Getting Real About Medical Care
SSD: What drew you to your field and how do you see it impacting Black People?
Dr. A: I became an occupational therapist because I wanted to be a part of the rehabilitation process, working directly with people to improve their level of ability and therefore improve their lives.
While I have helped people from all different backgrounds in all different settings – my presence in the field, even before being a business owner, I felt was impactful because I was able to see a more culturally relevant set of solutions for my Black patients and be sensitive to the needs of all patients of color.
That’s important for a lot of reasons but especially because it helps Black people be able to better trust at least someone within the health care system so that maybe there will be carryover in the recommended health behavior changes to prevent [any] worsening of symptoms and improve health overall.
SSD: Ok, you said a lot there in those last two statements. Biting on the first one…
What are some examples of the “more culturally relevant set of solutions” that you mentioned seeing for your Black patients?
Dr. A: While no culture is a monolith, it is important to be open to what a client’s goals and desires are and not just assume they are the same as your own. [For example,] While one person may not be interested in any modification to the kitchen because they don’t cook much or would just as easily have takeout, another person may be the block grandmother and is used to always cooking as a show of love to her community and her family – and wants to be able to cook a big Sunday dinner every week.
If you don’t have experiences working with or being from a non-majority culture, it is much easier to assume that what you do or value is how everyone else values things as well. A simple statement like, “Let’s not worry about the kitchen right now after your stroke, let’s just deal with getting to the bathroom,” could be dismissive and decrease motivation [of a client] because you’ve devalued what is actually most important to the client.
SSD: That makes sense. And now for the hairier point that you raised…
Why do you think there are so many Black People who are wary of America’s healthcare system, and what do you think can be done to remedy that?
I’m intrigued by this because I, like many Black People, know a fair share of others who look like me but also don’t trust our healthcare system and its representatives.
Dr. A: There is a long history of abuse, disregard, and disrespect that has come from the healthcare system directly to Black people. We have every right to be distrustful, actually. But I feel the only real way to change that is to have more diversity within the healthcare system because then change can happen from the inside out.
How much more open would you be to talk about what’s really going on with a clinician that is Black?
I work in healthcare and notice the difference in how open I am with different providers.
In addition, how much easier is it to take some feedback from a coworker than it is from a customer or client? We listen to others who are our peers far more easily than those who aren’t our peers. So, if we want other healthcare professionals to be better, they need to hear it from Black Healthcare Professionals!
SSD: So, you feel like you’re received differently by patients because you’re a Black Doctor?
Dr. A: Yes. I get more openness and immediate rapport from Black patients than some of my white counterparts do, and I’ve seen that explicitly. But I also have experienced racist comments, insensitive statements that stem from stereotypes, and also surprise or disbelief that I have a doctorate or am not a student.
The bad experiences actually pale in comparison to the positivity I’ve experienced – specifically working with clients that are Black, though. So, it is worth it!
SSD: That was real, and I thank you for the honesty there. Switching gears…
Can you tell us about a moment of working with a patient that brought you a lot of personal joy?
Dr. A: A recent story that happened just yesterday [involved] a wife whose husband had a significant stroke and is still in the hospital.
She wants to be able to care for him at home but right now he is not able to move himself, and he is twice her size. She needs to get the house ready to even have a chance for him to come home, but she also lives in a rural area where there are no providers to give her a look at the house and make clinical recommendations.
I was able to do a virtual home assessment with her on the same day, and collaborate directly with the contractor she had already chosen, and create a very doable plan for building a ramp and making some bathroom modifications that will allow her to bring him home in a few weeks!
The amount of relief on her face she showed by the end brought me so much joy because she was just so scared, she wasn’t going to be able to take care of him at home and we created a plan that she can easily follow through with. It gave her hope!
SSD: That’s powerful, and I can see why things like that keep you going.
As you keep advancing, what do you hope to accomplish as you continue in occupational therapy?
Dr. A: I hope to be able to create accessibility everywhere. People don’t need to suffer in silence, nor be forced to limit their daily tasks just to “the basics” because of all the barriers in their living environment. Accessibility also doesn’t have to only be had by those with a lot of money.
Our approach to accessibility, focusing on adaptive equipment, makes our solutions accessible to both renters and homeowners and can be ordered in order of importance to keep the budget manageable if everything cannot be purchased at once.
The main vehicle for wealth creation in America, that is accessible to most, is homeownership – and our elders worked hard to attain that. They shouldn’t have to sell [their homes] and use all the proceeds to pay for care at an assisted living facility for $5000/month. Instead, we provide solutions that allow them to stay in their homes successfully.
And hopefully, at the end of their lives, that house creates a better financial situation for their family and that grows over time to help fill in the gap we have in generational wealth in our culture.
SSD: Well said. Please don’t charge me for this next one, but…
What are some common signs that people should be aware of that it may be time for them to start looking for accessibility alternatives for their home? When should people invest in these things?
Dr. A: Now! Any one of us could break an arm or a leg at any time and be unable to use that limb for multiple weeks. If you couldn’t put any weight on one foot for 8 weeks, could you function in your home?
You don’t have to be 85 with multiple conditions to need accessibility, so consider it now – even as you do small things like fixing a leaky faucet.
[For instance,] If you are going to replace it, choose one with a lever handle instead of 2 knobs! Then it will be accessible because it will work just as easy for you now, when you have no problems, as when you only have one arm free because you are holding a new baby or when you have arthritis in your hands as an older person.
SSD: Is there ever a point when you would recommend a patient look beyond accessibility and into at-home care or supervised/supported living? And if so, what determines making that recommendation?
Dr. A: Yes. Sometimes there are not enough supports that can be brought into the home to make it effective to stay there and, in those cases, moving should be considered.
But it’s important to know A LOT can be done at home – including having a caregiver come in, meds prefilled, doorways widened, transportation provided, meals delivered… But that takes organization, follow-through, and money.
If there are not enough pieces of the puzzle in place to manage that, then that would be a time to recommend a move to a place that has some of those services already included.
SSD: What’s an accessibility faux pas or two that you see more able-bodied people commit often that you wish they stopped out of consideration for others’ common accessibility issues?
Dr. A: Parking in handicapped spots (or crowding the blocked-off area for handicapped spots) when you don’t need them! Walk a few more steps, leave a little more space because that could be the difference between someone actually being able to get out and go into the business or not when they have a disability!
Also, don’t demean people that have to do things differently than you by just doing it for them. Listen to them and do what they are asking you for — if anything! Just because it may take longer or be done differently than you, they still want to do it for themselves.
SSD: Lastly – what, if anything, can someone who is younger, or currently more able-bodied, do to prolong the duration of their un-aided capabilities?
Dr. A: Get a regular check-up with your primary care practitioner (physician or nurse practitioner) so you can catch the signs of any chronic, progressive diseases early enough to make the lifestyle changes you need to in order to avoid having to manage the disease process the rest of your life.
Chronic diseases like diabetes, high blood pressure, and heart disease are the things that spiral downwards and affect us the most – but [they] could be caught very early so that it never gets to that.