Introduction
For this assignment, a case story was provided, “A Day in the Sleep Clinic,” detailing a doctor’s encounters with three child patients and their parents. In all of these situations, his behavior is questionable and often rude. This rudeness is further exacerbated when non-white patients visit him, as Dr. Williams offends them and ultimately refuses treatment due to his cultural ignorance. This paper will examine the assumptions that caused such mistakes and the broader roles of factors like culture and ethnicity in disparities in health outcomes.
Assumptions and Mistakes
Dr. Williams’ interaction with the Reeses seems friendly as they chat about a common interest. However, he commits the same mistake as he does with the other two patients. He assumes specialized knowledge on the part of the patient’s mother and uses complex medical terminology that she is unlikely to understand. Despite that, he maintains an amiable demeanor that allows him to follow up on his diagnoses and have the appropriate equipment ordered. However, their friendliness causes him to ignore facts that raise doubts as to whether his treatment plan will be followed.
In Waleeds’ case, he misidentifies the family’s ethnicity and generally acts superior. He once again assumes medical knowledge on the parents’ part and uses terminology they do not understand. Furthermore, he fails to explain his hypothesized diagnosis due to the same assumption. His assumptions of poverty and not wanting medical help cause him to act indifferent and disinterested, and ignore the family’s concerns, failing to establish any rapport.
With the Phan family, his behavior is affected by his impatience. He addresses the wrong parent and perceives their polite nodding as agreement. He unknowingly offends the family with his nervous gestures, which are considered very rude in Vietnamese culture. He makes his explanation of an invasive procedure sound like a threat. Ultimately, his actions cause the Phans to leave, potentially seeking another doctor or allowing their child’s condition to deteriorate.
Causes for Disparities
The rapport that a healthcare provider establishes with their patient is an essential factor for the patient’s ultimate health outcome. As demonstrated by the case story’s example, cultural assumptions and misunderstandings can prevent this rapport from being built, affecting the quality of subsequent care. Race, while related to these factors, is potentially an additional biological cause of the disparity. Genetic differences can predispose one to certain conditions and must be considered when determining whether to screen for such conditions (Wheeler & Bryant, 2017). Similarly, a person’s socioeconomic factors, such as wealth and the neighborhood where they live, are linked with specific health problems and access to medical procedures. For these reasons, care providers need to possess cultural literacy and consider these factors when interacting with their patients.
Another source of disparities in health outcomes is structural barriers, like the lack of time, information, or health literacy. According to the study by Alang (2015), Blacks are more likely to cite such factors as reasons for unmet medical needs. Similarly, structural barriers can prevent people with disabilities from receiving healthcare, as parts of healthcare facilities may be inaccessible to them or lack the equipment that accommodates their disability (Krahn, Walker, & Correa-De-Araujo, 2015). Overall, accessibility and information play a crucial part in determining a patient’s health outcome.
Conclusion
The case story is a strong example of why cultural literacy is vital in provider-patient communication. Misunderstandings caused by cultural or ethnic differences can, often unknowingly, lead to worse health outcomes. Issues of information and accessibility of medical care are another factor that can cause disparity, putting Black patients or patients with disabilities at a disadvantage. Ultimately, healthcare providers need to be careful and attentive to their patients and make an effort to understand and accommodate them.
References
Alang, S. M. (2015). Sociodemographic disparities associated with perceived causes of unmet need for mental health care. Psychiatric Rehabilitation Journal, 38(4), 293–299.
Krahn, G. L., Walker, D. K., & Correa-De-Araujo, R. (2015). Persons with disabilities as an unrecognized health disparity population. American Journal of Public Health, 105(S2), S198–S206.
Wheeler, S. M., & Bryant, A. S. (2017). Racial and ethnic disparities in health and health care. Obstetrics and Gynecology Clinics of North America, 44(1), 1–11.