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Connecticut Doctors Gather to Discuss Disparities

Doctors and clinicians in Connecticut are increasingly aware of disparities in the way patients are treated based on race and ethnicity, and are working to address the issues, according to the state's largest group of doctors.

The Connecticut State Medical Society has spent two years on a campaign to get doctors to recognize that patients are receiving different care based on their race and ethnicity.

Aside from the lack of access among African-Americans, Hispanics and Native Americans, there is another disparity based on the way clinicians communicate with and treat minority patients, according to a gathering of about 40 doctors, insurance executives, public health officials and members of clinical associations who met recently to discuss health disparities at the Capitol.

The difference in treatment is often subtle and despite a clinician's best intentions the disparities have an adverse effect on health, according to doctors who researched the topic. For example, patients who don't speak English may not be fully understanding a doctor's instructions.

Cultural differences may also interfere. For example, if a doctor recommends getting plenty of exercise, how does that apply to a person who can't afford a gym membership and lives in a neighborhood that is too dangerous for walking after the person is finished working two jobs? That question was posed by Dr. Joseph R. Betancourt, a Puerto Rican and director of multicultural education at Massachusetts General Hospital.

If that same doctor recommends eating fresh fruit, what if the patient doesn't have access to fresh fruit, or can't afford it, never mind that their corner grocery's "fresh fruit" may not be as fresh as those sold in more affluent neighborhoods? Betancourt said.

The doctors discussed a variety of communication techniques and the need for practitioners to undergo cultural competency training to narrow disparities. Doctors say that resolving health disparities should include reaching out to minority patients through better coaching on health and wellness.

Treatment in communities that are largely black or Hispanic is often better if clinicians reflect the communities they serve, said Dr. Alice A. Tolbert Coombs, president of the Massachusetts Medical Society. That's why it's crucial to recruit minority clinicians and doctors, she said.

In Connecticut, the state medical society has been given a $400,000 grant from the Connecticut Health Foundation to train 1,200 doctors in cultural awareness. The foundation gave the medical society another $100,000 to provide training for residents and medical students and to look at hospital readmission trends in Connecticut by race and ethnicity.

"Today, Connecticut physicians are far more aware of their responsibilities to provide culturally appropriate care to our diverse population," said Dr. David S. Katz, the medical society's president. "Training makes a difference, and it's fair to say that every physician learned something just by participating."


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