Patients sometimes react negatively when asked for race and ethnicity data due to a lack of understanding on why hospitals ask the question at all. To prevent dissatisfaction:
- Explain why the information is necessary.
- Assure patients their responses are confidential.
- If someone doesn’t want to answer, don’t push the issue.
It’s easy for patients to understand why they must submit addresses or dates of birth, but the same is not true for race and ethnicity data.
“Patients aren’t clear how this information is affiliated with their medical treatment,” says Michelle Reno, patient access manager in the ED at The University of Tennessee Medical Center.
Patients often ask, “Why is my race important?” or “What is the information used for?” They react negatively to the question for various reasons, Reno says. Sometimes, patients view the question as intrusive or offensive.
“The most common example we encounter involves undocumented patients who are concerned that we are asking for the purpose of reporting to authorities,” Reno explains.
To ease concerns, registrars respond this way: “We want to make sure that all our patients get the best care possible. We would like you to tell us your racial/ethnic background so that we can make sure that everyone gets the highest quality of care. The only people who see this information are registration staff, administrators for the hospital, and the people involved in quality improvement and oversight, and the confidentiality of what you say is protected by law.”
Polite Explanation Given
Tammy Mendenhall, patient access manager in central registration at The University of Tennessee Medical Center, says a non-confrontational approach is always best.
“We take care not to push the issue, if it is clear the patient does not want to respond to the questions,” she adds.
In Mendenhall’s experience, asking about race and ethnicity is “the most sensitive question asked during a registration. It’s uncomfortable, and registrars tend to brace themselves for a negative response.”
Usually, patients provide the information after registrars explain why it’s needed.
“When you do so in a nonthreatening and polite manner, resistance to providing this information is minimized,” Mendenhall says.
About 20% of people still refuse to give the information. Typically, they tell the registrar, “You don’t need this information to treat me,” or “It really shouldn’t matter to you — it’s irrelevant to my care.”
“If someone does not want to answer these questions, we simply record ‘declined,’ and move on with the registration process,” Mendenhall says.
- Tammy Mendenhall, Patient Access Manager, Central Registration, The University of Tennessee Medical Center, Knoxville. Phone: (865) 305-6554. Email: TMendenh@mc.utmck.edu.
- Michelle Reno, Patient Access Manager, Emergency Department, The University of Tennessee Medical Center, Knoxville. Phone: (865) 305-6971. Email: firstname.lastname@example.org.