1) How do individual physicians contribute to health care disparities? Thinking about an area of health care of particular interest to you, what research do you think could be done to either understand the effect of individual physicians on health disparities, or to decrease this effect?
I believe that doctors or health team personnel can contribute intentionally or not to several levels, clearly, we see in Figure 1 of the article by Van Ryn and Fu. Perhaps two key points are the interpretation of the symptoms in the treatment plan. In the dental clinic, pain is a relevant area and perhaps one of the most important causes for not attending the consultation, so that pain management is a critical area both in the diagnosis and in the treatment that is often faced with false beliefs in the biological. Differences generating a bias. An example is to carry out a study similar to the article by Hoffman et al., Where we could determine in a population of dentistry students’ knowledge about key biological aspects susceptible to bias and detect false beliefs, in addition to exposing this population to cases that allow evaluation the pain score that they would determine. We could determine specific interventions for these students and improve the care they will perform in the future.
2) Structural issues within health care delivery are implicated in health care disparities. Please brainstorm 4 structural issues that might contribute to these disparities. Which of these are relevant to your particular area of research, and how?
If we consider that dental care as an oral cancer prevention tool, we could identify the following points:
Linguistic barriers: the correct use of language and effective communication are very important. Language barriers not only impede the exchange of information, but also pose important ethical issues during medical decision making that may affect access to medical services, and this limited use of medical services may compromise health outcomes.
Residential segregation and geography play an important role in the diagnosis and treatment, especially in diseases that require intensive therapies. For example, longer travel time and difficulties in traveling to the health care provider have an impact on patient visits.
Access to insurance: as a result of economic inequalities and lack of coverage, there is a decrease in access to frequent care by a dentist; a detection of an early injury reduces the risk of mortality of malignant tumors in the oral cavity.
Bias in relation to race influences patients' perceptions of health and illness. They influence the way in which symptoms are recognized and interpreted and how health services are sought. If caregivers do not support regular cessation of tobacco use, they do not help control one of the most important risk factors for oral cancer.