Years ago I did a presentation to a health care group on the subject of diversity. It went pretty well except for maybe a 3 minute period where there was a breakdown in belief that highlighted exactly what I was talking about. It wasn’t pretty but it was able to be handled fairly quickly so I could move on, as it occurred 10 minutes into the presentation.

Secret #57
Taylor Dawn Fortune via Compfight

What I’m showing below is a breakdown of the types of questions and issues faced by both the people who register patients when they come into the hospital and the people themselves. It’s interesting because these issues aren’t all due to the people themselves. These are things that have to be tracked, both for the hospital’s benefit and the government’s benefit as far as information gathering goes.

THE TYPES OF PEOPLE WHO COME THROUGH REGISTRATION

1. BREAKDOWNS BY RACE

Believe it or not, some hospitals tell their people not to ask this question but to try to guess what someone’s race is. I find this shocking and yet I understand why some are afraid of the issue.

2. BREAKDOWNS BY FINANCIAL STATUS

This is a major issue because it sets up an initial perception of the type of patient that’s in the facility, and the patient’s perception of the type of facility they’re in based on what the person registering them looks like and how they’re dressed.

3. BREAKDOWNS BY INSURANCE

This makes hospitals run. Getting the insurance information correct up front makes the billing process go smoother, but knowing the insurance type helps hospitals budget easier and negotiate contracts with those insurance companies they can negotiate with better. That and you figure you know how soon your money will be coming in, or not.

4. BREAKDOWNS BY LANGUAGE

This is a bigger deal than most would think. By law, a hospital has to have the ability to communicate with any patient that comes in, no matter what language they’re speaking. That part is handled easily enough. Yet, there are many hospitals with high minority presence in the community where English isn’t their first language that won’t even think about recruiting someone in the community who speaks that language. I used to rail against this one all the time without success, but finally, after 4 years, the hospital did hire someone who spoke Spanish and someone who knew sign language.

5. BREAKDOWNS BY PHYSICAL STATUS

How bad does the patient look when presenting themselves to the hospital? Are they disabled? What about how the person taking information; what do they look like? Is that person disabled, or hairy, or smelly, or dirty, or attractive, or…

6. BREAKDOWNS BY AGE

Major issue, especially when it’s a person on Medicare, which requires more forms to be signed and more questions to be asked, as well as a host of other issues.

7. BREAKDOWNS BY FAMILIARITY

If you’re in a small community you know a lot of the people who come into the hospital. It’s this very reason that many patients don’t want to go to local hospitals, because they fear that too many other people will know their personal business, HIPAA or not. Also, knowing someone immediately alters your perception of them as a patient, whether favorable or not.

8. BREAKDOWNS BY RELIGION

I always hated this question and it turns out not to be mandatory. However, you ask it because you never know if someone will turn for the worse and request a religious leader to visit them. And, as we all know, some people are against certain religions and thus might not treat some patients with the same professionalism as everyone else.

9. BREAKDOWNS BY DEGREE OF ILLNESS/INJURY

I can’t remember if I ever told the story of working in the emergency room and having two people present themselves as possibly having bugs crawling all over their bodies. That provoked strong negative feelings from all of us, even moreso than someone showing up with flu-like symptoms. The truth is that even medical professionals will show different attitudes towards patients depending on presenting symptoms, even though they shouldn’t. Health care workers get trained in presenting a professional face, but it doesn’t mean all their actions on the back end will mirror that.

10. BREAKDOWNS BY PERCEPTIONS OF ATTITUDE

Finally being addressed, the hidden and yet not so hidden problem. How does either party react when any of the first 9 points are reviewed internally? Do they matter in the long run or are any of them something that person can’t push aside and continue doing their job professionally? And if they can’t get it done, who does it hurt more, the patient or the hospital?

Some things to think about, especially for those hospitals who believe they have no diversity issues. Yeah, right.
 

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