Whether you are a physician, surgeon, nurse, or technician, being a health care or wellness practitioner is a stressful and taxing state of being. With strenuous demands and pressures created by the medical and insurance industries, balancing the incredible burn-out while still providing quality care is a constant battle for professionals in that arena.
Recent studies and media coverage have brought to the forefront, the prevalence of errors in the diagnosis, treatment and management of women of color in particular with a high percentage of those errors resulting in death. Literature suggests that these errors could have been prevented or at least reduced if they had been recognized as a symptom of implicit bias.
How inclusive is your medical practice? Based on female industry experts and patients of color, the suggestions below are a starting point for a more diversity-conscious and inclusivity-led approach to health care and wellness provision.
Have People On Staff Who Do Not Look Like You
The simple truth is that we all come from our own perspective as individuals. On a basic human level, we are who we are based on our upbringing, family setting, history, and our personal lives. Those dynamics do not check out at the door when we walk into our offices and we have to recognize that our preferences, our perspectives and perceptions, and our experiences will color how we see and engage with other people. That means that, no matter how high in esteem we hold ourselves or deem ourselves “woke” or “bias-conscious” we will still at some level fail to be the mystical unbiased human being we want to be. One simple way to address this is to ensure that staff and your colleagues “do not look like you,” meaning having a diverse team will ensure that a patient, a case has been analyzed and assessed from different perspectives, that factors that you did not consider because of your own blind spots have been pointed out by at least one team member. It is not an issue of lack but rather an approach to be comprehensive.
Listen to the Expert – Hear Your Patient
Time to check the ego at the door! When one becomes an expert or experienced in one’s field, the tendency is to know better than your patient/your client/your customer. The problem with the position is that this often leads to us not fully listening and actually hearing what is being said to us. As professionals, especially in the medical field, hearing your patient out and actually understanding what she/they/he is telling you can be the difference between life and death. There has to be a resistance to “know better” and already making up one’s mind about what the patient is presenting, which diagnosis to give, and what treatment to employ. Not to hurt your feelings, your patient – not you – is the expert in the room. Only she/they/he can truly explain to you what feels out of the norm for their mind or body. Just as you do not like to have your emotional or physical experience to have dismissed, so thou shall not do onto others. And just like you want your expertise believed, so should medical professionals believe the words of their patients.
The Best Advocate Might Not Be You
The second part of this ego-check is understanding and being comfortable with having an advocate for your patient other than yourself. Again, this is not a reflection of your skill or expertise level but rather ensuring that your patient is surrounded by the best team possible. Make patients aware of “patient advocates” in your hospital, clinic, or center, if your facility has them.
A note on accompanying family members. If your patient presents themselves with a family member, keep in mind possible cultural dynamics that may render that family member not the ideal representative for your patient, especially if the patient identifies as a woman or is a child. As a healthcare or wellness professional having an inclusive practice with a diversity-based approach means being mindful of gender dynamics and historical oppression of individuals of certain demographics. Having cultural, ethnic, and linguistically diverse advocates would be a great practice in this field.
Go Beyond the Script
A lot of us have the experience of waiting for our appointed time with our physician for several minutes only to actually be examined for five minutes before the white coat disappears out the door and you are already checking out. And yes, the pressures of the health care system and the allotted time per patient are a nightmare, but going beyond the script, meaning, asking more than just the basic questions and just in regards to the symptoms communicated can have a major impact on outcome. Especially with women of color, there is a tendency of “not making a big deal” out of pain or the body “acting not as usual.” Especially where a patient presents with symptoms but has no medical history, or communicates that they have felt like this before or for the umpteenth time, that should prompt you to ask more questions to look for the bigger picture that sits in front of you. Just because your patient may minimize (or just not know anybody or doubt themselves in what they are experiencing) should not be an absolution for you to ask more questions and put the pieces of the puzzle together.
Some medical and nursing schools have started to give more space to the conversation of diversity and inclusion to train future medical professionals to approach a case within a more comprehensive fashion. But that alone will not move the needle. The medical industry but, more importantly, the health insurance systems must and should put positive patient outcomes over profit in order to allow medical professionals to do what they set out to do when deciding to join this crucial line of work. A practice of diversity, equity, and inclusion can save lives…literally.
About the Author
Carla M. Kupe, Esq.
Carla M. Kupe, Esq., is the founder and principal of The Impact Alliance NFP, a DEI consulting firm, and the creator of Speak Truth, a platform giving voice and visibility to issues uniquely and particularly impacting women of color. Contributing authors are former Illinois MCH Title V Director Andrea Palmer, MPH, MBA, CHSM, University of Chicago faculty and trauma surgeon Priya Prakash, MD, and Founder of Mganga Midwifery Jeanine Valrie Logan, CNM, MSN, MPH.
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