CEO 5.2 Appropriately use system resources and assist patients in accessing healthcare that is safe, effective, patient centered, timely, efficient, and equitable.

Prior to medical school, I completed a program evaluation for a diabetes education program as my capstone project for my MPH degree. Barriers in the form of language and resources existed. Many patients were non-English speaking and were able to receive services with the help of an interpreter. Many patients did not have higher education. I watched the complexity with which diabetes was explained. The resources provided in the form of translator services, and diabetes educators helped patients to be able to gain access to healthcare. I was also able to see how providing a patient with the proper resources could help them manage their diabetes. It was there that I learned the importance of access to health services and my desire to advocate for patients was awakened.

I recognized I wanted to increase healthcare access to patients population while in medical school.   In an effort to accomplish this, I spent time volunteering at La Clinica Latina during M1 and M2 years.   It was here where I was able to improve upon my medical Spanish. By serving as an interpreter, I was able to help provide medical care for patients that otherwise may have had trouble accessing care.

My introduction to third year was the UPWP ring. This ring provided several opportunities to Spanish speaking interpreting skills.   When I was on my PM&R service, I was able to interpret for a patient. This was the first time on the wards, I was able to see the ease with which rapport could be built between provider and patient when a common foreign language is spoken.   When on a pediatric outpatient rotation, I was assured by a patient’s mother how nice it was to be able to speak to a provider in their native tongue so that nothing would be lost in translation. As the interpreter for the patient, I was able to bridge the communication barrier that existed between the patient and the team.

While on my ED rotation, I was able to once again implement my medical Spanish. There was a Spanish- speaking patient with a suspected small bowel obstruction that arrived from an outside hospital around 5 am.   At this point I was tired as it was nearing the end of my overnight shift. Walking into the room, the nurse informed me the patient was Spanish speaking. I had no time to think about speaking Spanish, it just came out naturally. I was able to converse with ease with this patient.   During this encounter I was able to notify nurse that the patient was asking for pain medication. I was also able to help get the patient a blanket. While an interpreter could have been used if I did not speak the same language as the patient, it would have taken twice as long to determine what the patient needed. By speaking a common language, I was able to advocate for the patient quicker.

I learned from this that having a diverse healthcare team is both necessary and important to serve a diverse patient population. If I had not known Spanish, I would have had to call an interpreter, resulting in a delay of care for the patient. There have been documented cases of black and Latino patients receiving less care for their pain management. By having the ability to speak Spanish, I was able to bring attention to the pain experienced by the patient. Being able to advocate for patients in a timely manner allows me to provide the best care that I can.

As a resident, I hope to continue using my Spanish speaking skills to advocate for patients.   Utilizing resources provided by the hospital, such as nursing staff, social work, case managers, and consult services will allow me to provide optimal care for my patients.

Citation:

Lee P, Saux ML, Siegel R, et al.  Racial and ethnic disparities in the management of acute pain in US emergency departments: Meta-analysis and systematic review.  AM J Emerg Med. 2019 Sep;37 (9):1770-1777. doi:10.1016/j.ajem.2019.06.014.