Most medical care takes place outside of the physician-patient encounter. Phlebotomy in the lab, “clean catch” urines, EKG’s, colonoscopy preps, mammography, and nasopharyngeal swabbing all happen when the physician is busy elsewhere. If there is a delay between the order and the completion of this task then the interpreter for that encounter has often moved on to the next encounter. Each site (i.e. the lab, the MA, radiology) then calls an interpreter for very routine tasks that are discrete, quick, and often require some demonstration.Continue reading
Tag: health disparities
Health Disparities and Clinical Research
This year the Vietnamese remember the end of a long civil war. Many of us who are old enough know exactly where we were 40 years ago when we were told that Saigon had fallen. So many Vietnamese lives in the North and the South were lost in that war, so many French and then American lives were spent fighting that war. In the chaos of the immediate aftermath of the war, and then for years to come, there was an exodus of Vietnamese to the West. The U.S. received over 1,000,000 Vietnamese refugees when all was said and done, and then the Vietnamese-American community has grown from there. In the first decades after the war it became evident that there were a number of conditions disproportionately prevalent in the Vietnamese community; diseases such as tuberculosis, hepatitis B, liver cancer, and cervical cancer to name a few.Continue reading
Profiling Populations and Health Disparities
“There it was: AIDS as the litmus test for nurses and physicians, a means of identifying who would and who wouldn’t. I had seen this before in Boston…..
“So,” I asked, “is this kind of stuff still going on now, with Gordon?”
“Hell yes! Except they know who is and who is not willing to take care of a patient like Gordon. I am willing. Mary is willing. And quite a few others. But I don’t think they should take advantage of us for that reason. It’s convenient for them. Because if they bitch and moan and if they don’t take care of the patient right, then I feel like I have to step in. I can’t let that happen.”
Verghese, Abraham. My Own Country: A Doctor’s Story. Vintage, 1995.
Through this exchange with a nurse, Abraham Verghese recalls attitudes in the 1980s among medical staff engaged in the care of the first HIV patients in rural Tennessee. His remarkable memoir of his years as an Infectious Disease specialist during the early days of HIV recapturesthe palpable possibility that contamination with HIV was a death sentence faced by many in operating rooms and on medical wards, a belief held by some among medical professionals and civic leaders. In repeated vignettes Vergesse describes how these attitudes affected the resources and care gay men received.Continue reading