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PTA Blog Talk

Discriminatory Care: Part One

Published February 7, 2013 9:12 PM by Jason Marketti

Being my cheerful self, I walked into the patient's room, introduced myself and immediately felt the frozen gazes of several family members. The one family member who could speak a little English told me it wasn't a good time to see his grandmother. I tried to get a commitment time from him but he deferred and suggested I come back later. No problem, I told myself, but later never came.

The family asked supervisors that I not come back because they didn't want someone like me to see the patient. Someone like me, in this instance, meant I'm male and don't speak the same language as them. The family specifically requested a female, fluently bilingual therapist. This isn't the first time a patient or family member has made a request pertaining to their comfort level in who treats them or their loved one. I have read about family members requesting that only white people treat their family member because of the patient's comfort level and facilities will sometimes honor the request.

When facilities begin to acquiescence to requests like this, it can interfere with the hiring of potential caregivers who have excellent patient care skills. These caregivers will travel where they are more welcome to provide their care to whoever needs it. Suppose I request only female EMTs when I call 911 because an accident happens at my home or only male CNAs for myself when I'm in the hospital? How about only male nurses and only female surgeons because I'm most comfortable with their care? Will this affect how a facility or business hires people? Yes. And it prevents extremely gifted people who are skilled at their jobs from doing what they do best.

In the instance above, it wasn't the first time I was asked not to see a patient based on my gender and limited language ability. Even with an interpreter by my side, I was asked to leave a room one time. The interpreter didn't tell me everything, but I suspected it was more than me being male and not fluent in the language they spoke. So I kept stepping, because I had work to do with people who wanted me to help them get them better.

4 comments

We provide service to caregivers and infants in their home.  We are in an urban centre and provide service to rural and urban clients.  We have various ethnic/race/religious groups both in the city and rural areas.  Usually we are visiting with mothers and their babies.  

Recently we had an instance where I told the mother that their Parent Infant Therapist would be starting soon and the name, a male staff member, the only one we have.  She looked shocked and dismayed and I asked if that was a problem.  She was muslim and she was uncomfortable with a male visiting her in the home while her husband was not there.  I told her to discuss it with her husband and that it is not a problem if she wanted a female, that she would wait 2 extra weeks but I would give service in the meantime if needed. Was this unreasonable?  I don't think so, many women would feel vulnerable in their homes with a stranger visiting, especially a male.  We try to respect the clients wishes and will not send a male alone to a muslim or amish/mennonite home unless we are sure it's ok.  If we know a woman has suffered abuse or trauma we may also be more sensitive.  We are priviledged to go into the homes of families and give them control over who they will allow in.  

Sharon , Pediatrics - Physiotherapist, Home Visiting Program February 21, 2013 11:20 AM
London

Two years ago I had a patient say, "I'm not having a bloody Yank in my home!" when I arrived to provide therapy in England. We worked with CNAs accompanying us. She was a locale and advised the gentleman that it would be a long wait for an English physio as we currently had only one on our team. She also suggested that he could go back into the hospital if he didn't want my care. He consented. She was more livid than I at the time. It is always the patient's right to refuse care, we have the responsibility to inform them of the possible outcomes of refusing care and then they get to make that decision. We have to behave ethically, they don't. It can be difficult to not take it personally, but don't, you make a very good point about having people wanting to work with you that can make full productive use of your time.

Dean Metz February 12, 2013 10:05 PM

Skip,

Oftentimes I worked in a predominately male environment.  Female therapists were not available and when a patient would make a request to have a female they were told there were none available.  The female patient either participated in therapy or was d/c'd early for being non compliant with her care by the insurance company.  

This may not seem fair to the patient but suppose the company fired one of us males to hire a female.  Would it be fair to the male therapist just to appease a patients request?  Now put a racial spin on it and see how fair it looks to the patient, the caregiver and the company who tries to please them both.

Jason Marketti February 9, 2013 7:38 PM

I have been working in healthcare a long time as a male PTA.  I have to tell you that I completely understand a female patients preference for a female healthcare provider.  I do not see this as a threat to my job.   I think this is becoming more and more the norm and, based on the amount of sexual abuse lawsuits, most likely a good thing too.

Skip Bagnell, PTA February 8, 2013 9:10 AM
Lansing MI

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    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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