The Health Care Workforce, Cultural Competence - Research Paper Example

? The Health Care Workforce and number submitted The Health Care Workforce. Expanding the cultural mix is an effective tool in achieving a more diverse and competent health care workforce to a nation that has minority groups that increase rapidly. If marginal groups should access similar health amenities in a racially polarized society then they need an equally diverse health care workforce that will help to expand access to health care for the marginalized. It will also go a long way in enhancing research in areas that seem to be ignored and empower more policy makers to assist more of these mixed groups. The lasting policy frameworks that can sustain a culturally diverse society should begin by empowering its education system by way of creating affirmative action tools in the system of learning in health oriented programs. This paper also evaluates the progress of past measure created to improve minority images in healthcare and provide a close look into future measures meant to bridge diversity gap. Thesis Statement: The racial/ethnic composition of the U.S. is projected to change enormously in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. Interventions to improve access to quality healthcare in the culturally diverse population of the U.S. medical workforce must be employed in the school system first. Research has shown that even with most factors of health i.e. age, status of insurance, level of income as well as the extent of illness have been attuned, many cultural groups still find themselves in a difficult position in accessing quality health care compared to their elite counterparts. As the demographic trends shift in the U.S, more input needs to be put in achieving diversity in the healthcare providers who can cater adequately to more diverse groups that are forming the major ethnic groups in the country. The practical rewards would be; enriching the medically trained professionals that will spearhead the healthcare system through their leadership, ensuring an accommodative workforce rich in ethnic diversity, as well as improving the access to quality health care in all cultural settings. The case for diversity in the healthcare workforce of the United States is very paramount due to its richness in the mixture of races and their subsequent rapid growths. Demographic figures illustrate a trend whereby the minority groups are becoming more diverse and increasing at a higher rate compared to that of their majority white populations. The ethnic and racial backgrounds are becoming more distinct as well. The country’s population constituting the whites only increased by 9 percent in the duration between 1980 and 2000, Hispanics by 122 percent, that of the African American race increased by 28 percent, the native American by 55 percent, and the Asians by more than 190 percent. In view of this, it is projected that the U.S. citizenship will constitute members of minority groups by more than half. This trend informs the need to increase the workforce diversity in healthcare, enhancing the student proportions in medical schools especially those of minority origins to prepare competent and more conducive healthcare professionals. Cultural competence refers to the acquired skills, knowledge, behavioral conduct and attitudes needed to equip a practitioner who will be poised to provide the best services by being able to work for and with people from diverse origins of culture. Healthcare professionals must be ready to handle all patients regardless of backgrounds that differ from theirs. In order to do this, the attitudes of care givers as concerns understanding that illnesses may be influenced by cultural factors and how patients respond to medical care and treatment is all different. Their beliefs, family structures and cultural biases all play an important role in access and acceptance of certain healthcare skills. Physicians, nurses, and all other health practitioners have to be mindful of language barriers, models of diseases, the “alternatives “of medical remedies, taboos, are all likely to cause an impact of how a patient is going to receive medical care effectively. They cannot become competent practitioners simply by studying medical books and going through formal teaching lessons. It calls for a learning session in an environment that is punctuated by culturally diverse races to which they will be dispatched to provide services. It is only by interacting with people from varied cultural societies can a student employ a liberal view to be able to understand and accommodate others’ way of life. To ensure this, more colleges need to enroll more students from diverse racial backgrounds to enable the already existing society to get a feel of being in a heterogeneous system. People’s opinions are informed by their socioeconomic status, unique racial characteristics, origin and gender. Policy makers use comparative studies and existing data to form a basis to their own experiences. The internalization of labor market especially in the health sector calls for a cross-national comparative process as a gain to more insights and precise knowledge of various health care systems. This perspective also acts as a tool providing contemporary insights to emerging healthcare workforce trends. The French health system, for instance, mixes tolerant fundamentals and a proper government form in a tandem universal labor market, regulation of the health care system and national networks that manage the public health care organizations. The ‘la medecine liberale’, was first formulated by the physicians union in 1928 to provide free choice of patients to choose their physicians, provided clinic autonomy, the physicians were also able to practice in any location of their choosing and the more important doctor-patient confidentiality. It also allowed the optional direct payment to doctors by their clients (Rodwin and Le Pen 2004). Germany, being a federal and corporatist system, has its healthcare structures embalmed in a set of institutional mechanisms and on different levels. The corporatist system reflects the much enforcement that makes it challenging to bring in changes (Altenstetter and Busse 2005). Providers and purchasers of health services work within a corporate framework that includes more than 300 sickness funds, 23 regional physicians’ associations, 22 regional dentists’ associations and their corresponding federal associations (Busse and Reisberg 2000). Norway on the other hand, shares some fundamentals with other Scandinavian countries in the management of labor relations and development of social policies. With a large number of public employees, a publicly funded provision of welfare, a consultative policy making framework together with a proactive labor market policy of moving allowances and job training (Blom-Hansen 2000; Erichsen 1995; Esping-Andersen et al. 1992). The United Kingdom, the National Health Service (NHS) initiated a couple of reforms that has had huge implications for its human resource sector in healthcare. A conservative Government during the Margeret Thatcher system formed an internal market in order to make a change in the incentives and accountability frameworks for all the healthcare providers and consumers of health products with a view of enhancing its micro- economic efficacy. It introduced a system of contracting between the providers and consumers to enhance an independent relationship void of managerial hierarchies (Tuohy 1999). In the late 1990s, the appointment of a Labor government gave a new organization to the NHS, with a symbolic change from competition and markets to collaboration. The NHS plan in 2000 provided various priorities with targets to achieve a higher number of NHS staff, give healthcare practitioners a modern regulation process and to make sure the health care workforce is appropriately skilled and deployed in sufficient numbers (Department of Health 2000). In the wake of these reforms, the NHS developed a multifaceted system that intended to promote a development of continued profession and to execute a wide-ranging management in performance structures. The United Kingdom has also had to respond to a shortage of health professionals. As a consequence, it has been particularly inventive in changing the skill mix of professional boundaries, and recruiting from other countries, so that it provides many examples of both the opportunities and challenges of increasing international mobility. Federal and State programs, one being the National Health Service Corps, the Rural Health Interdisciplinary Training Program and the Area Health Education Centers provide incentives for nurses, dentists, physicians, and other primary care providers to enable them carry out their services in underserved rural as well as urban areas. Many underserved minority communities are also making their own measures to enroll their own and more so retain non-physicians such as nurse practitioners, physician assistants, and certified nurse-midwives (Rural Information Center Health Service, 1995). Health institutions of learning and other professional associations have taken steps to promote cultural diversity and competence in the health care workforce. An Ethnic/Racial Minority Fellows program is run by The American Nurses Association, that seeks to improve the representation of minorities among health service researchers as well as enhancing the quality of health services provided to them. “The Association of American Medical Colleges' Project 3000 by 2000”, established in 1991, was formed to increase the enrollment of undeserved minority students who enter the nation's medical schools to 3,000 by the year 2000. In 1995, the AAMC was awarded a Robert Wood Johnson Foundation grant as a support to establish the Health Professions Partnership Initiative, which extends the same project to other health institutions. Two recent establishments have been put in place to promote progress on the healthcare workforce. One was by the American Reinvestment and Recovery Act (ARRA) which tried to strengthen the health care labor requirements while the other is by the Patient Protection and Affordable Care Act (PPACA). There is also the Health Care Education Reconciliation Act, which is a law that was passed only seven days following the PPACA, which made some changes to the access of more student to loans among other necessities needed in achieving better education and training among student of diverse origins. All this were aimed at providing labor and ultimately addressing workforce shortages. The bill provided included $ 500 million in support of National health Services Corps (NHSC) and this was able to provide and deploy labor to undeserved communities. PPACA provides for a commission in the National Health Care Workforce that develops strategies on a national scale to address challenges in work force shortages and foster training in key areas of health care. In doing this, PPACA has taken initiatives to provide increased amounts of loans plus flexible structures of repayment for all nurses, primary care physicians and all sectors affiliated to health care. It also provides additional funding to existing health care workers for a variety of programs and this is especially aimed at expanding the work force diversity. Federal and state governments should provide funding enough to conduct research into workforce trends, retrain health care workers at risk of dislocation, and disseminate information on model workplace partnerships. Promoting a climate that is accommodative to the minority should be done through support, recruitment, and retention of underrepresented minority students. Diversifying the student body will benefit the education of all dental students and the care of their future patients, regardless of race/ethnicity beyond the fact that underrepresented minorities are more likely to embrace care for the underserved as one of their career goals and responsibilities. Improved underrepresented minority recruitment requires increased exposure to the health professions. Such exposure is particularly critical for the dental profession, which some fear and associate with other negative emotions. While the efforts in ARRA, PPACA and the Health Care Education Reconciliation Act were steps in the right direction, more still needs to be done to promote building the work force necessary to deliver a high quality of care. Conclusion Cultural competence is the demonstrated knowhow and integration of the three population-specific issues: cultural values, health-related beliefs and disease incidence and prevalence, as well as treatment efficacy" (Lavizzo-Mourey and Mackenzie, 1996). To achieve quality in health care from the patient’s perspective, the patient’s needs and expectations must be met, with success measured not only in improving health status but also in increased patient satisfaction with care. To enhance the patient-health care provider relationship, it is imperative to increase the diversity in the health care workforce. To address the workforce shortage, academic institutions have to be committed to the education of culturally competent health professionals. The culturally competent clinician needs to maintain vigilance for ethnic disparities in screening, prescriptions, procedures and health outcomes. Culturally competency in health care is a key component in the efforts to eradicate racial/ethnic disparities in health and health care. References Altenstetter C. & Busse R. (2005). Health care reform in Germany: patchwork change within established governance structures. Journal of Public Health Politics, Policy and Law, 30(1–2):121–142. Busse R. & Reisberg A. (2000). Health care systems in transition: Germany. Copenhagen, WHO Regional Office for Europe, on behalf of the European Observatory on Health Care Systems. Blom-Hansen J. (2000). Still corporatism in Scandinavia? A survey of recent empirical findings. Scandinavian Political Studies, 23(2): 157–181. Lavizzo-Mourey R. & Mackenzie E.R. (1996). "Cultural competence: Essential measurements for quality of managed care organizations," Annals of Internal Medicine 1996; 124(10): 919-921. Rodwin VG. & Le Pen C. (2004). Health care reform in France – The birth of state-led managed care. New England Journal of Medicine, 351(22): 2259–2262 Rural Information Center Health Service, Nurse Practitioners, Physician Assistants, and Certified Nurse Midwives: Primary Care Providers in Rural Areas (National Agricultural Library: Beltsville, Maryland: 1995) Tuohy CH (1999). Accidental logics: the dynamics of change in the health care arena in the United States, Britain and Canada. New York, Oxford University Press. Read More