Overheard: "Is anyone concerned that what we do is called 'practice'?"
--John Close, MD, Chief Medical Officer, H.G. Stark Youth Correctional
Protecting Your Patients
In
these times of health insurance rescissions and denials, it's more
important than ever to help your patients understand their legal rights
and to arm them with information to help avoid problems in the first
place. The Los Angeles County Medical Association and the Neuropathy
Action Foundation have teamed up to create a one-page flyer that
summarizes patients' most important healthcare rights and provides tips
to help people avoid claim denials from their health plans. The flyer
is free for both physicians and patients; you can download it from
LACMA's website at www.lacmanet.org or from the Neuropathy Action
Foundation at www.neuropathyaction.org.
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The Diversity Problem
As
the United States-and especially Southern California-becomes more of a
melting pot, physicians need to understand not only their medical
specialties but also the habits of the cultures represented in their
communities. Lack of attention to cultural differences among
patients might contribute to racial healthcare disparities, according
to a study published in the Archives of Internal Medicine.
For the
study, Thomas Sequist, an assistant professor of healthcare policy at
Harvard Medical School and colleagues analyzed the electronic health
records of 6,814 patients in Massachusetts who were treated for
diabetes between 2005 and 2007. The patients were treated by at least
one of 90 primary care physicians with Harvard Vanguard Medical
Associates, which operates 14 walk-in clinics in the eastern region of
the state.
Each physician treated at least five white patients and five
black patients. Researchers examined the patients' medical data for
three standard measures of effective diabetes control: blood pressure,
LDL cholesterol levels and hemoglobin A1C, which reflects blood sugar
levels. The study found that although similar numbers of black and
white patients took each test, fewer blacks adequately controlled their
levels.
According to the analysis, 63 percent of black patients
adequately controlled their blood glucose levels, compared to 71
percent of white patients. Researchers determined that socioeconomic
factors contributed to 13 percent to 38 percent of the disparities.
Rather
than lower quality care, black patients experienced less-adequate
outcomes than white patients. Researchers recommended that physicians
learn more about minority communities and provide patients with more
individualized information. For example, physicians could list a wider
variety of fruits and vegetables to cover the tastes of more cultures.
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Studying the Health Disparities at NIH
Healthcare
disparities among various cultures isn't exactly a brand-new issue but
it's definitely gaining more attention. Recently, the U.S. National
Institutes of Health announced its establishment of the NIH Intramural
Center for Genomics and Health Disparities, a center for researching
how populations are differentially impacted by diseases, including
common ailments such as obesity, diabetes and hypertension. The center
will collect and analyze genetic, clinical, lifestyle and
socio-economic data in order to better understand the complex factors
that underlie health disparities.
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48 The percentage of black
women aged 65 to 69 who received mammograms in California, which has
the lowest mammogram rate for black women in the nation.
--Dartmouth University Institute for Health Policy and Clinical Practice's Atlas of Health Care project
