Primary Care Scenario 1

You observe a middle-aged man approach the registration desk. He is slightly out of breath. He glances at the staff member, who identifies as non-binary and is wearing a pride pin, and says, “Sorry I’m late—it took ages to get here. All those pride parades really slowed things down.” The staff member shifts their gaze, trying to remain professional, and proceeds with the check-in. 

1. Impact: How might this interaction affect the individuals involved?  Who might it harm? Why? Why does this matter? 

1. The staff member may feel insulted by this comment from the patient. Especially because pride month is likely a meaningful time for the staff member, they may be disappointed that the parade is simply an obstacle to the patient.  In addition, although we do not know how the patient truly feels about LGBTQ+ individuals, the phrase “all those pride parades” may raise reasonable suspicion that the patient harbors some underlying negative attitudes.   

2. How all of this impacts the staff member will of course depend on them, how they relate to pride month, how much social support they have, and how they have learned to cope with people who do not seem to understand or agree with the value of pride month. In addition, it may depend on how included, welcomed, and psychologically safe they feel in this work environment.  For some people, such a comment from a patient may contribute to larger feelings of burnout and job dissatisfaction and increase feelings of marginalization, especially if co-workers overhear and do not acknowledge it. To a bystander, it is important to recognize that this may impact the staff member in negative ways and not brush it off as meaningless.     

2. Intervention: If you were to intervene to address the potential harm caused… 

1. What might you do or say? 

1. You could say to the patient, “I’m sorry traffic made you late, that is frustrating. However we are very supportive of pride month here.” 

2. You could say to the patient, “Not a fan of pride month, huh?  We have many staff members for whom it is very meaningful, so please be respectful.”  

3. You might not be able to say anything to the patient, or in front of the patient. If so, you could wait for the patient to leave and then check in with the staff member.  You could say, “I heard that patient’s comment about the pride parade. Sorry about that.  Would you like me to say something to the patient?” 

4. If you know of others who may care for the patient at today’s visit who also may be insulted by him, you could give them a heads-up, or if it seems like that could make things worse, you could check-in after. 

5. It is ok for you to tell your supervisor/manager about the incident, in the service of providing additional support to the person harmed, if they want it. 

2. What obstacles might get in the way of you intervening? 

1. You may feel that the interaction happens too quickly for you to figure out what to say or do.  Then it becomes awkward for you to say something. 

2. You may be unsure what the staff member would want you to do.  Maybe they do not want you to do or say anything? Similarly, you may not want to do or say anything that would make the patient feel bad. In this case, you could still talk to the staff member afterwards, ask what they would have wanted, and offer validation. Also, we recommend that if you in doubt about what the person harmed wants, it is better to take the risk and speak up, rather than not.  

3. You may wonder if the patient simply was in a bad mood and if their remark really should be interpreted as biased or insulting to LGBTQ+ individuals. In this case, you could still ask the staff member how it impacted them.  If your relationships are appropriate, you could also ask others you know with similar identities for guidance on what the staff member might need in the situation.  

3. Repair: If you are the “offender”, how can you apologize or accept feedback? 

1. You may say, “I’m sorry, I do think pride month is important; I let my traffic frustration get the best of me.” 

2. If your relationships are appropriate, you could also ask others you know who have LGBTQ+ identities, for feedback on what you said and why it may have been offensive.  

4. More Information: Additional comments and background information about this scenario: 

1. Although this may feel like a minor insult, it is important to understand the long and ugly battle for LGBTQ+ rights and recognition. Consider this resource…