Dr. Miguel Ruiz
speaker
84 appearances
1 recordings
1 series
first heard Jul 2024
last heard Jul 2024
Dr. Miguel Ruiz’s voice in public audio — every appearance, attributed to the second.
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Appearances
where I think it's very important to realize from the get-go that we will never be able to really understand a different culture and community to ours to the degree that we are competent. Of course, absolutely, one has to study, learn, talk to the community, really get as much knowledge and understanding of that group of people
But I think with the humble approach of always going with the desire to know more, to have a healthy curiosity, seeking to understand before we try to be understood by them. And I think that's something that we as healthcare providers need to have very clear. We need to really understand.
put our ideas and our best ways in the back burner and become students of our patients and declare, I don't know, I need to know, I want to know, help me know what matters most to you, what's most important to you, how do you think, why do you think you are sick? What do you think is causing this problem?
really trying to get into the narrative that they are living in so that you can, from there, start to develop some approaches to helping them. And of course, also to always be conscious about the healthcare, the power differentials. The fact that many individuals who maybe may have a low English proficiency and thinking about the community and more familiar with the Hispanic Latino community,
there is this huge differential between providers and patients that we need to really be very creative about thinking, how do I equalize this encounter in a way that I'm going to be able to connect with this patient so that I can understand how to better help them as opposed to just trying to think that I am the one who knows how things should be done.
Yes. If I may say something about that, you're right. And yes, we don't have enough BIPOC providers to care for our BIPOC communities. And unfortunately, recent report in the New England Journal of Medicine, again, in the last 40 years, the number of black doctors, male black doctors in the US, not only has not increased at all, but has gone down slightly. 40 years.
So studies, I just read a recent study which showed that if Black patients were cared for by Black doctors, they estimate the disparity in outcomes, the health of cardiovascular outcomes, the disparity will decrease by 19%, by 20%.
The reality is we don't have enough BIPOC providers, but the reality is we need to do, that's one of the many things we need to do, is we need to advocate for more physicians of color coming into medical school, especially from those communities that are the most underrepresented, the black community being one of them.
So that is something at the level of policy and at the level of advocacy that we need to advocate for, because most people prefer to be cared for by a provider who looks like them, who may have a better understanding of their culture, or who may speak their language.
It's an issue of trust. There is something there about, I see you, I think you can understand me because I see you from a similar background. But you are right, Clarence, that that is not the only solution because that's going to be an impossible target.
We work on it, but what do we do in the meantime until hopefully one day we get there where we have our healthcare providers representing the same diversity of the community they serve. But you know, today, human resources and medical groups and clinics and hospitals
At least my hospital is tracking very closely what is the racial distribution of our nurses, of our, you know, CNAs, of our physicians, of our APPs. We are tracking that. And we have established clear benchmarks that we want to accomplish because we want to move the needle on this area.
Because it's an actionable area that we can do something about that we think is going to decrease disparities and improve it. the health of our community. But yes, you're right. We need to really get to the point of trust and care, even when we have racial and linguistic issues incongruity or despite differences.
And that's the importance of many, I mean, we could talk forever about what things we could do. I can tell you what we can do, what we are doing in my hospital and in my medical group. But I mean, absolutely, you need to use medically trained interpreters when you are seeing a patient who is not able to speak English. I will say, when I'm not able to speak Somali,
I need to get a Somali interpreter to help me care for my patient because I don't speak Somali. It's not that the patient doesn't speak English, it's that I don't speak Somali. I mean, we have to really start thinking, changing our way of thinking and removing the blame from the patient and putting it on us to be able to see what do I need to do to provide excellent care for this patient.
I think that's Those are the ways of thinking that will really increase the trust and will send the message that we do care for our patients.
Let me see if I understand the connection here. You're trying to connect this with the issue of disparities.
Yeah, obviously, as you very well point out, the cause of death of individuals have been the diseases that have been afflicting humanity and societies have changed based on on the evolution of our lifestyle and our environment and the development of antibiotics and treatments that hopefully are benefiting most people.
Although again, you think about infections, if you look at HIV, for example, clear disparity in terms of number of new cases of HIV in the US today, clearly higher among black individuals and Latino than white. Why is that? Again, back to the whole issue of education, living environments, stressors of life, and so forth. What we know is that people who are
living actually, before we talk about this ACE, correct? The adverse childhood experiences. And now the researchers are talking about the pair of ACEs, which is the adverse childhood experiences. experiences, but also the adverse community environments, ACE, both of them. So even before birth, pregnant women who are suffering from continuous stress because of poverty, homelessness,
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