Healthcare Industry: Can We Improve Outcomes By Understanding Our Patients Better?
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Scores of healthcare providers gathered at the M.C. Anderson Cancer Center in Houston this week to participate in a difficult diagnosis: Why does a patient’s culture affect treatment and whether, ultimately, the patient gets better or worse?
Their frank and, at times, painful dialog was designed to improve treatment in minority populations by identifying new policies and practices that target racial disparities.Just a few weeks before the 6th Annual Disparities in Health in America Workshop began, a new research study documented that “minority patients” treated for diabetes had worse outcomes than white patients treated by the same doctor. The study by Dr. Thomas D. Sequist, an assistant professor of health care policy at Harvard Medical School, highlighted the need for health professionals to understand a patient’s culture and beliefs.
Sequist said he doesn’t believe that doctors engaged in conscious discrimination. In an interview with the New York Times, he said the problem is that doctors tend to treat all patients the same, and fail to take cultural differences into account.
Some of the potential variables: Do drugs have various success rates among cultural groups? Is lifestyle counseling provided by culturally competent professionals? Does the patient harbor a deep distrust for the healthcare profession?
Inquiring minds need to know
The man behind the conference is an African American researcher who blended his passion for scientific data and social justice into a remarkable career. Dr. Lovell Allan Jones currently is the director of the congressionally mandated Center for Research on Minority Health at MD Anderson. He also is founding co-chair of the Intercultural Cancer Council, the nation’s largest multicultural health policy group focuses on minorities, the medically underserved, and cancer.
“The goal of the conference is to present the complexity of health disparities” he said. "That it is not just an issue of access.”
Even when minorities have the same level of education, and same type of insurance, disparities still may exist. But why?
The conference, which runs fro June 21 to 27 at M.D. Anderson's Robert C Hickey Auditorium, includes an impressive array of thoughtful speakers, researchers, and topics including: How health insurance perpetuates health disparities, community models to eliminate health disparities, social justice, and improving patient outcomes.
Lessons shared and learned
Lesson One: Networking is the way to grow
MD Anderson is widely considered one of the nation’s best cancer centers. Though located in a diverse city, the vast majority of its patients are white, which makes it more difficult to provide students with multicultural environment they need to be effective healthcare providers. Anderson solved the dilemma by reaching out to a long list of collaborative partners, including the Harris County Hospital District, where serves large numbers of minority patients. Dr. Vincente Valero said the partnership allows Anderson to include diverse patient populations in its cancer research studies and it gives indigent patients access to the latest cancer treatments.
Lesson Two: Insurance matters
The uninsured rate for African Americans increased to 20.5 in 2006, from 19 percent in 2005. The rate of uninsured Hispanics increased to 34.1 percent, up from 32.3 percent. During the same period, the insured rate for non-Hispanic whites remained unchanged at 10.8 percent, according to the U.S. Census Bureau. Speaker Rebecca Lunstroth, an instructor in family medicine at the University of Texas Medical School at Houston, said society must decide some basic ethical issues including: Is healthcare a right or a privilege? Another thorny issue: How much power or control should patients have over their treatment?
Lesson Three: Checking bias at the office door
Even with mounds of research on health disparities, it is hard to document to what extent bias or racism factors into racial disparities. Some speakers suggested that racism plays a significant role in disparate treatments while others disagreed. People of color can take steps to counteract bias by taking time to learn about new treatments and medicines on the market. Good communication between patient and physician helps. (Remember, patients have biases too.) It is also important to take time to learn about your disease. Many churches, health centers and schools provide free health education workshops or classes.
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