We would like to acknowledge that the vast majority of patients and visitors to our clinic demonstrate respectful communication and behaviour towards our staff. We understand how stressful it is when you are feeling sick or have concerns about your health and we are very appreciative of your ongoing understanding and patience.
We are also aware that the wait times to see physicians and nurses have on a number of occasions been longer than usual over the past year due to increasing requests for appointments and as we continue to work through the backlog created by the pandemic as well as staff shortages. We understand this can be frustrating and we are doing our best to address it and continue to meet the needs of our Spectrum patients.
Unfortunately, we have been experiencing an increase in incidents of harassment and inappropriate behaviour towards our staff. Our staff work very hard to keep our clinic running, process all referrals, make appointments, liaise with specialist and pharmacists among their many other responsibilities.
As employers, we have an ethical, professional and legal obligation to provide a safe work environment for our staff, free of all forms of harassment.
We have created the following policy outlining our process to address any such incidents:
Spectrum Health’s Policy on Workplace Violence and Harassment
- We have a zero tolerance policy for harassment, violence or abusive behaviour.
- It is required that all patients and guests (including family members of patients) at our clinic be respectful in their communication and behaviour towards the physicians, front desk staff, office manager, nurses, nurse practitioners and pharmacist.
- Harassment and abusive behaviour includes: abusive language and yelling, disrespectful or demeaning language/comments, discriminatory remarks, threats or threatening behaviour, bullying or sexual harassment.
- If an incident of harassment towards any member of our staff, including administrative staff, healthcare providers and the research team occurs, it will be recorded in a patient’s permanent medical record, including a verbatim record of any foul language, disrespectful comments, and a detailed description of the behaviour and incident.
- The patient’s physician will be immediately notified of any such incidents and the details of what occurred whether it was in person, or by phone.
- Following an incident of abuse or harassment a letter will be sent by mail and added to the medical record noting the date and nature of the incident, reiterating this policy, and our obligation to provide a safe work environment for our staff.
- Any subsequent incidents of harassment or abuse will result in a patient being deregistered from our clinic and required to seek healthcare elsewhere. For further information on how this decision may be made, please see the following statement from the College of Physicians and Surgeons of BC: “Ending the Patient-Registrant Relationship”.
- Please note, all our clinic rooms are equipped with a panic button for emergencies involving a threat of violence. Staff are instructed to press this button, which sounds a loud alarm to alert others to repsond. We are thankful we have not yet required the use of this safeguard. Emergencies services including police may be involved in these incidents if they occur.
The following statement is from the College of Physicians and Surgeons of BC: Ending the Patient-Registrant Relationship:
Registrants (Physicians) must base their decision to end the patient-registrant relationship on the unique facts and circumstances of each situation, including whether a particular incident or behaviour is isolated, or part of a larger problem.
The following are examples of situations where ending the patient-registrant relationship may be appropriate, where a:
• patient exhibits threatening or abusive behaviour towards the registrant or their medical office staff, including behaviour or comments of a sexualized or racist nature; as employers, registrants have a legal obligation to make reasonable efforts to ensure that their employees are afforded a harassment-free workplace
• patient poses a risk of harm to the registrant or their medical office staff
• patient makes an unambiguous declaration of non-confidence in the registrant; where a patient’s behaviour makes it clear that the practice is not being utilized as a primary care home by (for example) repeatedly attending at other clinics unnecessarily
• patient has repeatedly failed to pay for services after multiple discussions
• patient moves to another community making required in-person assessments impracticable
• registrant chooses to reduce the number of patients in their practice due to personal health or similar reasons
Note: In this instance, the registrant must not selectively discharge difficult or complex patients and take care not to be perceived to have otherwise discriminated. The process of patient selection must be well documented and consistently applied.
The following are examples of situations where ending the patient-registrant relationship would not be appropriate:
• it is prohibited by the BC Human Rights Code College of Physicians and Surgeons of British Columbia PRACTICE STANDARD Ending the Patient-registrant Relationship 4 of 4 February 17, 2022 (Version 5.4)
• the patient’s care is considered too complex and difficult to treat
• the patient’s objectionable behaviour is reasonably attributable to cognitive impairment, unless it is determined that the patient poses a significant safety risk to the registrant and/or staff
• the patient respectfully declines to follow the registrant’s advice
• the patient seeks treatment to which the registrant objects on the basis of scientific, conscience or religious beliefs