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The interviewee is a 21-year-old Hispanic female. She will be referred to as Maria. Maria had sought the help of a physician, as she had been having quite intense headaches for a while. The painkillers she had been taking had had only short-term effects. Maria drank mint tea to treat the headaches as well. She had some tests, completed some questionnaires, and answered the physician’s questions. She was diagnosed with a migraine that was triggered by menstrual periods and stress.
The overall evaluation of that experience was negative. Maria noted that she accessed the services quite easily, but it was associated with a significant financial expenditure because she did not have the insurance at that moment. She felt the visit was necessary, as her family thought that the headaches could be symptoms of a more serious issue. Recently, one of her distant relatives had died of brain cancer. The interviewee claimed that she would think twice before paying another visit to this doctor, as it was too costly for her. She was specifically dissatisfied with the tests she had to take. Another most significant negative aspect was the communication with the physician.
She stressed that he had asked quite personal questions “in a very improper way.” Maria was dissatisfied with the way the physician interviewed her (his impersonal manner, different “irrelevant” questions). The interviewee emphasized that she was reluctant to answer many of the questions. She also mentioned her surprise and fear associated with the prescribed drugs. Maria wanted to hear about some “more traditional” ways to treat headaches. Maria would not describe the services she received as high-quality. She stated that her previous doctor was much better and more supportive and informative.
However, she did admit that the physician made the correct diagnosis and provided an effective treatment plan. She had fewer headaches within a very short period, and the pills helped to soothe the pain. However, Maria added that she had had to ask other professionals (and her family members) concerning ways to replace some pills, as she never trusted fully in pharmacological methods. Maria did not notice any bias, prejudice, or unfair treatment, but she stressed that the doctor was not very supportive and failed to become a person she could trust.
The analysis of the patient’s account can help unveil potential areas for improvement within the US healthcare system. One of the major concerns associated with American health care is its affordability. People who do not have health insurance can hardly afford high-quality healthcare services, which makes them see a visit to a doctor as a last resort action. Clearly, this may have considerable adverse effects on their health, as well as public health, since people will address healthcare professionals only when costly treatment is needed and their health or even life is in danger (Griffin et al., 2016). Clearly, this is one of the areas where the system is failing to perform well.
The debate concerning the affordability of health care or even a shift to the public healthcare system is still ongoing in American society. The concept of interdependence may help make sense of this peculiarity of the American healthcare system. Historically, health care in the United States has been regarded as a service to be purchased by users. The interaction of diverse agents contributes to the maintenance of this approach. The physician who worked with Maria was one of those who accept the system as it is. He did not try to focus on the most relevant things while trying to avoid using less relevant procedures. He simply followed the standard procedure, which cannot be regarded as a patient-centered approach.
Another major concern is related to the area of doctor/patient communication. The physician failed to develop the appropriate communication patterns with the patient. First, the physician did not inform the patient about the importance of various tests, which made Maria think that many of them were a waste of her money. The patient stressed that she was not like her older relatives who distrust the healthcare system completely, but she still did not understand many things associated with her hospital experience. Juckett (2013) notes that proper communication (characterized by mutual respect and being informative) is the key to effective treatment of Latino patients.
It is necessary to note that the physician appears to be one of those who do not pay much attention to the cultural peculiarities of patients. According to adaptive systems theory, the systems are characterized by adaptability, as they can learn from their experiences and adapt to the changing environment. The modern US healthcare system is changing as it is transformed by different cultures and approaches existing in the world and in US society (Griffin et al., 2016). Healthcare professionals try to take into account the cultural peculiarities of their patients. Obviously, not all American healthcare practitioners have embraced this change.
The physician did not detect Maria’s emotional cues and did not take into account her values and beliefs. Blanch-Hartigan (2013) found that physicians’ inability to decode patients’ emotional cues led to the patients’ overall dissatisfaction with their experiences. As for the importance of values and beliefs, Latino patients tend to be quite religious, and all aspects of sexual life can be seen as too personal even for a conversation with a doctor (Juckett, 2013). Maria noted that she was not a teenager, but she found the physicians’ questions (“or mainly his tone”) concerning her sexual experience to be unacceptable. Notably, questions concerning menstruation and birth control drugs are common procedures, as these are some of the major triggers of migraines. Nonetheless, the physician had to explain the major triggers of migraine headaches and after that ask questions concerning this sphere of female life with the necessary degree of respect and modesty.
Finally, the treatment recommended was effective, but the physician failed to take into account the patient’s cultural peculiarities and needs. The medication prescribed was effective, but Latino patients tend to see traditional methods (for example, the use of herbs) as more desirable or even appropriate (Juckett, 2013). Maria was rather dissatisfied with the service and had to seek out other people’s advice. This practice can have quite negative long-term outcomes, as the patient will not trust the physician (as well as other healthcare professionals) and may seek assistance from others, including people who are unqualified. Self-organization has become a key solution to addressing similar situations.
Healthcare professionals ask their colleagues about the peculiarities of treating patients of different cultural backgrounds. Interprofessional teams are characterized by diversity in many respects (ethnicity, age, and so on). Healthcare professionals have self-organized to respond to emerging challenges. At present, interprofessional teams (including people of different backgrounds) have become a distinct system. However, it is clear that these systems do not operate properly in all clinical settings, and there are individuals who still tend to focus on practices used years ago. It is necessary to note that this analysis can help address the existing gaps in health care.
Insights for a Healthcare Manager
This interview provides valuable insights into the gaps associated with patient/client experience, some groups’ perspectives on the American healthcare system, and the implications for the healthcare manager. Healey and Marchese (2012) stress that healthcare managers have to use more flexible and creative methods to address emerging issues. The use of the concepts of adaptive systems theory can be one of these creative strategies. One of the major concepts of this theory to keep in mind is the non-linearity of systems. It is crucial to remember that even individuals can change large systems. Thus, the healthcare manager should believe that the efforts will lead to changes that are essential for the development of the US healthcare system.
The interview unveiled the lack of flexibility within the healthcare system—some healthcare professionals continue to use standard procedures, despite the fact that some adjustments could be beneficial and could improve the patient/client’s experience. It is noteworthy that all of the gaps revealed during the interview can and should be addressed. For instance, when it comes to the associated costs, the healthcare manager can improve the patient/client’s experience. The healthcare manager should launch a series of discussions concerning the use of a more flexible approach to diagnosing and prescribing processes.
Standards are sometimes outdated and too rigid, so healthcare practitioners should be able to alter some procedures. In Maria’s case, it was possible to avoid some tests and prescribe fewer items. Clearly, this flexibility will require some changes in the healthcare facility’s norms and standards. These regulations will be needed to minimize medical errors, but they should provide more freedom for practitioners. It will also require quite extensive training and encouragement as many people try to follow standards to remain on the safe side. The healthcare manager can launch a reward system for employees who are ready to be more flexible.
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Another significant gap is associated with healthcare professionals’ ability and willingness to take into account the patient/client’s peculiarities to improve their experience. The healthcare manager should launch a series of training sessions concerning the cultural peculiarities of patients/clients and ways to address them. The training should be facilitated by the creation of a platform (it can be digital) where healthcare professionals share their experiences and concerns. The healthcare manager should also make sure that all practitioners use the skills and knowledge obtained. This can be implemented with the help of self-reports, performance reports, and patient/client questionnaires. Regular discussions should shed light on the numerous benefits of this approach for all stakeholders involved. For instance, it is important to stress that the number of ethnic minority patients is increasing, which makes it important to understand these populations better (Loder, Sheikh, & Loder, 2015). As a result of these efforts, all healthcare professionals of the facility can become informed, supportive, and sensitive to people’s diverse needs, values, and beliefs.
Finally, the healthcare manager will monitor the healthcare facility’s employees with a focus on such issues as the cultural and socioeconomic peculiarities of patients. Maria’s experience shows that there are many gaps even though the focus on the cultural diversity of patients has become a norm nationwide. It is clear that some practitioners are still reluctant to change, which negatively affects the provision of high-quality healthcare services, patient/client experience, and the overall development of the US healthcare system.
Blanch-Hartigan, D. (2013). Patient satisfaction with physician errors in detecting and identifying patient emotion cues. Patient Education and Counseling, 93(1), 56-62.
Griffin, P. M., Nembhard, H. B., DeFlitch, C. J., Bastian, N. D, Kang, H., & Muñoz, D. A. (2016). Healthcare systems engineering. Hoboken, NJ: John Wiley & Sons.
Healey, B. J., & Marchese, M. C. (2012). Foundations of health care management: Principles and methods. Hoboken, NJ: John Wiley & Sons.
Juckett, G. (2013). Caring for Latino patients. American Family Physician, 87(1), 48-54.
Loder, S., Sheikh, H. U., & Loder, E. (2015). The prevalence, burden, and treatment of severe, frequent, and migraine headaches in US minority populations: Statistics from national survey studies. Headache: The Journal of Head and Face Pain, 55(2), 214-228.