Improving Health Care on the Menu at Community Dinner

While participants broke bread, the dinner table conversation focused on breaking down barriers.

The goal was for students and physicians to gain a better understanding of how Buffalo’s residents experience health care and what concerns they have about it.

Hosted in the Sol Messinger, MD ’57, Active Learning Center in the Jacobs School, each table of seven at the “Let’s Talk About Health Care” dinner had a mix of medical students, faculty members who also are physicians with UBMD Physicians’ Group, and community members.

Michael E. Cain, MD, vice president for health sciences and dean of the Jacobs School, welcomed participants, noting, “This is your medical school and we want you to be a part of everything we do.”

Community members talked about how empathy is critical to a successful health care experience and that doctors need to strive to communicate well — to make patients feel comfortable asking questions. It was noted that cultural sensitivity could improve over time, as providers gain more exposure to different cultures.

Participants discussed the role of logistics, such as the difficulty of getting to doctors’ offices and the cost of health care. They noted that physical spaces, such as waiting rooms, can be off-putting, as can long wait times, which become another health care barrier and a reason to not go to the doctor.

The front office staff also must be made to feel part of the team so that they don’t unwittingly become another barrier to receiving care. People said they also feel more comfortable seeing providers who are the same race and gender as themselves.

Among the community members’ suggestions to physicians were:

• have conversations, not checklists
• communicate with patients as people, not lists of symptoms
• know the communities the patients live in
• most of all, listen

The idea for the dinner grew out of several initiatives, including the Health in the Neighborhood course offered last year by the Jacobs School’s Center for Medical Humanities, which sponsored the event.

The center focuses on the psychological, social, cultural and economic forces that influence the practice of medicine and the doctor-patient relationship, especially social determinants of health and health disparities between white Americans and people of color.

“The health outcomes between black and white Americans are shockingly disparate for many complex reasons,” says Linda F. Pessar, MD, director of the Center for Medical Humanities and professor emerita of psychiatry.

“At least a component of it is this distrust and misunderstanding between black Americans and their physicians,” she adds. “A proportion of black Americans don’t trust doctors; they don’t feel we work for their benefit. An example is the belief that doctors are paid by the prescription.”

The Health in the Neighborhood course paired students with families in the community so that students could better understand their lives, their community and especially, their experiences with the health care system.

“The medical students and the people in the community sat down together and as people of goodwill were able to talk to one another and begin to trust one another,” Pessar says. “Eventually, they were able to negotiate some really good ideas about how to improve health care.”

Developed by Pessar; David A. Milling, MD, senior associate dean for student and academic affairs; and Henry Louis Taylor, Jr., PhD, professor of urban and regional planning in UB’s School of Architecture and Planning; in partnership with Pastor Dennis Lee of Hopewell Baptist Church and Pastor Kinzer Pointer of Agape Baptist Church, the course had begun to make a real difference in the perceptions of both students and community members.

Pessar thought: “Let’s open it up and see if we can begin this dialogue in a larger group.”

There was obviously a hunger for it.

“To my astonishment, when I sent out the invitation to the medical school community, there was overwhelming interest,” Pessar says.

Within days, the event reached its maximum capacity for medical students and providers.

Pessar attributes the interest to the growing realization that the medical community needs to better understand the communities it serves.

“We simply have to come to understand the lives and needs of our diverse population if we are going to do what we came into medicine to do, which is to treat well the needs of the people we serve,” she says.

While the efforts of the Center for Medical Humanities began long before the Jacobs School relocated to its new downtown home, Pessar thinks that the school’s new location has provided an even stronger impetus for the increased interest in addressing health care disparities.

“The fact that we’ve had so much interest in this says that the time has come to expand the coming together of the medical school and the community,” she says, adding, “It’s the beginning of a movement.”