deal with the shifting demographics
in the United States,” says Green.
Kaiser is also helping to re-
shape the health industry with an
emphasis on patient-centered care
through its own cultural-competence
programs, scholarships to Safety
Net partners, and taking a close
look at demographics to measure
and improve access to services
and target care across their diverse
membership.
Moving Forward
A unique program at one of Trinity Health’s hospitals shows how taking into account a physician’s background can improve the doctor/patient relationship. This fall, The Wall
Street Journal highlighted a cultural-competency course
developed at Trinity’s Mercy Medical Center in Mason
City, Iowa. Roughly a quarter of physicians in the United
States are foreign born, and the number is even higher
in rural communities such as Iowa. Sociologists at the
University of Iowa found that Mercy’s diverse group of
doctors often struggled to relate and communicate with
a patient base that was predominantly white and rural.
A new cultural training program helps foreign doctors,
such as Egyptian pediatrician Dr. Adel Makar, better
understand his patients. “There are misconceptions on
both sides,” he told The Wall Street Journal. “It’s good
we start to talk about it openly.”
Dr. Wong agrees that cross-cultural understanding is
a win-win. “The lessons we learn from the diverse nature
of our membership accrue benefit for everybody,” says
Wong. “If I’m able to figure out how I can make an immi-
grant from India feel like he’s getting top-notch care, I
should be able to translate those
ways of understanding to a person
who’s been in the United States for
six generations.”
To measure progress in closing
the gap, Kaiser uses an “equity
dashboard”—a quarterly transpar-
ent set of measures that focus
on inpatient and outpatient care.
The dashboard enables Kaiser to
identify gaps in clinical outcomes
across racial and ethnic population
groups and configure strategies to
address disparities. “Obviously, we
want to trend upwards,” Dr. Wong
says. For example, practitioners
at Kaiser wanted to know if health
outcomes were different when a
physician spoke the same language
as a patient. The data suggests that
when doctors and patients speak the same language,
patients are less likely to break appointments and
patient satisfaction is higher, says Dr. Wong. With this
knowledge, Kaiser can develop specific programs to give
non-English-speaking patients better care.
“We are creating a workforce that
will be culturally competent and
ready to deal with the shifting
demographics in the United States.”
Antoinette Green, Trinity Health
