Some of the answers a group of Connecticut doctors received were what you’d expect, while others were revealing, Dr. Kathleen LaVorgna said of a survey on health disparities.
The survey released Wednesday in The Journal of the Connecticut Medical Society found doctors need to take more steps to better serve patients with diverse racial, ethnic, and cultural backgrounds.
Funded with a grant by the Connecticut Health Foundation. the survey found fewer than two in five physicians received some kind of cultural diversity training and physicians ages 55-64, and those whose practices were mostly White, gave themselves lower ratings for providing culturally appropriate care.
At a press conference unveiling the survey results, Dr. LaVorgna, president of the Connecticut State Medical Society recalled the first time she practiced medicine with a culturally diverse population. She said she went out to practice at a Navajo reservation in Arizona and had to learn it’s impolite to look a Navajo in the eye or shake their hand, which is what she learned in medical school.
In most cases someone had to translate for many of the elderly residents on the reservation. LaVorgna said she would ask how a patient was feeling and after almost a three-minute conversation with the translator, the translator would turn to her and say, “No.”
“I was left with almost a non-ability to use all the tools I had been given in medical school to try and care for that patient,” LaVorgna said.
But LaVorgna isn’t alone.
“What we realized when we looked at how little data there was out there that we needed to take the pulse if you will of the physicians in our state to find out how each of us feels about the job that we’re doing,” LaVorgna said.
The survey says the most common approach to overcoming language barriers was for a doctor to rely on a patient’s family member to interpret.
Dr. William Handleman, past president of the Connecticut State Medical Society, said when he first opened his practice in Torrington most of his patients worked in factories, but as the factories began to disappear the demographics changed. Now there is a large Hispanic population and for some English is not their first language. The problem is there is only one physician in Torrington who is fluent in Spanish.
Handleman said the survey also found that specialists are even more disadvantaged when it comes to dealing with culturally diverse populations.
But despite the cultural issues the survey also found one of the biggest barriers to patients obtaining adequate care was their access to adequate insurance or their ability to use the insurance they have.
Forty-three percent of doctors cited types of insurance accepted by other doctors or specialists as a “big problem” in obtaining referrals.
The good news from the survey is that physicians were honest with their answers and are telling us they need help, Handleman said.
To that end the Connecticut Health Foundation has provided the Connecticut State Medical Society with enough money to create education programs for doctors.
Recent state legislation mandates adding cultural competency as a required area of medical education.