Treating patients with cancer is often challenging yet rewarding work. But caring for patients in an urban setting, where some patients don’t speak English and other patients aren’t fully insured and possibly facing significant financial challenges, can make it even more difficult to provide high quality patient care.
Take, for example, Montefiore Medical Center in Bronx, New York. Eighty percent of its patients are considered minorities, says Aditi Shastri, MD, an oncologist who specializes in the treatment of blood-related cancers at the medical center.
Specifically, many of the patients she treats are African American, Afro-Caribbean, and Hispanic. In addition, the median annual household income among Bronx residents is under $38,000 and the area has a 28.7% poverty rate.
Creating and sustaining a workforce that looks and talks like the patients treated at your hospital can help engage them in their own care, says Shastri.
Here are three other ways Shastri and her colleagues at Montefiore Medical Center are serving their patients’ specific needs:
Providing consent forms in patients’ native languages. To increase participation from minority populations in clinical trials, Montefiore Medical Center provides patient consent forms in the languages spoken by its patients. It’s standard practice to provide forms in Spanish, which is spoken by many of the health system’s patients. And recently, Montefiore Medical Center worked directly with the company sponsoring a clinical trial to translate these forms into Mandarin, which was the only language spoken by a patient who was interested in participating in the clinical trial.
Connecting patients with socioeconomic support. Shastri and her colleagues have to be sensitive to their patients’ needs and provide support to improve their clinical outcomes, she says. That means she needs to partner with social workers on her team to assist with patients experiencing housing instability and “financial toxicity” due to their cancer treatments.
For example, one of her patients experiences myelodysplastic syndromes, which the American Cancer Society describes as a type of cancer that’s caused when blood-forming cells in bone marrow become abnormal. When Shastri was talking to this patient recently, she discovered that he was spending at least $1,000 a month on medication for his gastrointestinal condition. Upon learning this, she worked with a social worker on her team and the patient’s gastroenterologist to convince the pharmaceutical company to offer more compassionate pricing for this medication.
In addition, some of her younger patients about to start chemotherapy treatments discover that fertility procedures such as sperm banking and ovarian harvesting aren’t covered by their insurance. For patients who want to have children in the future, this is a very important issue, says Shastri, and one where she also partners with her team’s social workers to secure financial support for these fertility preservation procedures.
Working with legal resources to secure insurance coverage. Another challenge faced by some of Shastri’s patients is that they were born outside the United States and are living in the country on an undocumented basis. Thus, they need help securing health insurance for life-saving procedures such as bone marrow transplants. That means she needs to liaise directly with lawyers to get insurance coverage for these patients.