Reasonably confident

by Mark Hartley
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German measles paid me a visit when I was around two years old, and the related fever wiped out most of my hearing. In many ways, I am essentially deaf. As I have written before in this space, you don't have to talk louder when communicating with me, but you do have to ensure that I am 100% focused on you before you even start talking.

Other than that rocky start, I have been pretty lucky. The bumps in the road in my health care have been few and far between over almost 60 years. But I also know the bumps will soon start occurring more frequently as I continue to age.

What's on the back of my mind with this realization is that I'm reasonably confident about it. I know health care is not perfect and mistakes are made. But, hey, I'm going to enter that hospital/doctor's office with a faith that the providers will give my treatment their best shot.

It startles me that I may even be in a minority with that confident feeling.

As Mary Therese Keating-Biltucci, RDH, writes in this issue on page 38, "Culture strongly influences how patients view the health care environment, and trust affects every aspect of the doctor/patient interaction."

This is not an argument for or against efforts to reform health care in the political arena. But it is just plain wrong for any citizen to feel that health care may not be on his or her side simply because of his or her cultural or economic status.

Keating-Biltucci, who works at the University of Rochester Eastman Institute for Oral Health as a health project coordinator in clinical dental research, received some corroboration for her observations last month from the federal Agency for Healthcare Research and Quality (AHRQ).

The AHRQ said its 2010 State Snapshots released on June 1 revealed, "Among minority and low-income Americans, the level of health care quality and access to services remained unfavorable. The size of disparities related to race and income varied widely across the states."

Dr. Carolyn Clancy, the director of AHRQ, added, "Every American should have access to high-quality, appropriate, and safe health care, and we need to increase our efforts to achieve that goal because our slow progress is not acceptable."

The State Snapshots can be viewed at statesnapshots.ahrq.gov.

Oklahoma, the home base for RDH magazine, is firmly in the "weak" section of the agency's "performance meter" for overall health care quality. That's no surprise, since Oklahoma frequently lags behind other states in these types of evaluations.

There is a section for each state where you can study the disparities in health care for different treatments (including diabetes and heart care – two systemic connections to the dental profession). The charts used an upward arrow to indicate superior treatment, an equal symbol to reflect even treatment protocols across the board, and a downward arrow to indicate inferior treatment.

There are too few equal symbols on these charts, particularly when income is a factor.

Why? Health is not a status symbol.

Noel Kelsch, the Infection Control columnist, has the words "Access to care: A right, not a privilege" in her email signature. She is an RDHAP in California, and many of the RDHAPs fight daily for improved access to care.

It startles me that we have to even fight about it. The bumps in the road in health for most Americans are not something that are sought. We are nervous and distracted by health disruptions in our lives. What will be the short-term and long-term impact from this breakdown in health to our lives? When will normalcy return, if it does?

All of us should be reasonably confident about health care.