Public Opinion

5B

Minority medicine has barriers
Local providers speak more languages

By Emily Phelps
Staff Writer

Removing language barriers: Nurse Macia Whitemore, left, has her comments translated into Spanish by Beth Shetter, right, while they talk to Yessenia Urbina-Hercules and her son Marlyn. A study released Wednesday found that minorities face more difficulties getting good health care due to cultural and language barriers.

Yessenia Urbina-Hercules, Chambersburg, speaks some English, but when it comes to discussing complicated medical problems, she's glad to have a translator available.

Her son, Marlyn Hercules, was delivered by a Spanish-speaking doctor seven months ago so there was no language barrier then.

In March, her son was admitted to Chambersburg Hospital for a few days. At that time, Urbina-Hercules relied on the services of Beth Shetter, a receptionist at the hospital who also translates for patients at both the hospital and Keystone Women's Care.

Translators and bilingual doctors are just two of the different ways Keystone Health Center and Chambersburg Hospital are trying to accommodate patients of different cultures and ethnic origins.

A study released Wednesday by the Commonwealth Fund found that communication breakdowns are a major factor in the disparity between the quality of medical treatment between whites and minorities. Hispanics in particularly were more than twice as likely than whites to report communication problems with their doctors, the study found.

At Keystone Health Center, there are doctors and nurses who speak Spanish because approximately 15% of the people who visit Keystone need some sort of translation services, or must see a Spanish-speaking doctor, said Joanne Cochran, president and chief executive office of Keystone.

Keystone's main site on Norland Avenue has four providers who speak different languages. Until a few months ago, there was a dentist who spoke both English and Spanish at Keystone Dental Center. Keystone Women's Care has one provider who speaks Spanish, and another who is studying Spanish, Cochran said.

Keystone also relies on the help of translators, some of whom accompany patients to specialists within the community.

"Anytime there's a translation, something gets lost," said translator Diane Martes, executive director of the Chambersburg Hispanic American Center.

But Martes believes Keystone is doing a great job in trying to accommodate those whose first language is not English.

Despite their efforts, it is not always easy for a person to explain exactly what kind of medical problem he or she is having, Cochran said. That problem can be exacerbated if there is a language barrier.

Spanish is not the only language besides English spoken at Keystone, Cochran said. People who speak Russian, Chinese and Hungarian have sought treatment there.

One doctor, Laszlo Madaras, speaks seven languages, Cochran said. He uses nearly every language weekly in his work.

Summit Health is also working to communicate with people of all languages. Nearly two years ago, Summit Health formed a culture diversity task force, said Sue Dooley, director of social services.

Dr. Bill Morgan, a retired Shippensburg University Spanish professor, translated several hospital documents and brochures into Spanish, including pamphlets on breast feeding and diabetes education, Dooley said.

Information is key: Yessenia Urbina-Hercules, and her son, Marlyn, benefit from programs designed to open communications between local hospitals and non-English speaking patients.

There's also a cultural diversity kit for each unit. The kit includes a pocket Spanish to English dictionary, a reference notebook outlining different cultural and religious beliefs and talking pictures.

Talking pictures are cards with a picture of, for example, a bed on one side and words in five different languages on the other.

Bob Rynecki, a nurse at the hospital, also helped develop RABIT, or the Rynecki-Arthur Bilingual Interview Tool.

RABIT translates specific yes and no questions into Spanish, Dooley said.

For translation emergencies, the hospital has a list of volunteer interpreters who speak a variety of languages it calls on.

All of the translators at Keystone are on staff. The health center could use some volunteers, Cochran said.

The hospital also has subscription to an interpreting service.

If there's a medical emergency, nurses or doctors can call a number and tell the service what language needs to be interpreted, Dooley said.

The doctor then picks up one phone, and the person needing interpreting picks up another phone.

A certified medical interpreter helps the two talk, Dooley said.

Martes also serves on the hospital's committee to address diversity issues. "They are trying," Martes said. "The hospital is trying."

The improvements in the area medical facilities have prompted more people in the Hispanic community to seek medical help, Martes said.

Urbina-Hercules agrees.

"People do come more often now because they do know there are people who speak Spanish at the hospital and at Keystone," Urbina-Hercules said.

"The most important thing is that people treat you very well."

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Survey: Good health care is hard to get for minorities

By Larry Bivins
Gannett News Service

WASHINGTON -- The confusion could arise on instructions that seem so simple: Take one tablet three times a day.

Does that mean one tablet every eight hours, one with each major meal or all three close together. Doctors too often assume no further explanation is needed. Patients too often fail to point out they don't understand.

And if patient is a minority, additional barriers likely block efficient communications and reduce chances of a patient receiving necessary treatment, according to a new health care survey released Wednesday.

Minorities fare worse than whites on almost every measure of health care quality, and a breakdown in communications is a major factor, The Commonwealth Fund 2001 Health Care Quality Survey found.

"Communication is essential to quality medical care, and a disturbingly high proportion of patients feel that their doctors do not listen to them or report that they do not understand what their doctors say," said Karen Scott Collins, vice president at The Commonwealth Fund. Hispanics were more than likely as whites to report communications problems with their doctors, the survey found. While 1 in 6 whites experienced difficulties, 1 in 3 Hispanics, 1 in 4 Asian Americans and 1 in 4 blacks cited similar experiences.

As the nation grows more diverse - census data projects that half of the U.S. population will be minority by 2050 - "these findings send a clear warning that the health care quality divide is in danger of turning into a gulf," said Karen Davis, president of The Commonwealth Fund. The foundation in New York City sponsors research on health and social issues.

The survey was conducted April to November 2001 and was based on telephone interviews with 3,488 whites, 1153 Hispanics, 1,037 blacks and 669 Asian Americans. The Hispanic and Asian American responses were further broken down by country of origin where possible.

A panel of minority doctors who participated in a briefing on the survey results applauded the effort as an important step in addressing issues they have confronted throughout their careers. They point out that many health care providers are disrespectful and insensitive to cultural and language differences. They also note that many minorities distrust doctors and other health care providers and neglect to seek needed counsel and help.

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