HEALTH AND LIFESTYLE

Inclusion in Health Care

by DR TAINA TURCASSO, ND RM

I’ve written about the important of inclusivity in a health care setting in the past but the demand for health care workers to actively work to be more inclusive has increased significantly over the last two years, or at least our awareness of it has. As we become more and more aware of the impact of a less than inclusive model of health care on certain groups of patients, it becomes apparent that it can actually be a matter of life or death for some of these folks and thus requires our urgent attention. This is especially relevant for racialized, Black, and Indigenous peoples, those at the lower end of the socioeconomic gradient, women and gender-diverse people, people with disabilities, and other equity-seeking communities. As I build my own small practice in Fernie, I am trying to do my own work to ensure that every aspect of my practice is inclusive but it truly is work. It takes more than just a passive interest in creating an inclusive space and experience for your patients. It takes intention, time, creativity, and a commitment to revisiting your website, forms, office space, etc. and make any necessary changes. It takes advocating for your patients when they are being mistreated. It takes checking your own biases (we all have them) by constantly doing the inner work to see where they may lie.

In an effort to ensure that my approach to creating an inclusive clinic and experience for my patients, I have put together a comprehensive list of items to work through that I plan to review quarterly to create the best and most importantly, safest, experience for them. I encourage everyone to work through this list (or something similar) whether or not they work in Stock Photo

“As we become more and more aware of the impact of a less than inclusive model of health care on certain groups of patients, it becomes apparent that it can actually be a matter of life or death for some of these folks and thus requires our urgent attention.”

healthcare, but it is especially important if you do.

It All Starts With You

What are your biases? What current practices do you currently have that discriminate against marginalized communities such as those listed above? Education is fundamental, beginning with completing coursework in cultural competence, anti-racism, and antidiscrimination. Learn about the different populations you expect to see in your community and in your clinic and find out what may make their health care concerns and experiences different.

Clinic Space and Marketing

Go over every aspect of your clinic materials, including intake forms, website, clinic space, and brochures/information sheets. Do they make everyone feel welcome and included? Is there any terminology that may be considered exclusive? If so, update them and keep doing so as your awareness evolves. Is your staff diverse? Have an awareness of who you are giving job opportunities to, particularly if you are a larger organization.

Welcome/Access

Do marginalized groups feel welcome by your clinic? Is it apparent on your website or in other marketing information that you welcome diverse populations and have a special interest in working with ALL people? Does everyone have access to your care? Do some outreach to local

Indigenous communities and organizations that represent people targeted by noninclusive clinics and health care and listen to what they say they need and let them know what you have to offer their community.

Feedback

Give everyone who sets foot in your clinic space an opportunity to provide feedback by way of a structured feedback form. Include specific questions about all aspects of your care and their experience, including diversity and inclusivity.

Institutional Diversity/Inclusivity

In health care we are often using standardized forms and documents and receive results in a pre-set format. It is our responsibility as practitioners to challenge the creators of these documents and forms and hold them accountable when it comes to using inclusive terms and ensuring that all aspects of the forms are applicable to any and all people. It may be helpful to look back further at your school or wherever you received your training. Examine your coursework and syllabi if you have them and provide feedback about potential areas of improvement.

As we are flooded with information about how marginalized groups are receiving inadequate care in many sectors of health care, it is our responsibility as health care providers to not only ensure that we are not contributing to the problem but actively working to resolve it. EVERYONE should have access to the fundamentals of good health, including access to clean water, healthy food, shelter, and health care. None of this has to be done overnight, but start now with some education. Find an online course or seminar. Read a book. Think about one thing that you can do this month to create a more inclusive environment for your patients or even for the people in your life.

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The Story Behind the Behaviour

by TYLA CHARBONNEAU

Have you ever been in an interaction with someone or watched odd behaviours from a distance and thought to yourself, “What is wrong with that person?” We all have. It is an honest response to witnessing something that we do not understand. I recently watched Prince Harry and Oprah’s Apple TV show called The Me You Can’t See and for pop culture psychology I was impressed at its honest look at mental health. In the first episode, Harry proposed that when we question another person’s behaviour we should automatically ask ourselves, “What happened to them?” instead of our go question of what is wrong with them. This is such a simple reframe that allows us to evoke empathy and compassion for the experiences of others.

While it may be easier for us to conceptualize someone else as a jerk or terrible person, please consider that no one behaves in these ways without a reason for doing so. Individuals simply do not wake up and think, “I am going to be real mean to someone today,” or “Wouldn’t it be fun to have a meltdown in public for everyone to see.” Taking time to reflect on what another person may have been through, or even better asking someone their story, allows us to gain alternative perspectives on a situation. It also creates space for people to be seen who might not otherwise be, and possibly get the help they need. Anyone who has been through significant trauma may feel the need to control situations in order to feel safe. Those who have been holding in pain for a very long time may break and have an angry outburst with a stranger as a way of letting it all out. A friend who is struggling to keep it all together may be short with you or avoid you all together because they simply cannot handle pretending for another moment.

I am not suggesting that we blindly tolerate or accept negative behaviours from others but rather we consider why the behaviour exists without judgment prior to distancing ourselves from the human. Dr. Michelle Buck, a leadership expert, suggests that in conflict or tense situations the best thing, and arguably the most difficult thing we can do is to ask the person to tell us more and then really listen to what they have to say. We can use a combination of empathy and understanding for the other person and also let them know it is not okay for them to treat us or others in that way, using empathy first.

September is a time for beginnings and as we begin this next cycle of our lives, I encourage you to try the following exercise. The next time you feel compelled to question what is wrong with someone challenge yourself to come up with at least five reasons for the behaviour. You can include your first instinct, but then consider all other possibilities. For example, you see someone yelling at their kids in a public place. You can think they are not good at parenting. You can also consider the following: that person just lost their job and are worried about how to feed their kids, they are struggling with mental health, they tried every effective communication strategy they could that day, it did not work and you witnessed them in their worst moment, or they have no one else in their life to help support them and they really are doing the best that they can. Be the person who chooses to see the story behind the behaviour and not the simply the behaviour itself.

Submitted Photo

“Taking time to reflect on what another person may have been through, or even better asking someone their story, allows us to gain alternative perspectives on a situation.”

The content provided in this article is for information purposes only. It is not meant as a substitute for professional medical or psychological advice, diagnosis, or treatment. If you find yourself in distress, please reach out to your local physician who can provide mental health resources in your community.