Monday, May 9, 2016

Local health leader reminds student-doctors to see patients as “humans first”

As the chief medical officer of the Lynchburg area’s Johnson Health Center, Margaret Kadree, M.D., knows firsthand that medically underserved individuals are not a distant population tracked by the federal government but instead make up a sizeable portion of the local public.

According to data she referenced in a presentation to student-doctors earlier this month, 22.6 percent of people in the city of Lynchburg live below the federal poverty level. Dr. Kadree also reviewed many other statistics about the medically underserved populations of Virginia.

“I think you have to have this information to make you realize that the medically underserved person may be sitting right beside you. Or may even be you,” said Dr. Kadree.

Johnson Health Center operates seven clinics in Central Virginia, assisting about 15,000 patients annually. Every month, Dr. Kadree says they add about 200 new patients to their files.

The federal government specifically defines medically underserved populations through a scoring system based off several criteria, including poverty and ratio of physicians to patients in the area. But Dr. Kadree warned student-doctors about defining their future patients by the label of “medically underserved.”

“See them first and only as humans. When you see them as humans, because you are a human as well, you can more closely identify with them. The importance of being able to identify with them is you will be more compassionate,” said Dr. Kadree.

Dr. Kadree’s instructions echo one of the foundations of osteopathic medicine: to provide compassionate, patient-centered care that treats the person, not just the disease.

“At a psychological level, when we place our patients into categories, an unintentional effect is to dehumanize them. And I know for a fact this occurs when people think of medically underserved individuals. They tend to think ‘It’s those people over there.’ But it could be any one of us in this room at any point in time,” said Dr. Kadree.

In recognition of Cinco de Mayo, Dr. Kadree also elaborated on the challenges to receive medical care for Lynchburg’s Hispanic/Latino community.

“When you’re talking about people of Hispanic or Latino descent, you are talking about a wide variety of people with a lot of cultural differences. This classification does not mean they approach health the same way that they have the same problems. Think outside of that box,” said Dr. Kadree.

The ability to be understood is very important to this group of people, explaining why Johnson’s Health Center employs Spanish-speaking staff members and works with a third-party company that provides translating capabilities.

One of the biggest barriers to treatment, besides language, is a Hispanic/Latino person’s legal status.

“Naturally, if you are undocumented you are going to be a little bit fearful about interacting with health care providers because you don’t want to expose yourself. You also don’t have access to insurance,” said Dr. Kadree.

Individuals in this community can also struggle with depression related to being separated from their family. They also may not be as comfortable discussing their health problems.

“Very often most foreigners are a little more conservative about talking about those things. So that can be a barrier in approaching those patients. They see approaching them openly as an invasion of privacy,” said Dr. Kadree.

In the end, Dr. Kadree advised student-doctors to not get caught up in checking patients off their list for the day, which is hard in the current medical field where data gathering and input seem to take center stage.

Instead, she told them to try to set the pressure aside and slow down; the health of their future patients depends on it.

“One of the most important things in medicine is that human touch and that connection. When you go to the doctor don’t you feel better when you have some sort of connection with that provider?” concluded Dr. Kadree.