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APDIM Fall Meeting

Published Date:

APDIM Fall Meeting. October 27, 2018.

Orlando, Florida

Patients as a Source of Harm – A Single Institution Resident / Employee Survey and Policy to Create a Safer Workplace

Speakers: Andrew J. Varney, MD, Vidhya Prakash, MD, FACP, and Ula Tarabichi, MD Follow the link to view the presentation. Scroll to the bottom of the page and click on the "Workshop 504 Presentation tab" to view the presentation.

The duty to treat is a professional obligation to provide nondiscriminatory care and is deeply ingrained in the history and values of the profession. However, no ethical imperative is absolute, and reasonable limits may be placed upon unacceptable patient conduct especially in non-emergent settings. Rejection of a resident physician that is motivated by bigotry or hatred is less deserving of accommodations, and anecdotally, contributes to resident moral distress and burnout. Little is known about how often residents feel verbally and physically threatened or harassed by patients and further, whether they are equipped with the tools to appropriately address such situations in a manner that does not compromise their core values or place the doctor-patient relationship in peril.

Following a local incident in which a resident felt verbally harassed by a patient, we sought to determine the extent of the problem among residents in internal medicine, family medicine, urology, and pediatrics at Southern Illinois University through a survey. The results of our 2017 survey indicated that we need to educate residents on how to address such patient encounters, and that a standardized process outlining the faculty's critical role when a resident or student feels threatened or harassed by a patient is imperative. We will also discuss an institutional approach to track incidents for further action. We hope to stimulate a discussion that encourages participants to share their stories and local, contextual, problem solving strategies to support residents when facing harassment, threats, harm, or injury.

Educational Objectives:
• Review the results of a single institution, multi-program survey to determine the number of times a residents was the recipient of harassment, prejudice, or harm from a patient.
• Discuss a proposed policy to standardize faculty behaviors when a member of the team is threatened and establish boundaries for the patient to promote their safe, effective care and maintain respect for all of the members of the team.
• Reflect upon the requisite faculty development, resident culture, and institutional monitoring necessary to achieve a safe workplace for our residents and faculty.

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