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What health disparities have you observed while shadowing the preceptors? What health problems are you seeing and what population groups have them? Who are you NOT seeing in the clinics?
posted by Health Disparities Education Core @ 12:04 PM
5 comments
Project EXPORT Center for Excellence in Rural Health University of IL College of Medicine-Rockford
5 Comments:
While shadowing my preceptors, I have noticed many patients in Lee County do not have health insurance. This is especially a problem when it comes to prescribing medications. Many times drugs that are not the physician's or pharmacist's top choice for treatment have to be used. Patient's in their late 20's and early 30's who do not have a high school degree have made up the majority of the uninsured patients that I have seen while following my preceptors. The physician I have been following is fluent in Spanish, yet while I have been following her, there has not been a single Spanish speaking patient come into her office.
C.M.D.
Anonymous said...
While shadowing my preceptors, I have noticed many patients in Lee County do not have health insurance. This is especially a problem when it comes to prescribing medications. Many times drugs that are not the physician's or pharmacist's top choice for treatment have to be used. Patient's in their late 20's and early 30's who do not have a high school degree have made up the majority of the uninsured patients that I have seen while following my preceptors. The physician I have been following is fluent in Spanish, yet while I have been following her, there has not been a single Spanish speaking patient come into her office.
C.M.D.
28/6/06 20:45
I have, personally, witnessed a few disparities while shadowing my preceptor. The first one is language. Several Spanish-speaking patients were admitted and the staff had difficulties commuicating with these patients. An interpreter had to be called in. Another disparity seen was the lack of health care among the working. Many working people cannont afford medical care. These patients had difficulties attaining proper health and mental health care. A third disparity seen was a basic lack of education. Patients who were not well educated tended to have trouble seeking medical attention.
My shadowing experience has shown that health insurance coverage is a problem in this area. More and more younger girls are haveing babies and may not have the coverage. Many have Medicaid and finding doctors to take the medical card is a big problem also. Language barriers are a bit of a problem in some instances. Most nurses don't speak Spanish and this complicates trying to give the best care possible to patients.
I.T.
While shadowing the preceptors, lots of issues surfaced:
a. In the past few years several companies who used to employ a large majority of the town’s people have either shut down or moved their business elsewhere. Consequently, a lot of people don’t have health insurance anymore. However, this hospital or even the public health department, don’t turn people down due to a lack of insurance. Usually, according to the protocols I observed, if an individual has no insurance at all, then paperwork is filled out with/for them and inquires are made as to whether or not they are eligible for Medicare, Medicaid, or public aid. For mental illnesses, even if a person has none of the above or has no social-security number or a resident alien number, the patient can still be seen and then referred to other institutions like Sinnissippi (as long as they are a resident of this county). For kids, Blagojevich’s new plan (All Kids) for covering a kid’s healthcare needs will probably help with the situation but we have yet to see the results.
b. I was recently notified that a lot of dentists in this community don’t accept Medicare. Additionally, public aid is not available for the skilled unit in the hospital. Therefore, such factors have caused a great deal of stress not only for the low-income patients and their families but public health in general.
c. In one of the meetings, we were notified that a lot of elderly (as I’m sure is happening nation wide) are not adequately informed about the “correct” health care insurance they should be on, especially with medicare. Unlike an urban population where information might be available to them in abundance, these rural community elders have little idea for what is best for them; consequently, they are not receiving the right kind of care or are paying a lot for their coverage from their own pockets.
d. The Latino population in this county has increased, but not by a large amount. However, it seemed that their needs were being met. Even though this county is a bit less diverse, there are still other populations whose needs are probably not being met. For instance, the small migrant worker population that stays here mid-summer through October is hard to care for or to be seen in clinics. Most of these individuals don’t have the time to take off of work and/or the transportation; additionally, some of these workers might even be illegal immigrants to the US and therefore, be even more hesitant to seek care from the local health department (which is cheaper than the hospital). In this scenario, SES, culture, money, time, etc are all factors that go in treating these patients, especially in cases of birth control, pregnancies, or STDs. Here, the healthcare workers have to empower the patients to seek care and learn to trust them (the workers).
e. Another underserved population is the teens in the area, especially the gay, transgender young kids who might need counseling (especially [as told to me by a mentor,] since this area is renowned for its conservative republican views). According to one of my mentors, there was a committee for high schoolers that collapsed about a year ago due to a lack of leadership. This group comprised of doctors, community and school nurses, the health department, etc, and was responsible for family fairs, outreach, and creating connections within the community. This incident really is an example of a rural disparity, very much so different from an urban setting where there might be so many leaders in a setting that elections have to take place.
f. Finally, the lack of communication and advertisement is the biggest disparity that I personally observed in all races and populations of the rural health sector. People’s limited knowledge about the services being offered in their hospital, public health department, pharmacies, or even by their doctors gives people the disadvantage that a lot of other people say in the city wouldn’t ordinarily be a victim of because more media resources are available in the urban areas.
- SP
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