Upon arriving at the room, we learn that the nurse continued trying to speak to this patient in English despite the patient’s evident inability to speak the language. Following her half-hearted attempt at “patient education,” she proceeded to lift the patient’s gown and attempts to strap on the monitors. As a result, the woman is frightened by her nurse because she is unaware of what this foreign nurse is doing to her and her unborn child. One week out from detention. She is scared. Imagine.
The Iranian Consultative Assembly, the equivalent of a parliament, legalized living non-related donations in 1988 and set up a new government-run transplant matching system. Within this novel framework, living donors could choose to have their organs typed and registered in advance. If they are needed, a third-party independent organization, the Dialysis and Transplant Patients Association (DTPA), would set up contact between the donors and recipients. The donors would be compensated by a payment from the government, free health insurance, and sometimes additional payment from the recipient. The payment from the government is said to be in the range of $2,000-$4,000.
In this episode we interview Dr. Ijeoma Nnodim Opara. Dr. Opara received her medical degree from Wayne State University School of Medicine (WSUSOM) and completed a med-peds residency at the Detroit Medical Center where she served as chief medical resident. Currently, she is a double-board certified and an assistant professor of internal medicine and pediatrics.
In 2018, a patient filed a complaint against a medical student for wearing a “Black Lives Matter” pin on her white coat. When the student reached out to her school’s administration, she received this response: “It is best to not raise barriers in the way we present ourselves … Some of your political pins may offend some people, and it is probably best not to wear them on your white coat or while you are working in a professional role.”
As we seek to understand this phenomenon, there are many subjective variables that contribute to the trust between patients and providers. Measuring trust in a reliable and consistent fashion is challenging in itself. With these limitations in mind, three salient factors are involved in the decline of patient trust in physicians: one, a commodified health care system; two, lack of quality time spent with the patient; and three, racial influences on the patient-provider relationship.
The notion that a person’s health is only impacted by the clinical care they receive is not a reasonable one. Currently, as a first-year medical student, I have had the privilege to learn from a variety of professionals that have once again reminded me why I am on this path and why I want to serve underserved populations.
I entered the office of the Community Health Council of Wyandotte County, Kansas City, on a muggy, late-summer day during my family medicine rotation. The air-conditioned building boasted a large front room with sporadically placed desks, children’s books and toys, and what looked like a large food pantry. I flexed my elbows and wagged my arms to fan out the sweat from my Black body enshrouded in my white coat.
Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
If there is one thing I have learned, it is that what we, the medical providers, think is important may not necessarily be the priority of the patient. We want to know: why are your sugars uncontrolled? How is your diet? Have you been able to take your metformin? However, for the patient, these things are often trivial. The patient wants to know: how will I be able to afford these medications with my part-time job? How am I expected to see a specialist without insurance? Should I be going outside to exercise, or will I contract coronavirus?
We will recall when, during the summer of 2020, the moral and political duty to engage with the most momentous anti-racist movement since the 1960s reanimated a nation paralyzed by fear. By the fall, cataclysmic wildfires on the West Coast poisoned the air from San Francisco to New York City. Coronavirus, cultural upheaval and manifestations of climate change all bore down on us as we entered the most consequential and divisive national election in living memory.
His parents attended a parent-teacher conference with the hopes of encouraging his teachers to transfer him to the gifted track. After their inquiry, the principal explained, “It would be better for Chris to be in the remedial track, so he can see people who look like him.” This instance of racism would be the first of many for Chris, whose journey to medical school required him to rise above institutionalized racism and implicit biases.
Mercedes drove two hours to the nearest healthcare clinic to get her first physical exam in ten years. I met Mercedes while shadowing a primary care physician, Dr. L. In the clinic, Mercedes divulged to me how nervous she had been driving in – she knew what the meeting held in store. Her fears were confirmed: just five minutes into her exam, Dr. L advised her, “Mercedes, you have to lose weight.”