While performing a hernia exam, a patient told the female resident that he usually got a “special reward after a woman handled his testicles.” His meaning was clear, and he seemed to consider this a perfectly reasonable thing to say to a doctor. When the resident came out to present the patient, she mentioned what had happened to the chief resident (also a woman), but did not bring it to my attention. However, the chief made sure that I knew about it before going into the room. The patient then proceeded to make the same “joke” when I was in the room and I was frankly flabbergasted that he thought it was such a normal thing to say that he would repeat it in front of me. While I tried to politely educate the patient that this behavior was not appropriate, and pointed out that he would never say such a thing to me, he seemed more confused than enlightened by our conversation.
Looking back, I wonder if I handled this situation well. Having never been trained to handle such a situation, I was essentially figuring it out on my own.
Could I have been more forceful or taken a different approach with the patient?
How have other attendings handled such situations?
Is there a good way to educate patients who regard such behavior as acceptable?
How can we help our trainees deal with these problems?