my experience at a highly rated hospital in an urban, low income community

WARNING: long "ranting type" post! LOL

Let me preface this by first saying that I am not a racially driven or racially opinonated person. I was born and raised in a multi-cultured community. Furthermore, my first experience in an "all black" atmosphere was not even until I went to Howard University, a top of list HBCU (historically black college/university).

However, I do recognize the reality of certain racial disparities...in the medical field, specifically the WLS community, I find these disparities haunting!

So...I am currently enrolled in a program in Baltimore. Although Bmore is a large urban city, the hospital is in its downtown area and a home to a mix of people/staff/patients. To make a long story short (I'm trying!), I decided to go to another hospital closer to me that I knew from their website had a very extensive bariatric program, just for a second opinion in this major life changing decision. Before this, I'd aleady seen 3-4 presentations at other area hospitals.

Outside of them starting like 15 min late b/c the projector wasn't set up ahead of time (as it had been at other seminars I'd already attended), the visual quality of the presentation was less than what I'd previously experienced, the information was...very "bland"...vague...not detailed...short, all of the above! Previous presentations I'd seen were equally informative and impressive, and I felt like I'd taken away something from each one. But after experiencing this presentation at this last hospital, I was very disheartened...If this had been my first presentation, I realized that I would have been ignorant to a great deal of important info that all people seeking WLS should be exposed to. The surgeon didn't even finish the powerpoint before he started taking questions, so people lost out on even more info. Some good questions were asked but the doc failed to guide/lead the session to provide optimum info and explantions. It became a ranting session for those in attendance. It lacked so much educational value and I would pray that none of them would make the decision to start the process just based on that info alone that was provided. I literally had to control myself from jumping up and adding like 20 more of my own slides! And since the surgeon just let people start talking during the presentation, I started expounding on more info and answering some of their questions when I felt like the doc was just breezing right over the details. I even asked questions that I already knew the answers to just so that they could hear the response from the doc. I'm sorry, I just couldn't resist!

What bothers me is this...the whole room was all Black, except for the surgeon. Even in 2011, there is such a stigma associated with black uneducated people in urban areas, who are uninformed and do not read. Of course I know this NOT to be true, but I realize that there ARE a great amount of people in urban/low income areas who ARE uneducated, have mental health barriers and do not read, research, and DO have difficulty understanding and comprehending at a level to make an informed decision about their health (this is not just black people of course!).

Why would this hospital, as such a staple in a community that is very concentrated with low income people, where many are categorized as uneducated, be so lackadaisical in their initial approach and introduction to their program? I don't understand why they would fail to provide researched information that is significant and up to date. It's not a secret that culturally, due to most african american's diets, that we are prone to obesity and other health related illnesses/diseases. The last thing needed is the short end of the stick.

The stats they used seemed so outdated in comparison to other hospital programs I'd seen in just the last month.This is supposed to be a research 1 hospital that has won several awards...

I am just shocked by their inadequate information provided to potential bariatric patients. Their website does outline a pretty extensive program. I just hope that it's not shallow like their seminar was...

Given your clear community health perspective and concern about the program, why don't you express the same things you posted here, in a letter to the hospital administrators?  Maybe they need someone from the top to take a second look at how they are running their bariatric program.  You are intelligent and articulate, maybe you'll be the voice that effects a change for that community!

Thanks for being involved and caring........that's all it takes to make a difference!

I was thinking the same things as the other poster....  It just takes one person speaking up to make a difference. 

We could hope it was an 'off' night for the surgeon giving the presentation....possibly attend another of his seminars and see if this is the case. 

Lexie, I would hazard a guess that from the setting you've described, this hospital is strapped for resources.   They probably get a lot of indigent patients who can't afford to pay their bills and the hospital has to absorb the cost.  I'd question whether they can afford to recruit the brightest and the best under these cir****tances.

IMO, approaching this as a racial issue will only serve to make people defensive and uncomfortable.  Administrators respond to improving the bottom line.  Frame your discussion in a way that shows how their hospital will profit and you will have a captive audience.  Find literature that demonstrates better pre-op education can have a direct impact on things like Length of Stay, Rate of Readmission, Patient Satisfaction, Post Op Infection or other complications.  Also, there are some consumer websites out there that compare hospitals' performance in different areas.  If their competitors are doing better, it will be incentive for them to step up their game.

Good luck!

Was it at Hopkins?  Sometimes you hit a bad or unorganized department there.  On the other hand, they offer fabulous medical care.  I take my daughter there (and to Kennedy-Krieger) for all her care -- she has special needs.  Wouldn't want to go to any other hospital.

I had my surgery down 95 a bit in Washington D.C. at another inner-city majority black hospital.  A teaching hospital.  A similar experience with lots of waiting around and some administrative roadblocks and what have you.  But fantastic quality of care.  No problems with my surgery, recovery, or counseling about weight loss.  Sometimes you can't judge a book by its cover, just because it's no frills?

I totally agree that the presentation seems to have been less than optimal; It is my "opinion" (for
what it's worth) that often there is a lack of respect for those patients who are considered to be
of a lesser social position than the one doing the presenting (the doctor) and this is often dis-
played by the lack of information which is given on ANY topic.

This doesn't happen only in populations with high numbers of Black American citizens, but also
in White, Latino, or Asian populations where the socio-economicand educational levels are con-
sidered lesser than that of urban professionals.

It is up to all of us, whichever color we are, to demand the best that can be given for our medical
dollars. As citizens, and patients, we are entitled to no less.

That being said, I agree that offering a solution to a perceived problem is often the best way to
effect the change wanted. If you write a letter to the hospital management, mention by example
at least two, if not three, of the presentations you had attended that you considered to be superior
to the given meeting. This would give the management of the hospital the opportunity to make their
own investigations regarding the presentations and then make changes in their own.

Good for you for standing up for the health and wellfare of others who are beginning their own
searches for a better life.

Best wishes,

Hi Lexie

I have to admit to you many times I skip long posts. I read yours ... Twice! I will tell you I agree with the other posters the hopital administration needs to hear this. I would send a letter to everyone from the top administrator to the ombudsman. Is this hospital a "County" hospital? I was so fortunate I was able to have my RNY at a Center of Excellence hospital, and it really was! However I was not so lucky when it came to my Total Hip Replacement. I have insurance through my job with the state that gives me county insurance. Our County hospital is a teaching hospital, and honestly until my THR I had No complaints. This surgery was a NIGHTMARE!!!!! (That is one long story also that I'll save for a later date) I had it at the county hospital. I am white, no actually I am Transparent ( :-D ) and as much as I would like to say, No Lexie it has nothing to do with race, I think it does, but more than race, I think the discrimination is money oriented.  Those with money; black, white, asian, or otherwise will ALWAYS be better cared for.  Sadly I think the only way to start changing this is for those who are being discriminated against to organize and start advocating for themselves, it is the only way change has happened in the past. From Emancipation to Women's Suffrage to the Civil Rights Movement the only way Americans have acheived their rights was by organizing and standing up for themselves.

 It takes a leader to start it, maybe You're that leader Lexie.  If you pursue anything with this I would love to hear about it.

Be Well My Friend

 

 

I was afraid I'd get backlash from this post or that people would ignore it so I appreciate you all taking the time to read it and comment positively. It wasn't Johns Hopkins by the way, it was a well known hospital in DC that actually IS a "center of excellence," which is why I was sooooo suprised. I don't want to discredit them b/c I know it's a great hospital. It's just that the differences and negativities I saw were soooooo drastic and extremely noticeable that I had to comment. I will probably go to one more seminar at the end of August to hear from their other surgeon. I'm interested in seeing if it will be a totally different experience. (I started the process in bmore but the doc really wants to RNY me instead of sleeve me so I wanted to talk to another surgeon before fully committing)

When I saw in your sig that you're 4'10", I took a look at your profile and saw that you're diabetic.Have you considered the DS? It has the Sleeve as its stomach portion, and the intestinal bypass part is REALLY good at treating diabetes. And sadly, short women have a harder time losing weight, period. (I'm 5'1".)

Just thought I'd mention it in case you haven't researched it.

I can't speak for the docs at your seminar but I know the ones I worked for hated doing the seminars. They were usually held at night after a full day in the OR or seeing patients or on the weekends when they wanted to be home with their families. Too many times they did just phone it in.

They showed the same slides, said the same things, and answered the same questions time after time. The biggest reason for them doing the seminar was to bring in patients. Attendiees converted to patients which converted to dollars. So they pretty much had to do it.

We were contracted with a variety of hospitals from an urban Detroit medical center to community hospitals in working class and more affluent neighborhoods. Locale didn't seem to matter.

What did seem to motivate them to show some interest were when those attending seemed interested and connected. If they had an enthusiatic audience they were more enthusiastic in their responses and presentation.

I think you should talk to whomever is in charge of the bariatric service at that hospital and share your experience with them. I think you would be invaluable in showing them how much more effective their seminars could be.