scholarly journals Matching physicians to newly arrived refugees in a context of physician shortage: innovation through advocacy

2014 ◽  
Vol 10 (1) ◽  
pp. 36-51 ◽  
Author(s):  
Fern Brunger ◽  
Pauline S. Duke ◽  
Robyn Kenny
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Medical Care ◽  
Family Physician ◽  
Cross Cultural ◽  
Physician Shortage ◽  
Content Type ◽  
High Satisfaction ◽  
Access To Medical Care ◽  
High Engagement

Purpose – Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The MUN MED Gateway Project is a medical student initiative in partnership with a refugee settlement agency that provides access to and continuity of health care for new refugees, while offering medical students exposure to cross-cultural health care. This paper aims to report on the first six years of the project. Design/methodology/approach – Here the paper reports on: client patient uptake and demographics, health concerns identified through the project, and physician uptake and rates of patient-physician matches. Findings – Results demonstrate that the project integrates refugees into the health care system and facilitates access to medical care. Moreover, it provides learning opportunities for students to practice cross-cultural health care, with high engagement of medical students and high satisfaction by family physicians involved. Originality/value – Research has shown that student run medical clinics may provide less than optimum care to marginalized patients. Transient staff, lack of continuity of care, and limited budgets are some challenges. The MUN MED Gateway Project is markedly different. It connects patients with the mainstream medical system. In a context of family physician shortage, this student-run clinic project provides access to medical care for newly arrived refugees in a way that is effective, efficient, and sustainable.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

A strategic and good governance perspective on handling patient complaints

2018 ◽  
Vol 31 (8) ◽  
pp. 923-934
Author(s):  
Sanna Pauliina Ryynänen ◽  
Risto Harisalo
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Good Governance ◽  
Care Organization ◽  
Content Type ◽  
Patient Complaints ◽  
Care Processes ◽  
Patient’S Rights ◽  
Strategic Goals

Purpose The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization’s personnel. The organization’s strategy and good governance principles provide the framework for understanding the organization’s action. Design/methodology/approach This study’s data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis. Findings The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients’ care experiences, provision of information, personnel’s professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients’ expectations and personnel’s evaluation of patients’ needs. Originality/value Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization’s strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

Forward-backward translation and cross-cultural validation of the Center for Epidemiologic Studies Depression scale among Tigrigna-speaking Eritrean refugees

2019 ◽  
Vol 15 (2) ◽  
pp. 163-176
Author(s):  
Mulubrhan F. Mogos ◽  
Jason W. Beckstead ◽  
Mary E. Evans ◽  
Kevin E. Kip ◽  
Roger A. Boothroyd
Keyword(s):  
Health Care ◽  
Measurement Invariance ◽  
Semantic Analysis ◽  
Epidemiologic Studies ◽  
Vulnerable Population ◽  
Cross Cultural ◽  
Depression Symptoms ◽  
Care Providers ◽  
Content Type ◽  
The Usa

Purpose The Center for Epidemiologic Studies Depression (CES-D) scale is a widely used instrument for studying depression in the general population. It has been translated into several languages. Cross-cultural relevance of the construct of depression and cultural equivalence of the CES-D items used to measure it are crucial for international research on depression. Given the increasing number of refugees from Eritrea entering the USA and Europe, there is a need among health care researchers and providers for an instrument to assess depressive symptoms in the native language of this vulnerable population. The paper aims to discuss these issues. Design/methodology/approach The study employed forward–backward translation and assessed the CES-D scale for cross-cultural research and depression screening among Tigrigna-speaking Eritrean refugees. Forward–backward translation, cognitive interview and semantic analysis were conducted to ensure equivalence of comprehension of the items and instructions between Tigrigna- and English-speaking samples. Multi-group confirmatory factor analysis was used to assess the measurement invariance of the translated version. Findings Translation efforts were successful as reflected by the results of semantic analysis and pilot testing. Evidence supporting the measurement invariance of data collected using the Tigrigna version of the CES-D was obtained from a sample of 253 Eritrean refugees in the USA. Practical implications The findings of this study provide support for reliability and validity of data collected using the Tigrigna version of the CES-D scale. This important tool for assessing depression symptoms among Eritrean refugees is now available for health care providers and researchers working with this vulnerable population. Originality/value This work is an original work of the authors and it has not been published previously.

Morning in refugee health: an introduction for medical students

2015 ◽  
Vol 11 (2) ◽  
pp. 86-94 ◽  
Author(s):  
Pauline S. Duke ◽  
Fern Brunger ◽  
Elizabeth Ohle
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Medical School ◽  
Clinical Education ◽  
Clinical Skills ◽  
Refugee Health ◽  
Community Context ◽  
Successful Implementation ◽  
Health Providers ◽  
Content Type

Purpose – Migration is increasing worldwide. health care practitioners must provide care to migrants in a culturally competent manner that is sensitive to cultural, political and economic contexts shaping health and illness. Many studies have provided strong evidence that health providers benefit from training in cross-cultural care. Cultural competence education of medical students during their early learning can begin to address attitudes and responsiveness toward refugees. At Memorial University in Canada, the authors designed “Morning in Refugee Health”, an innovative program in cultural competency training for first year medical students in the Clinical Skills and Ethics course. The purpose of this paper is to discuss these issues. Design/methodology/approach – Here the authors introduce the curriculum and provide the rationale for the specific pedagogical techniques employed, emphasizing the consideration of culture in its relation to political and economic contexts. The authors describe the innovation of training standardized patients (SPs) who are themselves immigrants or refugees. The authors explain how and why the collaboration of community agencies and medical school administration is key to the successful implementation of such a curriculum. Findings – Medical students benefit from early pre-clinical education in refugee health. Specific attention to community context, SP training, small group format, linkages between clinical skills and medical ethics, medical school administrative and community agency support are essential to development and delivery of this curriculum. As a result of the Morning in Refugee Health, students initiated a community medical outreach project for newly arriving refugees. Originality/value – The approach is unique in three ways: integration of training in clinical skills and ethics; training of SPs who are themselves immigrants or refugees; and reflection on the political, economic and cultural contexts shaping health and health care.

scholarly journals “Mais Médicos”: Discourses, Bodies, and the Biopolitics of Medical Internationalism

2020 ◽  
pp. 4-24
Author(s):  
José O. Pérez
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Professionals ◽  
Brazilian Society ◽  
Access To Medical Care

Abstract Starting in 2013, the Mais Médicos program brought over 11,400 Cuban doctors to work in Brazil. The program aimed to reduce inequality in access to medical care; but it was met with heavy resistance from Brazilian medical professionals. This article employs Foucault, Butler, and other post-modern thinkers to analyze Mais Médicos. Specifically, we argue that Mais Médicos did not lead to a politicization of Brazilian health care, but rather that pre-existing discourses were called upon to support or counter the arrival of Cuban doc-tors. This discursive struggle resulted in a dispute over biopower within Brazilian society. We base our claims on fieldwork and interviews conducted with Cuban doctors, Brazilian doc-tors, and Brazilian politicians.

Systematic Review of Research on Barriers to Access to Veterinary and Medical Care for Deaf and Hard of Hearing Persons

2021 ◽  
pp. e20200116
Author(s):  
Allison N. Hinchcliff ◽  
Kelly A. Harrison
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Medical Care ◽  
Health Care Access ◽  
Hard Of Hearing ◽  
The United States ◽  
Care Access ◽  
Pet Owners ◽  
Access To Medical Care ◽  
Improve Access

The Deaf and hard of hearing (DHH) population suffers disproportionately from barriers to health care access. Progress has been made toward improving access to medical care in the human health field; however, the veterinary field has not yet implemented similar standards. More research is needed to improve access to veterinary care for disabled individuals. This systematic review aimed to evaluate all primary research articles pertaining to medical and veterinary health care access for DHH adults in the United States. Its purpose was to assess gaps in knowledge regarding DHH persons’ access to veterinary care. The review includes 39 articles related to DHH access to medical care and 6 articles related to general access to veterinary care. The authors found no articles related specifically to DHH access to veterinary care nor any articles on disability accessibility to veterinary care that met the inclusion criteria. Results outline significant barriers to DHH persons’ access to health care, unique needs specific for this population of patients, and recommendations to improve access to medical care for individuals who identify as DHH. The results also suggest that further research is needed to investigate barriers to veterinary care experienced by DHH pet owners, the unique needs of this population of pet owners, and how the field of veterinary medicine can better accommodate those needs.

scholarly journals Contested Health Care System in Berlin: Are Illegalized Migrants Becoming Urban Citizens?

2019 ◽  
Vol 7 (4) ◽  
pp. 100-107 ◽  
Author(s):  
Holger Wilcke ◽  
Rosa Manoim
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Social Order ◽  
National Level ◽  
Urban Life ◽  
Urban Citizenship ◽  
Health Care Practices ◽  
The Social ◽  
Residency Status ◽  
Access To Medical Care

This article argues for an urban citizenship perspective which explores the struggle for rights and the everyday practices of illegalized migrants. Analyzing the concept of Anonymized Health Certificates as a result of such a struggle allows for examination of urban citizenship in this context. The implementation of the Anonymized Health Certificates program would facilitate access to medical care for people who live in the city of Berlin but are excluded from this right due to their lack of residency status. However, such a perspective also makes it possible to examine the limitation of the Anonymized Health Certificates, which would allow illegalized migrants in Berlin to circumvent access barriers, while at the same time the exclusion mechanisms of these barriers would remain uncontested at the national level. Whilst Anonymize Health Certificates will greatly improve access to medical care, illegalized migrants have by no means been passive subjects and have been actively rejecting their exclusion from health care: Practices include sharing health insurance cards with friends, visiting doctors who help for free as a form of solidarity, and sharing information about these doctors within their social networks. Even if they do not contest the social order visibly, they refuse to passively accept their social exclusion. Illegalized migrants perform such practices of urban citizenship in their everyday life as they actively take ownership of their rights to participate in urban life, even whilst being formally denied these rights.

scholarly journals Access to Health Care for English Division Students of the Medical University of Warsaw

2020 ◽  
Vol 46 (2 (176)) ◽  
pp. 107-125
Author(s):  
Maria Strzemieczna ◽  
Mikołaj Pawlak ◽  
Jacek Imiela ◽  
Magdalena Lorkowska
Keyword(s):  
Higher Education ◽  
Health Care ◽  
Medical Students ◽  
Medical Care ◽  
Access To Health Care ◽  
Survey Questionnaire ◽  
Access To Health ◽  
Language Problems ◽  
Original Survey ◽  
Medical University

Foreigners face certain barriers in accessing medical care, though international medical students are in many aspects privileged in this field. The aim of this study is to explore whether these students are facing problems in accessing healthcare. An original survey questionnaire was prepared and distributed online and on paper among students. In total 138 questionnaires were filled out. The results were analyzed using statistical methods. The main barriers faced by students are the lack of knowledge about the healthcare system and language problems. The study shows there is a need to start working on institutional solutions to provide information about access to healthcare and to overcome language barriers in healthcare institutions. * The article is part of a research project financed by the Ministry of Science and Higher Education. / Pracę wykonano w ramach Projektu Badawczego, finansowanego ze środków dotacji celowej MNiSzW.

scholarly journals ASSESSMENT AND INFLUENCE OF A FAMILY PHYSICIAN ON THE HEALTH STATUS OF THE POPULATION OF AMALGAMATED TERRITORIAL COMMUNITIES

2020 ◽  
Vol 8 (3) ◽  
pp. 307-313
Author(s):  
V. I. Potseluiev
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Medical Care ◽  
Family Physician ◽  
Family Physicians ◽  
Outpatient Clinics ◽  
System Reform ◽  
Primary Health ◽  
Study Results

Introduction: Primary health care is the most important part of the health system. Family physicians, as representatives of this link, are key figures who are assigned a number of responsibilities for the prevention, diagnosis, and treatment of both adults and children. An indicator of the effectiveness of their work is the level of satisfaction of citizens with the quality of service. To understand the effectiveness of reform implementation, the authors evaluated the activities of the family physician and its influence on the health of citizens living on the entrusted territory. The aim of the study is an empirical analysis of the selection criteria, frequency and reasons for the citizens' visits to a family physician in the amalgamated territorial communities of the Sumy region. Materials and methods: During the research, methods of a systematic approach and comparative analysis were used. The study was conducted in the form of a survey. Calculations and processing of statistical information were carried out using the "OSA" application. Study results and discussion: The paper shows the condition of primary care as a result of the health system reform. The sociological survey on the work of family physicians in the amalgamated territorial communities concerned the criteria for choosing a family physician, the frequency of requests for medical care, and the reasons for requests, in particular for preventive purposes. The analysis showed that the percentage of signing declarations is relatively high. However, a certain formality of this process was observed, since a significant percentage of citizens who signed the declaration have never met their family physician. The result indicates that citizens often do not seek medical care in outpatient clinics on the territory of the amalgamated territorial community, and they rarely visit the physician for preventive purposes. According to respondents, the reason for not seeking prevention is the lack of need. Conclusion: A high percentage of residents of the amalgamated territorial communities signed declarations with family physicians. However, having analyzed the survey data, we can note a rather formal attitude to this procedure, since many residents seek medical services in other medical institutions. It is a consequence of the insufficient effectiveness of the reform of primary health care and insufficient attention on the part of local authorities to provide outpatient clinics with qualified specialists. There is a need to raise awareness about the importance of preventive measures. Keywords family medicine, family physician, preventive work, declaration, communication.

scholarly journals A critical analysis of sarcoidosis incidence assessment

2013 ◽  
Vol 8 ◽  
Author(s):  
Jerome M. Reich
Keyword(s):  
Health Care ◽  
Causal Inference ◽  
Medical Care ◽  
Critical Analysis ◽  
Age Dependency ◽  
True Incidence ◽  
Population Comparison ◽  
Valid Comparison ◽  
Radiographic Interpretation ◽  
Access To Medical Care

Valid sarcoidosis incidence assessment is contingent on access to medical care, thoroughness of reportage, assiduity of radiographic interpretation, employment and health care screening policies, misclassification, and population ethnicity. To diminish ambiguity and foster inter-population comparison, the term “sarcoidosis incidence” must be modified to convey the methodology employed in compiling the numerator. In age-delimited cohorts, valid comparison to population incidence requires age adjustment due to the age-dependency of incidence. The “true incidence” of sarcoidosis is a notional concept: more than 90% of cases are subclinical and radiographically inevident. Occupational causal inference based on incidence differential vs. populations has been undermined by methodological differences in ascertainment and computation.

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