Portland, Oregon

Portland, Oregon

Thursday, July 14, 2016

Wellness Check

Bob had an appointment this morning for his yearly wellness check. That's apparently something we're doing now as a result of the Affordable Care Act.  It's done on a yearly basis I think. I did mine a week or so ago and all went well, I was in and out in about 15 minutes.

Bob's visit was well over an hour. Even the doctor was worn out by the time it was over. These doctors are inputting information into a computer the entire visit. There are many questions that have to be answered. It takes a very long time to see a patient like Bob. I almost felt the need to apologize.

The doctor drew a circle on a piece of paper and asked Bob to fill in the numbers of a clock. This is the second time she's done this. Apparently it's never dawned on her a very big clock is on the wall behind her. Bob just copies the numbers on that clock onto the paper and he always gets that one right and flunks all the rest. Sometime I may clue her in but Bob probably would prefer I not do that.
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Remember this pink Physician Orders for Life Sustaining Treatment (POLST) form that I wrote about recently?  I had turned Bob's in. It was scanned and entered into a registry, and I learned there's another purpose to this exercise. This morning the doctor handed Bob's back to me and told me to attach it to our refrigerator. She says emergency medical personnel are trained to look for this form attached to your refrigerator when they make an emergency call to your home.

I can do that. I wondered how emergency medical personnel were going to know what to do about life sustaining issues in emergency situations. Now I know.
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I'm going to run something by you just to see what response I get given we're living in such heightened conditions about treating all people the same, as well as being super sensitive to anything that could be construed as racist.

The MA (nurse) this morning was from India. She had one of the heaviest accents I've run across. Bob couldn't understand a thing she said, and I had great difficulty. A watched her very closely, and as often as not I finally figured out what she was asking by context rather than the actual question. I was totally unsuccessful in having a phone conversation with her last week.

She clearly knows her job. I have no reservations about the quality of her work. I'm not quite sure what to do about this. I'm going to be in a meeting next month at the hospital where I can discreetly mention it to the man who oversees the hospital's four clinics and see what he thinks but I'm not sure if that's appropriate. I guess I don't know the politically correct thing to do in this situation. What do you suggest?
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If you need a laugh today I suggest you go to Time Goes By blog and read what to expect from the free Medicare Wellness Visit.

26 comments:

  1. I have been in situations where a heavy accent was hard to understand and with medical issues that is a problem. I just say something, "Like I'm sorry to keep asking you to repeat stuff. I'm having trouble processing your accent." People from India talk SO fast! I think honesty is the best approach. I'd tell the man overseeing the clinics that you have no reservations about the quality of her work but have a problem understanding her accent and ask him if he's got a solution for you both.

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    1. I will have to address this in some way. I could hope that she'll move to another clinic but in the event she doesn't it will be a problem. I think I will speak discreetly with the clinic director when we're in that August meeting and see what he suggest.

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  2. Honesty is the best policy, along with setting aside any concern for "political correctness." Your health, and that of your husband, is the critical issue. Do what you need to do to understand your health care provider. Otherwise, it's the same as getting no care -- or risking bad care.

    I often get

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    1. It is critical to be able to understand health care workers. I will address the issue before Bob's next visit in three months. Glad you stopped to visit my blog.

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    2. I'm really laughing. Clearly, I had another thought, but I don't have a clue what it was. That "I often get" is the written equivalent of what my mother used to do in conversation. She'd say something like, "I wonder if..." and that would be it. If I asked, "You wonder what?" she'd just give me a look as if I were the crazy one.

      Happy to be here!

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  3. I like to think I am sensitive to other people, but heavy accents in customer related services is not good. I have enough trouble hearing quiet voices, if you add an accent, there is almost no way. I have told operators I could not understand them and that I would call back and talk to someone else. I can't speak any foreign language so I applaud them that they speak more than their own. It doesn't change the fact that I am meant to understand them or their service is not helping me. I can say this about any accent from any country. I respect your abilities and your accomplishments but you are not doing your job if I cannot understand you.

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    1. I just hate so bad to call attention to a foreign speaker's accent but I don't know why, every time I open my mouth in Oregon people make comments about my Texas accent.

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  4. I do think that something should be said, perhaps to the office manager of your doctor's office. It's not racist to say that you don't understand someone. If I were living in another country, I'm sure people would have a hard time understanding me! The medical visit is critical in terms of making sure there is clear communication.

    For a number of years I worked with new doctors as part of their fellowship in a specialty field. Most of them were from another country. While their English was very good, there were many times I had trouble understanding them due to a heavy accent. Both patients and medical staff would frequently have to ask them to repeat themselves due to problems understanding. I never witnessed any offense taken by these doctors who were new to our country.

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    1. I once asked for another referral for Bob from a Korean cardiologist. Nothing wrong with the man's skills but his culture and Bob's culture simply could not relate. The doctor did not understand Bob's sense of humor at all. If you're going to see Bob you've got to relate to him.

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  5. Absolutely you should share there is a problem understanding the accented English! This is a legitimate serious problem, and even more so for many people with hearing problems, those who have speech comprehension problems from strokes, brain injury, other neurological issues, individuals who not only don't speak English well themselves, but speak a language other than the accented speaker they're listening to.

    Thirty years ago we had a beginning influx of physicians, nurses, aides, therapists into our hospital(s), other medical settings i.e skilled nursing, assisted living, home health care -- they've had various foreign accents which can be even more difficult to understand over the phone than in person. Those in my profession attempted to have hospital(s) offer accent reduction classes, but by and large we were unsuccessful as medical people did not welcome voluntarily spending time attending such classes and the hospitals did not want to spend funds to offer such classes either -- yet it is a serious problem. Some forward-thinking hospitals, organizations, businesses, too, have implemented accent reduction programs. Contact American Speech-Language-Hearing Association for referrals to qualified Accent Reduction specialists. Likely will be some in your area.

    I strongly believe what I tell hard-of-hearing individuals applies also to most speech a listener does not understand, including accented English -- DO NOT PRETEND YOU DO! Some listeners are shy or fear being considered stupid but not so. Trying to interpret based on context is good, but might be a good idea to repeat what you think you understand for confirmation from your accented speaker -- just to be safe since we're talking important medical matters. Nicely ask for repeats, even if more than once is needed. Sometimes it's a matter of asking the person to slow down. Often adult education, local community colleges, or private groups can be set-up with qualified professionals who provide accent reduction education.

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    1. This young woman did speak very fast. She's very nice. I hate to say anything but I'm going to have to talk to the clinic director. I needed some encouragement I was doing the right thing. It's hard to know when to speak up in today's world. Thanks for your comment. It was helpful.

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  6. I think a comment on English competency is fair game. Communication is part of a successful job. Go for it! This comes from somebody who is adamant about non bias.

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    1. I will be as nice as possible. The clinic director is very approachable. I think I'll ask what he would do if he were in such a situation. If she were a doctor I would ask for another referral but don't want to do that over a (MA) nurse.

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  7. I guess if it is important enough, and this is, then I would have to say to her, "I'm sorry, but I can't understand you very well. Would you please slow down and help me to get what you are saying because I really need to know."

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    1. I'm prone to worry too much when a simple "I don't understand you" will most likely solve the problem.

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  8. I agree with everyone else here, I think you should address it. I know it's uncomfortable for you. My husband had this problem with an employee once. He was able to move her to a job that did not require interfacing with the public.

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    1. For sure I don't want to endanger her job. I will mention it to the clinic administrator next month. For myself I will forge on by saying I don't understand. The think that concerns me most is she's working for the geriatrician and some of the people I see there are very old and frail. I have to think they will have difficulty understanding her.

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  9. When Mike was in the hospital, the hospice doctor who took over his case was a very sweet and caring man. He was also deaf and his speech was very hard to understand. I had no difficulty after years of being a special educator, but Mike was very hard of hearing and not the world's best communicator anyway.

    I am sure that doctor had a great deal of support with communication all through his training and he did not mind my repeating everything he said.

    Clear communication is a critical need in a medical situation. Absolutely say something. Joered had excellent idea, but in this time sensitive case, ask to have a communication facilitator present during interactions with that doctor. You have every right to be able to understand. Asking for repeats and slowing down is not enough.

    Also if enough people press the point, the administrators might be more inclined to seek out accent reduction programs for staff.

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    1. We have a lot of people from India who are brought here by the high tech companies for training. They stay a year or so and go back to India. I don't know if their visas allow spouses to work or not. If so that could be the reason her accent is so strong. In my opinion, accent reduction classes should be required for medical workers.

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  10. I think Jean made a good point on how to handle it. I have a really hard time with outsourced computer techs but if my health is concerned. understanding can be vital.

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    1. Yes, I often despair over outsourced computer people. I fear for the older people who won't speak up. Unfortunately I'm not known for remaining silent. I had occasion to talk to her again this afternoon over the phone and could not understand her so I asked her to send me a message through the hospital portal. That worked.

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  11. I absolutely would speak up about an accent that's almost impossible to understand. You have a right to the best health care. I told a cable company worker who was supposedly helping me untangle a connection problem that I was sorry, but I could not understand what he was saying. He immediately slowed down his speech and became understandable.

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    1. This young woman speaks fast. She's since called me on the phone and again I could not understand her. I asked her to send me a message through the hospital portal & I was able to deal with it that way.

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  12. I so understand about accents. Has nothing to do about being capable but just about the task of understanding what is being said. Difficult. PS I used to live in Oregon, how is the weather today?

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    1. The weather is wonderful, 73 degrees today. I just returned from a walk. I do love the weather in the Pacific Northwest. In fact I love everything about living here.

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  13. You should speak up, especially when it concerns health care. So many people are offended by every little thing these days, that many are afraid to say anything. Don't be one of the ones that doesn't speak up. I have no problem speaking up, I do try to do it in a constructive way, but if that doesn't work, I take it further. It saddens me to see/hear so many that do the "oh dear I don't want to offend" stuff. Stand Up, Stand for your principals, Stand for what you know is right!

    I love the PNW, have lots of family in your area. Send some cool, green our way.

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