Pulse
Cultural Savvy
As a family physician at Columbia Park Medical Group’s Columbia Heights clinic in 2000, Sandra Eliason, M.D., noticed changes in the neighborhood spilling over into the exam rooms.
The corner of 40th Street and Central Avenue, where the clinic is located, had become a stockpot of diversity, surrounded by family-run Mexican restaurants, Indian grocery stores, and Middle Eastern cafes. The doctors and nurses who cared for people in the neighborhood weren’t familiar with their languages and traditions. “There was increasing frustration on the part of physicians and patients. I kept realizing there had to be a better way to do this,” says Eliason, who still does part-time urgent care work for Columbia Park.
In 2001, Eliason received a Bush medical fellowship and began working with the Center for Cross Cultural Health (CCCH) in St. Paul to create a model for incorporating culturally competent care into medical practices. “I looked at national assessments and found there wasn’t one that was easy to take, easy to score, gave numeric results, and allowed people to see improvement,” she says.
With additional funding from UCare Minnesota and the Columbia Park Education and Research Foundation, Eliason, who also is director of medical programs for CCCH, worked with a consulting firm to design an assessment that clinics could use to measure their ability to accommodate patients from different ethnic backgrounds. The 57-question survey focuses on culturally competent care, access to language services, and organizational support for cultural competence.
Park Nicollet’s Brookdale Clinic and Affiliated Community Medical Center in Willmar have used the assessment and are making changes based on what they’ve learned from it. Stratis Health, Minnesota’s Medicare quality improvement organization, had 28 clinics complete the assessment last year as part of a quality initiative on cultural competence.
The assessment, as well as assistance with scoring and analysis, is available from CCCH, 651/209-8999.—Kim Kiser
Studying the World
Minnesota’s medical schools are making it easier than ever for students, residents, and fellows to go abroad. Here are a few ways they can gain international experience.
University of Minnesota
IMER. Short for the International Medical Education and Research program, IMER provides third- and fourth-year medical students with the chance to have a clinical experience in places such as India, Africa, South America, Norway, Sweden, and Ireland.
The Department of Medicine’s Global Health Pathway. Internal medicine and med-peds residents complete a curriculum in international health, do a research project, take the Global Health Course, sit for the American Society of Tropical Medicine and Hygiene certification exam, and take part in international rotations.
Global Health Course: Diploma in Clinical Tropical Medicine. A component of the Global Health Pathway, this seven-week course is one of 13 worldwide that makes one eligible to take an exam leading to a Certificate of Knowledge in Clinical Tropical Medicine and Travelers’ Health.
Global Pediatrics Program. Residents interested in improving the health of children in or from developing countries spend time abroad and take a core global health curriculum, international or Indian Health Service electives, and optional courses in global health, tropical medicine, and travel medicine.
Mayo Clinic
Hoffman Clerkship. Third- and fourth-year medical students experience how medicine is practiced in underserved areas in the United States and overseas. Students typically arrange clerkships through medical missionary or other service organizations.
Mayo International Health Program. Residents and fellows do one- to six-week clinical rotations in underserved regions throughout the world.
Students Lend a Mano
In what was once the garage of a Mendota Heights home, six second-year University of Minnesota medical students sort through bins of surplus medical supplies. Donated by hospitals, clinics, and manufacturers throughout the Twin Cities, the goods are destined for Bolivia, a country in which 95 percent of residents live in poverty and nearly two-thirds have limited, if any, access to medical care.
The students are volunteers, and the house is the U.S. headquarters for Mano a Mano (Spanish for “hand in hand”) Medical Resources, a nonprofit launched in 1994 that collects and ships medical surplus to Bolivia. By the late 1990s, Mano a Mano expanded its mission to building medical clinics and improving the country’s roads, sanitation system, and water supply. Last year, its 72 clinics had nearly 240,000 patient visits, and the organization shipped 206,130 pounds of equipment and supplies.
Second-year medical student Travis Olives began sorting supplies and equipment four years ago when he was a student in the university’s master’s in public health program. He continued volunteering after entering medical school in the fall of 2005 and has been a regular in Mano a Mano’s sorting room and nearby warehouse. “You don’t give much back to the community during those years,” he says of the first years of medical school. “This keeps me going.”
After hearing about other students who were hungry to help those in need, he organized a group of approximately 30 medical students, three or four of whom show up every Friday afternoon to sort and package equipment. Nursing, physical therapy, dental, and pharmacy students recently started volunteering as well.
Olives got to see for himself the results of Mano a Mano’s work when he traveled to Bolivia last August. “What we’re collecting is going to folks who never had access to health care,” he says. “You could immediately see results.”—Kim Kiser
Bad News for Psych Patients
The shortage of psychiatric hospital beds in Minnesota became more critical last month when Immanuel St. Joseph’s Hospital in Mankato announced that it would stop providing acute inpatient psychiatric care.
The hospital admitted between 500 and 600 patients annually for psychiatric care, according to a report in the Mankato Free Press. Officials from the Mankato Clinic, whose physicians provided psychiatric services at the hospital, cited the loss of psychiatrists as the reason behind the hospital’s decision. According to the article, the clinic had lost three of its six psychiatrists.
Minnesota Medicine reported on the shortages of psychiatrists and inpatient psychiatric beds in January.