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    Addressing disparities in healthcare delivery

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    With increasing diversity in the United States, a question has arisen regarding what accommodations should be made to assist the diverse population. Some groups or individuals feel that in order to address the increasingly diverse population; we must employ a medical staff that is reflective of a community's population. For example, if half of the population in a community is Hispanic, the medical office staff should be comprised of Hispanic workers.

    Do you agree or disagree with this solution for addressing diversity in healthcare and why or why not? How would you address these diversity issues of the Unites States?
    In the United States healthcare system, disparities such as socioeconomic, racial, and ethnic can be found. What do you feel are the most important disparities that need to be addressed in the healthcare industry?
    How do the disparities affect individuals in terms of healthcare and what do you feel is the best course of action to remedy each disparity and why?

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    Solution Preview

    In my thirty plus years of medical practice, I have seen many examples of disparities in healthcare delivery related to race, gender, socioeconomic status, and patient labeling ("pain patient"). One of the most glaring was the revelation in differences between the treatment of men and women in regards to cardiovascular disease. (Ayanian JZ, Epstein AM, Differences in the use of procedures between women and men hospitalized for coronary heart disease, N Engl J Med. 1991 Jul 25;325(4):221-5.) There have been several studies since the initial article confirming that there is a problem, though it is not clear whether the issue is related to gender differences in presentation or gender bias. The literature is replete with articles addressing healthcare delivery discrepancies related to race and socioeconomic status, acknowledging that it is not clear whether the later is an indicator of the former.
    My personal feeling from years of observation is that most, if not all physicians want to practice medicine ...

    Solution Summary

    Disparities in accessing equal heathcare are related to race, gender, and socioeconomic factors. The first two will not be resolved on an individual provider basis by trying to achieve provider parity alone. Since much of the bias is subconscious, provider education as to its existence is critical. Socioeconomic disparities must be addressed both on the payment side and the cost side while maintaining useful incentives to achieve healthcare goals.