Published September 12, 2018
Have conversations, not checklists. Communicate with patients as people, not lists of symptoms. Know the communities they live in. Most of all, listen.
These are some of the recommendations that came out of “Let’s Talk about Health Care” when approximately 70 students, medical residents and faculty members from the Jacobs School of Medicine and Biomedical Sciences and dozens of community members ate dinner together last Thursday to discuss health care in the community and how to improve it.
Sponsored by the Center for Medical Humanities at the Jacobs School, led by Linda F. Pessar, MD, its director, the goal was to gain a better understanding of how Buffalo’s residents experience health care and what their concerns are.
The dinner, catered by EM Tea Coffee Cup, based in the Hamlin Park neighborhood, took place in the Sol Messinger Active Learning Center in the Jacobs School building downtown. Each table of seven had a mix of medical students, faculty members who also are physicians with UBMD Physicians’ Group, and community members.
Michael E. Cain, MD, vice president and dean of the Jacobs School, welcomed participants, noting, “This is your medical school and we want you to be a part of everything we do.”
Community members talked about how empathy is critical to a successful health care experience and that doctors need to strive to communicate well, to make patients feel comfortable asking questions. It was noted that cultural sensitivity can improve over time, as providers gain more exposure to different cultures.
Participants discussed the role of logistics, such as the difficulty of getting to doctors’ offices and the cost of health care. They noted that physical spaces, such as waiting rooms, can be off-putting, as can long wait times, which become another health care barrier and a reason to not go to the doctor. The front office staff also must be made to feel part of the team so that they don’t unwittingly become another barrier to receiving care. People said they also feel more comfortable seeing providers who are the same race and gender as themselves.
The idea for the dinner grew out of several initiatives, including the Health in the Neighborhood course offered last year by the Center for Medical Humanities. The center focuses on the psychological, social, cultural and economic forces that influence the practice of medicine and the doctor-patient relationship, especially the social determinants of health and the health disparities between white Americans and people of color.
“The health outcomes between black and white Americans are shockingly disparate for many complex reasons,” said Pessar. “At least a component of it is this distrust and misunderstanding between black Americans and their physicians. A proportion of black Americans don’t trust doctors; they don’t feel we work for their benefit. An example is the belief that doctors are paid by the prescription.”
The Health in the Neighborhood course paired students with families in the community so that students could better understand their lives, their community and especially, their experiences with the health care system.
“The medical students and the people in the community sat down together and as people of goodwill were able to talk to one another and begin to trust one another,” said Pessar. “Eventually, they were able to negotiate some really good ideas about how to improve health care.”
Developed by Pessar, Henry Louis Taylor, Jr., professor of urban and regional planning in the UB School of Architecture and Planning, and David Milling, MD, senior associate dean for student and academic affairs at the Jacobs School, in partnership with Pastor Dennis Lee of Hopewell Baptist Church and Pastor Kinzer Pointer of Agape Baptist Church, the course had begun to make a real difference in the perceptions of both students and community members.
Pessar thought: “Why leave this at Hopewell? Let’s open it up and see if we can begin this dialogue in a larger group.”
There was obviously a hunger for it.
“To my astonishment, when I sent this out to the med school listserv, there was overwhelming interest,” said Pessar. Within days, the event reached its maximum capacity for medical students and providers.
Pessar attributed the interest to the growing realization that the medical community needs to better understand the communities it serves.
“We simply have to come to understand the lives and needs of our diverse population if we are going to do what we came into medicine to do, which is to treat well the needs of the people we serve,” she said.
While the efforts of the Center for Medical Humanities began long before the Jacobs School relocated to its new downtown home, she thinks that the school’s new location has provided an even stronger impetus for the increased interest in addressing health care disparities.
“The fact that we’ve had so much interest in this says that the time has come for this coming together of the medical school and the community,” she said, adding, “It’s the beginning of a movement.”