A Yale Department of Psychiatry program to help doctors manage mistreatment by patients was recently highlighted by the Association of American Medical Colleges (AAMC).
Kirsten Wilkins, MD, Associate Professor of Psychiatry; Matthew Goldenberg, MD, MSc, Associate Professor of Psychiatry; and Kali Cyrus, MD, MPH, a 2017 graduate of the Yale Psychiatry Residency Program, created the framework for the program, known as ERASE.
They have presented several 60-90-minute training workshops at several departments at Yale School of Medicine and Yale New Haven Hospital, and at national meetings of the American Association of Directors of Psychiatric Residency Training and the Association of Directors of Medical Student Education in Psychiatry. In November they will do a workshop on ERASE at the AAMC national meeting in Austin, Texas.
ERASE gives doctors a practical approach for recognizing and addressing mistreatment by patients. The framework has five elements:
Expect. With over half of physicians reporting discriminatory comments or other forms of mistreatment from patients, it's important for doctors to anticipate these events - and prepare for response.
Recognize. Mistreatment by patients can range from overt verbal abuse to microaggressions to sexual harassment disguised as "compliments." Be mindful of how patients treat you, your colleagues, trainees, and staff.
Address. It's not uncommon to "freeze" in the moment of mistreatment. ERASE training arms physicians with specific language they can use for different types of mistreatment, whether they are the recipient or a bystander.
Support. Check in with your colleagues and trainees when you witness misbehavior by patients. You should seek support from your supervisor or Human Resources Department, too, if you've been a victim of mistreatment.
Establish/Encourage. Approach your institutions about developing workshops and training modules for how to handle patient harassment.