on the resident or the GME level in internal medicine but I don’t know if there’s any CME training on this.” [Third-year resident, woman, Latina] |
Abbreviations: BEST, Behavioral Education and Support Team; CME, continuing medical education; C-section, cesarean section; GME, graduate medical education.