Getting Over the Hurdles

June 10, 2016

By Peter Young

 

D. Watkins, local author and columnist, spoke to a crowd of physicians, nurses, social workers, and policy-makers at Johns Hopkins Hospital last week. He shared his experiences growing up in Baltimore, specifically how neighborhood kids used to joke by saying if you went to Bayview Medical Center, you would never come back alive. If you got shot in the pinky or stung by a bee and went to Bayview, you would probably die. The anecdote received some nervous laughter from the crowd. Watkins was referring to Johns Hopkins Bayview Medical Campus in East Baltimore, and its troubled relationship with the surrounding, impoverished, urban community. Johns Hopkins Hospital has had a varied history with Baltimoreans including ethically complex stories such as that of Henrietta Lacks, an African American woman who was diagnosed with cervical cancer at Johns Hopkins Hospital and who unknowingly participated in medical research without giving informed consent.

 

The occasion for Watkins remarks was the inaugural conference, Partnering with Patients in Decision-Making: Continuing the Conversation at Johns Hopkins. This one-day conference last Wednesday featured four panel discussions and two keynote speakers, D. Watkins and Dr. Larry Allen, with presentations intended to boost understanding of the best ways to involve patients in their own medical decision-making. The goals of the conference were to conceptually explore decision-making and its relationship to the broader issues of racial, socioeconomic, and healthcare disparities; to understand barriers to shared decision-making; and to describe innovative ways to promote shared decision-making.

 

Watkins, who gave the introductory speech in the morning, continued to explain that while many see Hopkins as a world-renowned institution, this is not how the urban community sees Hopkins. He clarified saying, “I look at Hopkins as a place that underpaid my mom for 20 years and then fired her on a technicality.” “That 20 years she worked there she never had anything positive to say about the hospital.” He continued saying, “I look at it as a place that’s swallowing my whole neighborhood. Every place I [knew growing up] in this city is gone. It has a Hopkins stamp on it now.” The urban community may not see a world-class institution that solves pressing issues in healthcare and science. Instead, many do not trust the hospital nor the work physicians do. In recognizing this, we can then wonder, what are the best ways to bridge gaps in communication and trust to overcome these barriers and help patients get the care they need?

 

Dr. Zackary Berger, associate faculty member at the Johns Hopkins Berman Institute of Bioethics, assistant professor at the Johns Hopkins School of Medicine and organizer of the conference, says teaching doctors, nurses, and other clinicians the importance of asking about patient preferences is paramount. “These are teachable skills,” he noted. Also important is acknowledging the existence of implicit bias and training clinicians to treat others with respect and dignity. This, however, does not solve the entire issue, and the long-term solution would have to include institutional-level talks about racism.

 

Watkins offered his perspective on the same question saying, “It’s about your ability to understand where that other person is coming from … to understand your social context versus their social context and then [to find] those gray areas so you can meet and build and learn and grow.” Also important, are acknowledging a history and tradition of racism in this country and recognizing that it becomes difficult to make changes if you believe every black person is the same person. One way to achieve these goals is through better communication, which is why Watkins works towards improving literacy rates in Baltimore City through his organization, Baltimore Writer’s Project. But there is no one answer, he concluded, and everyone has some skill or talent to offer towards helping patients and the greater community prosper.

 

To continue this conversation, feel free to join Progress in Partnering, a monthly brainstorming session and get-together for shared decision-making at Johns Hopkins. The first meeting will take place September 7 in Hampton House (624 N. Broadway, Baltimore MD), room 668, from 12 – 1 pm. All are welcome to attend.

 

To see video footage from last Wednesday’s conference click here.

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