Cell 2 Soul: The Humane Health Care Blog

Revelations in a Wheelchair

In late 2001, I heard Daniel Gottlieb, a psychologist and best selling author, talk about an experience he had while waiting in the hallway to give a keynote lecture at a prestigious conference. Gottlieb had been in a serious accident years before and was left quadriplegic. He was sitting in his chair outside of the lecture hall, a coffee cup resting on briefcase on his lap, looking down at his notes. A woman walked by, eyes averted and thinking that he was begging, put a dollar in his mug.

Nolan Ryan Trowe tells a similar story in an Op-Ed piece in the Sunday, November 25, New York Times entitled: “Revelations in a Wheelchair: A recently disabled New York City photographer gets an education in the discrimination that people like him must face.”  You may find it worth reading.

 

Medical Hysteria

Personally-Mediated Racism in Medical Training

An important essay appeared in JAMA Internal Medicine recently.  It begins:

I was in medical school when I learned that I did not matter in medicine.

One particular day on service started uneventfully. However, after the team’s discussion of a patient, all attention turned toward me when a senior physician asked me a question about the rap music that had been playingin the background.

“Help me understand something:” I recall the physician saying. The physician asked about word choice in rap lyrics, and then, pretending to quote a rap song, repeated the word “nigger” several times in rapid-fire succession.

Most of us will benefit from reading it:  Download Mensah JAMA  For more on the three levels of racism see: CP Jones: Levels of racism: the gardener's tale.

On Cabbies and Kahunas

It is no secret that primary care physicians and specialists in large numbers deny care to Medicaid patients.  They claim that they cannot afford to see this group.  Insurers, patients, and the medical societies tolerate this situation.

It’s just as bad in the Big Apple as it is in the aina of Hawaii.  A recent article in the NY Times put the situation in perspective for me.

“The taxi lurched away from the curb in Midtown Manhattan, leaving behind a black family of three who had flagged it down. The driver told them he was off duty and then picked up two white women 25 feet away and drove away.

“The judge ruled that the driver refused to transport the family on the basis of their race and color violating a section of city human rights law that protects equal access to public accommodations and fined the cabbie $25,000.”

This ruling made a splash in the NY Times on August 8, 2015.  At the same time, most private dermatologists in New York City do not see Medicaid patients.  How is this not discrimination too?  Yet, the complicated Medicaid credentialing regulations allow physicians to abandon poor patients with inferior insurance coverage and consign them to emergency rooms, Medicaid mills and public clinics.

It’s strange that a family being denied transport in a taxicab can outrage us, but we turn a blind eye to a large segment of our society that is refused competent caring health care.  It is also ironic that a cabdriver can be fined for this act of discrimination; while sanctimonious physicians get a pass.

See:  Cherry Picking in the ‘Aina: Inequalities of Access to Dermatologic Care in Hawai‘i