If I had to give a singular piece of advice to myself entering freshman year, it would be that all things which are meant to be shall be. I have struggled often in all aspects of my life this year with uncertainty–from the health of family members to the achievement of grades, and everything in between–and in the end, things are turning out as they should. I could have saved myself many sleepless nights and worried days with the knowledge that my life will continue even if there are stressful issues at play, and things will end up as they should. I am satisfied with where I am for the majority of things in my life, and I wish I could have told my past self that things would be okay. I’m proud, looking back, for making it through what I’ve endured and where it’s lead me in my development to be better as a person. I have struggled and thought I would fail, but in the end I have completed this portion of my journey and grown because of it. I wish I would have known that things would end up this great in the end.
I was very surprised that Dr. Zikmund-Fisher still advised people to do what they felt was best for them, and not what is statistically safest. I had a preconceived idea that people who consume and work with research for public health would practice the safest possible means of living by practicing what others in their field preach, but that is not the case. I agreed with him that instead of blindly following what experts in the field may say about every possible dangerous thing, it is always best to follow what you believe will allow you to live a happy life, and take the risks which you are willing to live your life the way you choose. Coming from someone whose mother obsessed over ever new study and warning for simple, relatively safe food items, it’s nice to hear someone talk about the other side for a change.
As a nurse, it’s probably a little important to be good at communication. If I don’t communicate clearly enough, someone could die, which sets the stakes a little high. Translating what treatment I intend to carry out from medical terminology to common language can be tricky, and doing it right makes the difference between a well-informed patient and one who knows nothing about their treatment, which means they can’t make well-informed decisions. That’s a dangerous recipe that could lead to more pain and suffering instead of a healed patient. I have to help patients make decisions not by what I think is best, but by informing them impartially about their choices and letting them decide what’s best for them, whether that be the decision to undergo a potentially risky surgery, or whether or not their favorite cookie dough is a safe choice to eat
I cycled through many titles for this final post of the semester, including illustrious openers such as “Denial & Other College Survival Tips” and “What the Hell Just Happened: A Semester Reflection,“ but I settled on “Tears, Anxiety, and Stress-Eating: An Autobiography” not only for the comedic value, but because I feel it more accurately encapsulates my experience, and all of these things you can do with other struggling friends. All light-hearted, sarcastic titles aside, this semester has been hard, but also held within it some of the best times of my life. Within a few short months, I’ve met some of my favorite people on this Earth who I feel like I’ve known for years. This semester has been nothing short of the most interesting, ambivalent, fun, and wondrous time of my life.
My struggles so far have been numerous and stressful, from schoolwork to situations at home, and it’s been a rough road. I have enjoyed most of my classes, but they have been challenging and pushed my ability to comprehend and learn. My home situation has been difficult to say the least, and my year so far has been littered with periods of time I wasn’t sure if I would make it through.
My saving grace has been the support of my friends, who are like family to me. I have cried with them, and held them as they cried. They have been there for me without equal, and I will always be indebted to them for holding me up when I have been at my lowest. I really don’t feel like discussing the struggles because I feel that the main point I’ve learned from this semester is that all can be overcome with my new family by my side. If I’ve learned one thing from my first semester at college, it’s that having people who you can laugh, cry, and shop with is paramount to survival. Finding those special people with whom you can share tears, anxiety, and stress-eating is what’s gotten me through the hard times. I love each and every one of my new friends, and I’m looking forward to taking on whatever Michigan has to throw at us with them by my side.
The inequity between health outcomes among different racial groups in health care settings is a disgusting dark side to what is typically portrayed as an upstanding pillar of society. The bias and prejudice which exists in the health care field is not only palpable, but measurable. The public is predominantly ignorant of the statistics and data which highlight the vast disparities in quality of care and overall outcome of health facility visits among these diverse groups. Others dismiss the claim that there exists institutionalized racism in our health care system, and disregard the studies as misguided or unfounded. To truly establish equal health outcomes following care and create an environment in our hospitals which allows the patient, regardless of color, to receive the highest standard of care which can be provided, we must accept this information for what it is, the truth, even though it may be uncomfortable. Embracing that discomfort will allow providers to realize their own biases and not allow any perpetuation of this issue affecting millions.
On the intrapersonal level, physicians’ personal biases, whether conscious or not, affects treatment speed and efficiency of patients with different racial backgrounds. According to studies referenced in the article Can Health Care Be Cured of Racial Bias? by April Dembosky, African-Americans who present with the same symptoms and chief complaints as whites receive on average less prescription pain medication. Dembosky also states, “Black patients with chest pain are referred for advanced cardiac care less often than white patients with identical symptoms.” This chasm between whites and blacks receiving proper care adumbrates the prejudice and racism which exists in ambivalence, griping minorities with anxiety who seek treatment, while not affecting whites entirely, and completely results from health care providers acting upon their implicit biases.
Interpersonally, a lack of community understanding or acknowledgement of controversial fact perpetuates the inequality of health care outcomes. Studies, such as one published in the National Institute of Health’s National Library of Medicine stating that blacks were less likely than whites to receive opioid analgesics for the same health conditions, rarely make headlines. It is an unpopular topic of discussion to propose that those in charge of saving lives may also be treating patients differentially due to race and biases, a topic which is uncomfortable perhaps for the reason that it may install worry, and rightfully so, in such affected populations who will call upon these care providers for treatment in the future. Those who do find information on this subject may dismiss it because, similar to climate change, it is easier to dismiss an issue as being untrue than it is to try and generate a plausible solution. Whether it is due to ignorance of fact or blindness of truth, the lack of community involvement preserves the biases which leave some recipients of care behind. Were there more news coverage of such disparities, the public would pressure health institutions in which the gap is most extreme and catalyze positive change.
In the broader scope of public policy, there exists no legislation or regulation which standardizes the clinical pathways, the ideal sequence of treatment and timing of such care for a particular diagnosis, which must be followed for any patient, regardless of race. A mandatory level of standardization ensures equality for treatment of all groups, indifferent to the biases of any particular health care provider. Perhaps if such a standardization was incentivized, such as a penalty on insurance payments to the institution for differential health outcome due only to a difference in race without other complications, there could be a positive impact on reducing the difference in treatment of varying ethnicities with the same diagnosis.
According to the International Consortium for Health Outcomes Management, “We believe outcomes are the ultimate measure of success in health care.” If this is indeed the case, then our current health care system is blatantly failing the needs of underrepresented populations, and it is not only our responsibility, but our duty as the future of health care to establish an equity so desperately missing from our care of individuals, regardless of cultural background or ethnicity. To truly call oneself a health care provider, one must do so without difference of color or creed, for to do so is a disservice to not only the patient, but the entirety of the health care community.
What do you think is a good way to help break the cycle of prejudice and bias in our health care system? Is it feasible to dream of a health care system without prejudice?