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?
While individual physicians can contribute to health care disparities in a number of ways, one of the ways that is most concerning to me, and also discussed in “A Silent Curriculum”, is medical education’s influence on the way in which physicians are taught to practice medicine. The curriculum of the first two years of medical school is improving with more programs incorporating curriculum designed to emphasize socioeconomic factors and their influence on healthcare disparities, understand and minimize bias, and practice patient-centered medicine. However, once the time comes to marry the critical lessons learned in the classroom with the practice of clinical medicine, oftentimes the lessons that emphasized scientific expertise and efficiency become the priority and meeting every patient where he or she is becomes second string. As long as we continue to treat clinical medicine as, first and foremost, a scientific practice in which the greatest powers lie in pattern recognition and accurately predicting a patient’s course, gross bias and stereotyping will continue and thus healthcare disparities.
An area of healthcare that is of particular interest to me is women’s health. Understanding how we as providers can help our patients feel comfortable undertaking the difficult task of disclosing deeply personal information which, in turn, can influence the quality of care they receive is key to minimizing some of the ways in which providers contribute to healthcare disparities.
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?
Structural issues within health care delivery implicated in health care disparities can include decreased service availability (i.e. a patient who lives in a community or state where access to abortion or contraceptive services is limited), transportation to services in proximity to a patient (i.e. a patient who works hours that do not allow her to utilize public transportation to reach services), accessibility to providers or interpreters that speak a patient's preferred language (i.e. a patient who is forced to use a language that she is not comfortable with to disclose and discuss sensitive and personal information regarding her reproductive health), and access to preferred sources of health information (i.e. a patient who does not have access to a smart phone/ internet to confidentiality locate a clinic). Understanding both why these structural issues exist and how minimize, if not eliminate them all together, is very relevant to my particular area of research as all of these factors can directly influence a women’s ability to or ease with which she can obtain reproductive health services.