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Bridging the disconnect in health care

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

Moises connection sketchMy family has always expressed that they’re proud of what I’m doing – the funny thing is, they go on to say that they’re unsure of exactly what I do.

My parents know I’m studying medicine and that this means I’ll be a doctor. What they don’t get is where in the process I am, what specializing means or what I’m talking about most of the time when I share stories from school. Perhaps the unfamiliarity results from them not being exposed to the general structure of professional training, or it could be that the U.S. health-care system is simply a bit confusing. I’ve tried explaining to my aunts and uncles the process of going from college to medical school to residency. “Okay," they respond, "but when can we call you Dr. Gallegos?” Adding one more ingredient to the mix, I took a year away from medical school to get a second degree.

Even though I’m not “Dr. G” yet, four years of medical and public-health training are worth something. I know enough to be helpful on a medical team, in patient encounters and to my family. Having family members approach me with medically related questions is both empowering and humbling. My family has played a large role in the support system that has helped me get to where I am today; to pay back by sharing some of the knowledge and skill I've gained along the way feels great. I have to remind them constantly that I’m not in a position to offer definitive advice, but they still appreciate the context-framing guidance from my simplified explanations. A doctor yet or not, I'm a resource for them to better understand their health and how to maintain it.

These family experiences remind me of one of the reasons I felt an urge to enter medicine: the disconnect. My parents, aunts, uncles and majority of cousins are first generation in the United States. They come from meager means and little exposure to medical care and health education. As such, they haven’t had the most positive experiences in pursuit of health care. Growing up, I witnessed plenty of challenging encounters between my family and health-care providers. Without the need to assign blame, I think several negative experiences were reflective of a mutual misunderstanding. My family being unsure about the functionality of the health-care system and the meaning of illness likely didn’t help the provider, who was unaware of my family’s need for extra guidance, education and reassurance. A patient labeled non-compliant may better be characterized as non-adherent – the difference is understood when the disconnect is acknowledged.

This last point is ever so important regarding the Affordable Care Act. Many people in the U.S. haven’t had the chance to develop an understanding of the health-care system or grasp what constitutes good or bad health. New access to health-care coverage doesn’t mean that people will magically be able to navigate the system. In my career I hope to carry the lesson my family has helped me learn: As a health-care provider, I must consider the level of understanding of my patients so that I don’t exacerbate, but rather bridge, the disconnect on matters of health.

Moises Gallegos is a medical student in between his third and fourth year. He’ll be going into emergency medicine, and he’s interested in public-health topics such as health education, health promotion and global health.

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