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Thursday, February 23, 2006The most recent report from the Agency for Healthcare Research and Quality suggests this is so. It examines, separately, quality by race and quality by income. It says that “remote rural populations” receive poor care, and “many racial and ethnic minorities and persons of lower socioeconomic positions” receive suboptimal care. In short, white people who live in these areas get bad care too; conversely black people living in majority white areas tend to get good care. Much has been made of the need for greater sensitivity in the doctor-patient relationship. Common sense dictates that patients benefit when they trust their physicians and interact with them productively. But the remedies for unsatisfactory doctor-patient relationships do not reside in racial sensitivity training for health-care professionals, affirmative action in medical-school admissions, or the specter of Title VI (civil-rights) litigation — all avenues of redress that have been advocated. Since class makes a much greater contribution to heath care and health status than does race, sound solutions should target all underserved populations. Low-income patients benefit from many factors: a strong safety net provided by the federally funded community health-care system (guaranteeing a usual source of care); grassroots outreach through black churches, social clubs, and worksites; patient “navigators” to help negotiate the system; language services; and efforts to get more good doctors into distressed neighborhoods. Seemingly simple innovations, such as clinic night hours, mobile clinics, and more extensive use of school nurses, could be a great boon to patients with hourly wage employment who risk a loss of income, or even their jobs, by taking time off from work for doctor’s appointments. Having practiced in smalll, poor rural areas and in large suburban areas near tertiary care centers, I can attest that it's location, location, location that matters most in healthcare. Financial barriers also play a role. It's often difficult for people in manual labor positions or service positions to get time off to take care of health needs - be it getting an MRI done or visiting a specialist. At least, that's a frequent excuse I hear, even out here in the suburbs. But Satel and Klick are exactly right. It's a misuse of government funds to mandate racial sensitivity training for health professionals when the real problem is access to care. And, it speaks more of the biases of those designing the solutions (ahem, public health officials, politicians) than it does of the biases of healthcare providers. posted by Sydney on 2/23/2006 09:44:00 AM 4 comments 4 Comments:
You must have the life skills of dedication, discipline and self-denial to keep healthy especially if you have a chronic medical condition. You must also have those life skills to keep our of poverty.
Don't forget those who were affected by Katrina. As hurricane victims struggle to rebuild their lives, one of the most immediate needs is access to medical care. Congress has the power now to help the children, elderly, sick or people who have lost their jobs to get the health care they need by temporarily covering them under the federal Medicaid program -- without red-tape and hassles.
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Yes, you need cultural sensitivity...but the real barrier is philosophical.
By i think economics is one of the largest reasons for poor healthcare among the lower classes, being one of them.. after working many years as an ICU nurse.. i now find that i struggle to pay for healthcare.. even though i have a pricey private ppo and medicare.. i recently had to make the decision to forgo an MRI because my cost would have been 1000.00.. which would have been required to be paid out in 3 mo.. i do not have an extra 330 dollars a month to spare. when i tried to make other arrangements to pay over a 6 mo period..(still be difficult but not impossible). i was told no dice.. this is real .. this is healthcare in america
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