The pandemic has trained a spotlight on numerous healthcare disparities faced by Black and brown residents across senior living communities and nursing homes. Monica Payne, a veteran clinical manager for Omnicare for south Texas and Louisiana, tells the McKnight’s Clinical Daily that reflecting on how everyday actions affect care and access to treatment can benefit everyone in the industry.
Q: What is your role in the long-term care industry?
A: I have been practicing pharmacy for the past 32 years. The clinical manager role at Omnicare requires me to wear many hats and work to ensure that my team has the tools necessary to provide quality service to their long-term care facilities. The most rewarding experience has been working with my team of consultant pharmacists, peers and managers during the pandemic to provide COVID-19 testing and vaccine administration to our most vulnerable populations.
Q: What can clinicians do to better engage with Black and brown residents and their families?
A: We as providers may be contributing to healthcare disparities without even knowing it. In a long-term care/eldercare setting or anywhere in the healthcare ecosystem, the first step we can all take is to recognize, acknowledge and understand that disparities exist in the industry. By becoming more educated on these issues, improving how we communicate, and adjusting our actions, we can ensure that people feel heard and properly addressed.
Q: How does this effort look in everyday practice?
A: Communication is a key factor in gaining trust of our residents and patients and improving the care we provide. Actions we can take to address disparities include seeking out diversity training, working within our local and professional communities to affect positive changes in the healthcare system, and recruiting and training diverse healthcare candidates to increase representation in less-served communities.
Other ways our industry clinicians can tackle racism and inequities in our daily work is to establish more access within communities of color. Meet people where they are and consider demographic data, prevalent mode of transportation, religious influences, etc., that may affect access to care and/or treatment. Build relationships within communities of color that have socioeconomic challenges by networking through trusted advisers. This could include using health clinics, churches, local businesses, historically Black colleges and universities, etc., to broaden outreach.
Q: Elders of color may have mistrust in the medical profession for long-standing reasons. How might that manifest in day-to-day clinical situations?
A: Studies show that mistrust in the healthcare system can be related to poor patient experiences, lack of care, poor quality of care, negative patient experiences, systemic racism and other reasons. An example of how this manifests today in long-term care facilities relates to when a resident experiences pain. The literature shows that Black and brown communities are perceived to experience less pain or may be considered as more prone to addiction. As a result, they may receive less-than-optimal quality of care in terms of pain management, studies show.
In addition, due to affordability concerns, people of color may perceive that doctors do not recommend the appropriate level of testing and care when it comes to serious illnesses such as cancer. In fact, Black people have been shown to have higher death rates than all other racial/ethnic groups for many types of cancer.
Along with acknowledging the effect this may have on patient care and outcomes, steps that would help include educating providers and healthcare workers about bias — which can be intrinsic, direct and indirect — and engaging more frequently with residents, patients and their families.
Regardless of ethnicity, race and/or gender, we need to understand that we should all strive to treat our residents and patients with respect and care for them as we would our own family.
Q: What can we do to encourage more conversation among our colleagues about tackling racism and inequities?
A: It’s always a great idea to begin with diversity training as this type of training enhances our ability to better serve diverse communities. This allows us to acknowledge our own biases toward communities of color and seek education and support to broaden our cultural competencies.
It’s our responsibility to uphold our commitments for why we chose to be in the healthcare profession and create an inclusive space for everyone. By building our cultural competencies, we are better able to effectively communicate across multiple communities. As such, we can be viewed as more effective listeners and as empathetic and trusted advisors in the communities we serve.