Community health survey has interesting findings

Gouri Banerjee, Saheli Boston

Results show that for South Asians the relationships between themselves and their doctors are very satisfactory, virtually in every age group and for both sexes, doctors engender respect, confidence and trust. There were however, differences between South Asian males and females and between how they viewed their physicians of the opposite sex.

Saheli, Support and Friendship South Asian Women’s latest survey on doctor patient relationship was supported by a grant from Community Health Networks Association 15.org. The study contains evidence that— there is a high level of satisfaction with physicians, female physicians scored higher on interpersonal factors than male physicians, and health care facilities and other medical personnel scored lower than physicians, in general.  

Evaluation of patient-physician interactions along many variables shows that overall South Asians trust treatment plans, feel doctors are good listener, they allow patients to share opinions, and make an attempt to know their culture. Most South Asians are younger, healthier, and employed, as compared to the general population, therefore fewer reported major illnesses. However, among the major diseases, diabetes is the most reported illness. Among the 102 people who responded to the survey diabetes was the leading disease, followed by cancer and heart disease.  Most people in this survey were fortunately disease free, ranged in age from a young of 21 to 70 years old, they were mostly employed, had health insurance, and most heeded the importance of annual physical checkups.

Most people trust their physicians and the treatment regimens set up by them, but, not all do. Some feel that their physicians have little knowledge of South Asian culture, no time for small talk, or were not familiar with alternative ways of treating disease. Male physicians were more likely to write down treatment summaries, whereas female physicians were more conscientious about writing down follow-up plans and do’s and don’ts.

We also found that whereas 61% of South Asian men preferred male physicians, 89% of females went to female physicians. However, it was ironic to note that the highest level of satisfaction with doctor patient relationships were among males who went to male physicians, followed by females who went to male physicians, females who went to female physicians, and the least happy group were males who went to female doctors. Try to figure that out!!  What complicates the picture even further in assessing doctor patient relationships is the fact that the majority of South Asian women go to female physicians by choice, but still think male physicians are better. How do they know?

Those findings and more came from a recent survey of South Asian men and women between December and February this year. The study was a part of a grant received by Saheli, Support and Friendship South Asian Women, and funded by Community Health Networks 15.org.

Among the notable findings is the large number of people who have diabetes, these are relatively well-educated people, 65% had more than 4 years of college. They were mostly young, and almost all went to see a doctor at least once a year. Predictions are that India will be the diabetes center of the world in 2020; it appears that immigrant South Asians are already moving fast towards this undesirable goal.

Across the entire age-span South Asians were able to talk to their physicians, ask questions, share opinions and get suitable responses. However, female patients indicated higher levels of anxiety about being able to understand their physicians, and reciprocally, be understood by their doctor. About 10 persons, 1/10 of the sample, had requested that a language translator be made available to them when they visited the doctor. Although, language barriers, for the most part were not a significant issue,  for some South Asians, language did create anxiety. Some of these patients were very favorably disposed towards the idea of having a health care advocate who would speak on their behalf to physicians, health care staff and professionals. This service already exists in Boston, and it is good to know that the South Asian community can get help from the Indian Circle of Caring (ICC).

There is the overarching message that doctor patient relationships are good, they are satisfactory, most South Asians have good access to care, and do not feel discriminated against in any way. It is especially useful to know that Boston has additional resources such as Saheli, ICC, and a network of caring physicians to whom the community can turn to for help.

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Sangeeta Pradhan, well-known nutritionist, spoke at the Saheli Health Symposium on March 26^th at 128 Wheeler Road in Burlington.  She emphasized, "the  relationship between diet and lifestyle and the onset of diabetes. She also examined the specific role that the South Asian diet plays as it relates to diabetes onset. She suggested do’s and don’ts and circulated a handout that you can use to manage this epidemic.  Manju Sheth MD, of the Indian Medical Association of New England, moderated the Health Symposium and brought her medical expertise to the discussion.

Samir Desai of the Desai Foundation sponsored  the symposium, and emphasized the importance of good health, well-being and continued vigilance in health care research. He will discuss how it impacts people from India, Pakistan, Bangladesh, Sri Lanka and other South Asian groups.

In the afternoon session, Saheli member, Elyse Whitehead and Gouri Banerjee, who did the survey of doctor patient relationships observed “this study is a good resource for medical professionals and community activists to understand where disparities exist in the delivery of excellent health care to all citizens of Massachusetts,” and presented further findings of the study.

Health advocate Girish Mehta offered his insight into how very sick South Asian patients can use the Indian Circle of Caring (ICC), a group of volunteer health care advocates, identify the best care, and how they facilitate physician patient interactions, and coordinates logistics for those who have little family support.

The Health Symposium was an opportunity to launch the new Saheli domestic abuse resource book compiled in 2011 by Salita Mehta and Nahid Abhar of Saheli, containing a wealth of information about what domestic abuse is, how women can identify if they are in an abusive relationship, how to deal with it if they are undocumented, and what resources exist to reduce this serious problem.  

A complimentary lunch was served by Saheli and members of all communities were made welcome to this event. If you wish to be kept informed of Saheli’s future events please send email to sahelihelp@gmail.com.

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