In follow up to November's post, Language gaps hinder doctor-patient relaitonships:
Recently posted on the Healthcare Careers Channel, a good discussion by MIRIAM JORDAN, Staff Reporter of The Wall Street Journal Online, tackles the real challenges of bilingual healthcare.
In Making Strides to Recruit Doctors Fluent in Spanish, she observes that Hispanics constitute 14% of the nation's 300 million people, but only 5% of U.S. practicing physicians. But there are new approaches, including international recruitment and university programs, such as one offered by UCLA, which takes advantage of the surplus of medical-school graduates in Latin America by helping them finish coursework to prepare for boards in the U.S., where a blend of medical and language skills are in chronically short supply.
Friday, December 21, 2007
Wednesday, November 28, 2007
Language gaps hinder doctor-patient relationships
This article, to me illustrates a polarity/dichotomy that we see too often in cultural competency as a whole. Cost and profitability vs. patient safety and quality of care. Opponents of accomodating non-English speakers use the argument that doctors will be put out of business if they have to provide translation/interpretation services. One could argue that they will be put out of business and out of much more money (where acquiring new patients (with health insurance) who speak English as a second or third language and potential costs of malpractice if an error is made as a result of a patient not understanding the doctor or the translation not being made correctly. The bottom and top lines are that we have to pay for both. One is responsive (providing the services to assure that people's needs are met regardless of their language capacity) vs. reactive (resisting inevitable changes in how clinicians practice based on the culture(s) of their patients).
People who are insured but speak little or no English often experience embarrassment, stress and confusion. State regulations aim to help.
By Francisco Vara-Orta, Los Angeles Times Staff Writer November 23, 2007
Shortly after being diagnosed with breast cancer, Enaida Cornejo had another problem: She and her oncologist could not understand each other.Her primary doctor was bilingual, but this new doctor spoke English. Cornejo, a native of Peru, felt more comfortable speaking Spanish. At their first few appointments, doctor and patient relied on Cornejo's husband, her friend and even strangers in the waiting room to help them talk about her illness."It was already painful enough to deal with the cancer itself," said Cornejo, 42, of Santa Ana. "Let alone not being able to understand my doctor and then having strangers come into my room."The state Legislature decided four years ago that the estimated 1.1 million patients in California who pay for private health insurance but speak little or no English should receive services such as language interpreters and translated materials from their insurance providers. Lawmakers set a deadline of mid-2008 for providers to submit a compliance plan to state regulators, with fines for noncompliance scheduled to begin in 2009.The move, expected to cost tens of millions of dollars in private money, has generated little opposition. P
Proponents of English as the official language of the United States vary in their views of the new regulations.K.C. McAlpin, executive director of Washington, D.C.-based ProEnglish, called California's decision a "misguided approach.""Instead of spending money on doctors, nurses and medicine, private providers will have to use that for interpreters," McAlpin said. "It's going to drive up costs, encourage doctors to turn away limited-English patients because they're too much trouble, and may even force doctors and providers out of business.
"Rob Toonkel, a spokesman for D.C.-based U.S. English, said basic healthcare services generally do not draw much ire."I don't think anyone in their right mind would tell someone in a health emergency, 'Sorry, you didn't learn English, so too bad,' " he said. "If we English-speakers were in another country, you bet we'd hope there would be translators on hand to help us understand."Insurance providers are taking steps to meet the state requirements. Blue Cross of California, the state's largest private insurer, expects to spend about $20 million to meet the new regulations.
Several other insurance providers declined to provide cost estimates or indicate whether premiums will increase. State officials said each provider's language assistance program will vary in cost and size, depending on their number of limited-English patients. But all plans must include a demographic profile of their membership, a list of what services they will offer to limited-English-speakers, and a system for training staffers on how to handle phone calls in different languages, officials said. Under the new regulations, limited-English patients must receive vital medical documents, including bills and medication forms, in their native language.
Non-vital materials, like promotional fliers, may be issued in English but must be translated within 21 days if the patient asks for such a service.Most important, according to some officials, the new rules will require that private health plans provide an interpreter, either in person or by phone, for patients at appointments or for those calling customer service.
The new regulations focus on a group that usually gets lost as most attention goes to uninsured residents or those receiving public healthcare, said Ellen Wu, executive director of California Pan-Ethnic Health Network, a patients' rights group. "It helps cover a large portion of limited-English-speakers who have jobs and have insurance but don't know their rights to better services," Wu said.Health officials said they could not provide examples of any fatalities tied directly to the existing conditions. The problems generally result in stressful, embarrassing, confusing moments that come at times when people already are at their least comfortable. Marbella Sala, operations manager at UC Davis' Center for Reducing Health Disparities in Sacramento, said she's seen various mishaps over the years related to miscommunication. In one case, Sala said, a Chinese-speaking patient was rushed to the hospital after she mistakenly placed hemorrhoid ointment in her eye.
In another case, a Spanish-speaking patient whose husband served as her interpreter during a medical visit believed she had contracted a venereal disease from a toilet seat. In another, a deaf patient canceled a minor surgical procedure after her 12-year-old daughter broke down while using sign language to explain the risks, which included death, Sala said. Those patients received proper treatment after interpreters arrived to help, she said.
People need to understand that language services have to do with a patient's quality of care," Sala said. "I mean, just go ask your 8-year-old what an IV is, they won't likely be able to describe it to you in any language."
California's hospitals and public healthcare plans, such as Medi-Cal, are already required to offer interpreting services and translated documents.With the new regulations, private providers could face fines of $10,000 or more if they fail to comply, said Lynne Randolph, a spokeswoman for the Department of Managed Health Care, the state agency enforcing the new law for HMOs. PPOs are regulated by the state Department of Insurance.
See the rest of the article at:
http://www.latimes.com/news/local/la-me-language23nov23,1,2670969.story?ctrack=1&cset=true
People who are insured but speak little or no English often experience embarrassment, stress and confusion. State regulations aim to help.
By Francisco Vara-Orta, Los Angeles Times Staff Writer November 23, 2007
Shortly after being diagnosed with breast cancer, Enaida Cornejo had another problem: She and her oncologist could not understand each other.Her primary doctor was bilingual, but this new doctor spoke English. Cornejo, a native of Peru, felt more comfortable speaking Spanish. At their first few appointments, doctor and patient relied on Cornejo's husband, her friend and even strangers in the waiting room to help them talk about her illness."It was already painful enough to deal with the cancer itself," said Cornejo, 42, of Santa Ana. "Let alone not being able to understand my doctor and then having strangers come into my room."The state Legislature decided four years ago that the estimated 1.1 million patients in California who pay for private health insurance but speak little or no English should receive services such as language interpreters and translated materials from their insurance providers. Lawmakers set a deadline of mid-2008 for providers to submit a compliance plan to state regulators, with fines for noncompliance scheduled to begin in 2009.The move, expected to cost tens of millions of dollars in private money, has generated little opposition. P
Proponents of English as the official language of the United States vary in their views of the new regulations.K.C. McAlpin, executive director of Washington, D.C.-based ProEnglish, called California's decision a "misguided approach.""Instead of spending money on doctors, nurses and medicine, private providers will have to use that for interpreters," McAlpin said. "It's going to drive up costs, encourage doctors to turn away limited-English patients because they're too much trouble, and may even force doctors and providers out of business.
"Rob Toonkel, a spokesman for D.C.-based U.S. English, said basic healthcare services generally do not draw much ire."I don't think anyone in their right mind would tell someone in a health emergency, 'Sorry, you didn't learn English, so too bad,' " he said. "If we English-speakers were in another country, you bet we'd hope there would be translators on hand to help us understand."Insurance providers are taking steps to meet the state requirements. Blue Cross of California, the state's largest private insurer, expects to spend about $20 million to meet the new regulations.
Several other insurance providers declined to provide cost estimates or indicate whether premiums will increase. State officials said each provider's language assistance program will vary in cost and size, depending on their number of limited-English patients. But all plans must include a demographic profile of their membership, a list of what services they will offer to limited-English-speakers, and a system for training staffers on how to handle phone calls in different languages, officials said. Under the new regulations, limited-English patients must receive vital medical documents, including bills and medication forms, in their native language.
Non-vital materials, like promotional fliers, may be issued in English but must be translated within 21 days if the patient asks for such a service.Most important, according to some officials, the new rules will require that private health plans provide an interpreter, either in person or by phone, for patients at appointments or for those calling customer service.
The new regulations focus on a group that usually gets lost as most attention goes to uninsured residents or those receiving public healthcare, said Ellen Wu, executive director of California Pan-Ethnic Health Network, a patients' rights group. "It helps cover a large portion of limited-English-speakers who have jobs and have insurance but don't know their rights to better services," Wu said.Health officials said they could not provide examples of any fatalities tied directly to the existing conditions. The problems generally result in stressful, embarrassing, confusing moments that come at times when people already are at their least comfortable. Marbella Sala, operations manager at UC Davis' Center for Reducing Health Disparities in Sacramento, said she's seen various mishaps over the years related to miscommunication. In one case, Sala said, a Chinese-speaking patient was rushed to the hospital after she mistakenly placed hemorrhoid ointment in her eye.
In another case, a Spanish-speaking patient whose husband served as her interpreter during a medical visit believed she had contracted a venereal disease from a toilet seat. In another, a deaf patient canceled a minor surgical procedure after her 12-year-old daughter broke down while using sign language to explain the risks, which included death, Sala said. Those patients received proper treatment after interpreters arrived to help, she said.
People need to understand that language services have to do with a patient's quality of care," Sala said. "I mean, just go ask your 8-year-old what an IV is, they won't likely be able to describe it to you in any language."
California's hospitals and public healthcare plans, such as Medi-Cal, are already required to offer interpreting services and translated documents.With the new regulations, private providers could face fines of $10,000 or more if they fail to comply, said Lynne Randolph, a spokeswoman for the Department of Managed Health Care, the state agency enforcing the new law for HMOs. PPOs are regulated by the state Department of Insurance.
See the rest of the article at:
http://www.latimes.com/news/local/la-me-language23nov23,1,2670969.story?ctrack=1&cset=true
Tuesday, November 20, 2007
Culture-Based Care in NYC
As you can see, part of the purpose for this blog is to keep you up to date with things happening in healthcare that related to cultural competency and diversity. Kaiser foundation recently published this article about the New York City Public Hospital System.
Culture-Based Care Hospitals in New York, Other Cities Increase Culturally Competent Care, Particularly Among Minorities With Diabetes
[Oct 23, 2007]
Medical professionals across the nation are "beginning to bone up" on culturally competent health care, in particular with diabetes, "given the rising incidence of the disease, its prevalence among minority groups and the changes in diet and lifestyle that treatment often entails," the Wall Street Journal reports. In New York City, nearly 50% of Asian-Americans have diabetes or pre-diabetes and about one-third of blacks and Hispanics have one of the conditions, compared with roughly 30% of whites. According to the Journal, the 50,000 diabetes patients at the city's 11 public hospitals speak "scores of languages" and are accustomed to "varied cuisines." Area hospitals have begun to tailor treatment and educational materials to minority populations, including making print information available in several languages, providing on-site cooking classes that focus on ethnic-specific recipes and offering a range of translation services. The public hospitals' electronic health record system is the "backbone" of the city's effort, the Journal reports. It allows providers to track clinical indicators, check when patients are due for certain exams and alert patients to missed appointments in their native languages.
For more. . .
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48391
Culture-Based Care Hospitals in New York, Other Cities Increase Culturally Competent Care, Particularly Among Minorities With Diabetes
[Oct 23, 2007]
Medical professionals across the nation are "beginning to bone up" on culturally competent health care, in particular with diabetes, "given the rising incidence of the disease, its prevalence among minority groups and the changes in diet and lifestyle that treatment often entails," the Wall Street Journal reports. In New York City, nearly 50% of Asian-Americans have diabetes or pre-diabetes and about one-third of blacks and Hispanics have one of the conditions, compared with roughly 30% of whites. According to the Journal, the 50,000 diabetes patients at the city's 11 public hospitals speak "scores of languages" and are accustomed to "varied cuisines." Area hospitals have begun to tailor treatment and educational materials to minority populations, including making print information available in several languages, providing on-site cooking classes that focus on ethnic-specific recipes and offering a range of translation services. The public hospitals' electronic health record system is the "backbone" of the city's effort, the Journal reports. It allows providers to track clinical indicators, check when patients are due for certain exams and alert patients to missed appointments in their native languages.
For more. . .
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48391
Tuesday, November 13, 2007
In DNA Era, New Worries About Prejudice--New York Times
At Cook Ross, in our healthcare cultural competency work, we talk about pharmacogenomics and genetics and its impact. The research is allowing practicioners to be more patient centered. The opportunity is to leverage difference. The challenge is when scientific distinctions are used, like other diversity distinctions (race, gender, sexual orientation, ethnicity, etc.) have historically been used, to discriminate. With genetics, this could engender a very interesting and in some cases dangerous dynamic in that, as we know phenotypically we may be one thing while our genotypes may yield something totally different. There are also the social implications of people making implicit associations about someone because they have heard or read about one ethnicity or race having something less than or greater than another. . .if in fact greater dichotomy and social division is created from the Human Genone Project we could lose the profound impact of the scientific traction that the deconstruction of DNA has provided.
By AMY HARMON
Published: November 11, 2007
When scientists first decoded the human genome in 2000, they were quick to portray it as proof of humankind’s remarkable similarity. The DNA of any two people, they emphasized, is at least 99 percent identical. . .
Such developments are providing some of the first tangible benefits of the genetic revolution. Yet some social critics fear they may also be giving long-discredited racial prejudices a new potency. The notion that race is more than skin deep, they fear, could undermine principles of equal treatment and opportunity that have relied on the presumption that we are all fundamentally equal. . .
For the full article:
http://www.nytimes.com/2007/11/11/us/11dna.html?em&ex=1195016400&en=654c92ed2a9ed7fe&ei=5087
By AMY HARMON
Published: November 11, 2007
When scientists first decoded the human genome in 2000, they were quick to portray it as proof of humankind’s remarkable similarity. The DNA of any two people, they emphasized, is at least 99 percent identical. . .
Such developments are providing some of the first tangible benefits of the genetic revolution. Yet some social critics fear they may also be giving long-discredited racial prejudices a new potency. The notion that race is more than skin deep, they fear, could undermine principles of equal treatment and opportunity that have relied on the presumption that we are all fundamentally equal. . .
For the full article:
http://www.nytimes.com/2007/11/11/us/11dna.html?em&ex=1195016400&en=654c92ed2a9ed7fe&ei=5087
Sunday, November 4, 2007
Great Article about Pharmacies and non-English Proficiency
Blogger's note: I think this could be the beginning of something that is talked about more in hospital pharmacies, too. I have heard anecdotally in some hospitals we have worked with that it can be a significant challenge even with a good interpreter services program, so I am sure the conversation about it is only going to increase. . .
By ANNE BARNARD
Published: October 31, 2007
Pharmacies across the city routinely fail to help non-English speakers understand their prescriptions, raising the chances that customers could harm themselves by taking medicines incorrectly, immigrant advocacy groups charge in a discrimination complaint that they plan to file today with the New York attorney general’s office.
The complaint names 16 pharmacies in Brooklyn, Queens and Long Island, most of them operated by chains. It argues that federal civil rights law and state health regulations require pharmacies to provide linguistic help to guarantee that people who speak little or no English receive equal access to health care. That assistance should include interpreters at pharmacies and written translations of medication instructions, the advocates say.
For the full article click below:
http://www.nytimes.com/2007/10/31/nyregion/31pharmacies.html?_r=1
By ANNE BARNARD
Published: October 31, 2007
Pharmacies across the city routinely fail to help non-English speakers understand their prescriptions, raising the chances that customers could harm themselves by taking medicines incorrectly, immigrant advocacy groups charge in a discrimination complaint that they plan to file today with the New York attorney general’s office.
The complaint names 16 pharmacies in Brooklyn, Queens and Long Island, most of them operated by chains. It argues that federal civil rights law and state health regulations require pharmacies to provide linguistic help to guarantee that people who speak little or no English receive equal access to health care. That assistance should include interpreters at pharmacies and written translations of medication instructions, the advocates say.
For the full article click below:
http://www.nytimes.com/2007/10/31/nyregion/31pharmacies.html?_r=1
Monday, October 29, 2007
Racism May Affect Infant Mortality Rates
Racism May Affect Infant Mortality Rates
by Halimah Abdullah
WASHINGTON - For decades, health experts have tried to determine why African-American babies are twice as likely to die as white infants. A new series of studies from the Joint Center for Political and Economic Studies’ Health Policy Institute, along with a small but growing number of neonatalogists nationwide, suggests that the stressful effects of racism play a role.
more...
http://www.commondreams.org/archive/2007/09/29/4203
by Halimah Abdullah
WASHINGTON - For decades, health experts have tried to determine why African-American babies are twice as likely to die as white infants. A new series of studies from the Joint Center for Political and Economic Studies’ Health Policy Institute, along with a small but growing number of neonatalogists nationwide, suggests that the stressful effects of racism play a role.
more...
http://www.commondreams.org/archive/2007/09/29/4203
Tuesday, October 23, 2007
Upcoming Diversity Healthcare Events of Interest
Cook Ross Web Seminar Series, Cultural Competency in Healthcare
Making the Case for Cultural Competency in Healthcare
January 9, 2008
Location: Web Seminar
Transform your healthcare organization by practicing daily cultural competence while improving patient satisfaction and bottom-line results. Module I of Cook Ross series.
http://cookross.com/docs/free_jan_2008_HC.pdf or visit http://www.cookross.com/
American Association for Cancer Research
The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved
November 27 - December 1, 2007
Location: Atlanta, GA
http://www.aacr.org/home/scientists/meetings--workshops/cancer-health-disparities.aspx
Making the Case for Cultural Competency in Healthcare
January 9, 2008
Location: Web Seminar
Transform your healthcare organization by practicing daily cultural competence while improving patient satisfaction and bottom-line results. Module I of Cook Ross series.
http://cookross.com/docs/free_jan_2008_HC.pdf or visit http://www.cookross.com/
American Association for Cancer Research
The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved
November 27 - December 1, 2007
Location: Atlanta, GA
http://www.aacr.org/home/scientists/meetings--workshops/cancer-health-disparities.aspx
Diversity in Pharmaceuticals and Biotechnology
According to Universum Communications and THE BLACK COLLEGIAN’s report “The Top 100 Diversity Employers 2006” healthcare surpasses financial services as the most popular industry among diverse students overall. Healthcare was also determined to be the top industry among undergraduate students.
Undergraduates listed top pharmaceutical companies including Johnson & Johnson, Pfizer, Mayo Clinic, Glaxo Smith Kline and Merck in the top 40 desired companies. Pharma companies that were on the top 100 list in previous years have moved up in preference. Wyeth Pharmaceuticals rose in undergrad preference from 186th to 64th, Eli Lilly from 95th to 80th, Novartis from 140th to 130th and Roche from 154th to 140th. Even newcomers that were not ranked the previous year such as Hospira, Bayer and Takeda Pharmaceuticals North America made it in the top 200 list.
So what is causing diverse students to migrate towards the healthcare industry and hold a better opinion of pharma companies as potential employers?
These are conditions explored in a recently posted feature article on the Healthcare Channel, Diverse Talent Recognizes Pharma’s Efforts to Create More Diverse Workforce. This guest contribution presents the insider's perspective of Kristin Rand, JD, Director of Education Strategy in the Professional Education Support Department for Wyeth Pharmaceuticals. Her exploration, focusing particularly but not exlcusively on the representation of women in the industry, thoughtfully examines the benefits of diversity to industry organizations -- both to the customers and to the organizations. It also examines how smaller, more nimble companies in the biotechnology sector are succeeding in raising the representation of women in their ranks, and how Big Pharma -- despite its strides -- can still learn a thing or two from these companies.
The feature appears on both the Healthcare Industry Careers Channel and the Pharmaceutical Industry Channel at IMDiversity.
Undergraduates listed top pharmaceutical companies including Johnson & Johnson, Pfizer, Mayo Clinic, Glaxo Smith Kline and Merck in the top 40 desired companies. Pharma companies that were on the top 100 list in previous years have moved up in preference. Wyeth Pharmaceuticals rose in undergrad preference from 186th to 64th, Eli Lilly from 95th to 80th, Novartis from 140th to 130th and Roche from 154th to 140th. Even newcomers that were not ranked the previous year such as Hospira, Bayer and Takeda Pharmaceuticals North America made it in the top 200 list.
So what is causing diverse students to migrate towards the healthcare industry and hold a better opinion of pharma companies as potential employers?
These are conditions explored in a recently posted feature article on the Healthcare Channel, Diverse Talent Recognizes Pharma’s Efforts to Create More Diverse Workforce. This guest contribution presents the insider's perspective of Kristin Rand, JD, Director of Education Strategy in the Professional Education Support Department for Wyeth Pharmaceuticals. Her exploration, focusing particularly but not exlcusively on the representation of women in the industry, thoughtfully examines the benefits of diversity to industry organizations -- both to the customers and to the organizations. It also examines how smaller, more nimble companies in the biotechnology sector are succeeding in raising the representation of women in their ranks, and how Big Pharma -- despite its strides -- can still learn a thing or two from these companies.
The feature appears on both the Healthcare Industry Careers Channel and the Pharmaceutical Industry Channel at IMDiversity.
Wednesday, October 10, 2007
Abbott Named One of the Best Companies for Hispanics by Hispanic Business Magazine
Abbott Named One of the Best Companies for Hispanics by Hispanic Business Magazine
We will highlight things such as this regularly on our blog where healthcare and health-related topics are concerned. Abbott has been pretty active in their diversity efforts for quite some time. From what I understand they are moving towards more cultural awareness and cultural competency-related work to better service their customers in sales interactions. In fact, many pharmaceutical companies are engaged in these efforts now.
We will highlight things such as this regularly on our blog where healthcare and health-related topics are concerned. Abbott has been pretty active in their diversity efforts for quite some time. From what I understand they are moving towards more cultural awareness and cultural competency-related work to better service their customers in sales interactions. In fact, many pharmaceutical companies are engaged in these efforts now.
Tuesday, October 2, 2007
Racism May Affect Infant Mortality Rates
Saturday, September 29, 2007 by McClatchy Newspapers
Racism May Affect Infant Mortality Rates by Halimah Abdullah
WASHINGTON - For decades, health experts have tried to determine why African-American babies are twice as likely to die as white infants.
A new series of studies from the Joint Center for Political and Economic Studies’ Health Policy Institute, along with a small but growing number of neonatalogists nationwide, suggests that the stressful effects of racism play a role.
more...
(http://www.commondreams.org/archive/2007/09/29/4203/)
Monday, October 1, 2007
Healthcare, Cultural Competency, Diversity Live Here. . .
Greetings All,
Welcome to our new Blog. Diversity HealthWorks has created this blog to share relevant health care information and editorials to you on a regular basis. Our intention is to create a space that allows you as a healthcare professional, consumer, or advocate to gather and share information about healthcare, cultural issues affecting healthcare, and the myriad diversity-related issues that impact our health that we are aware of and those we are not.
The fact is, all of us are aware of something. Given this fact, PLEASE SHARE what you know. We welcome you and if you are blogosphere or someone that is not and has something to say, please pass it along and we will do the same.
Stay tuned for what we are hoping is the #1 blog focused on the opportunities, challenges, and overall elevation of the diversity/inclusion and cultural competency conversation in healthcare.
Welcome to our new Blog. Diversity HealthWorks has created this blog to share relevant health care information and editorials to you on a regular basis. Our intention is to create a space that allows you as a healthcare professional, consumer, or advocate to gather and share information about healthcare, cultural issues affecting healthcare, and the myriad diversity-related issues that impact our health that we are aware of and those we are not.
The fact is, all of us are aware of something. Given this fact, PLEASE SHARE what you know. We welcome you and if you are blogosphere or someone that is not and has something to say, please pass it along and we will do the same.
Stay tuned for what we are hoping is the #1 blog focused on the opportunities, challenges, and overall elevation of the diversity/inclusion and cultural competency conversation in healthcare.
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