Public Vs. Private Hospital

I volunteer at both (I see what the patients see + a little more) and from what I see, I definately would rather see myself working for a hospital like the first (below).

The privately funded hospital is smaller, better funded and more patient orientated--not to mention that the staff's attitudes (and therefore patient's) are generally more positive---everyone has a smile.

The publically funded hospital is huge, doesnt even have enough wheelchairs for the patient demands, is overstaffed in some areas and understaffed in others, I constantly hear staff complaining about their jobs and they generally dont look happy to be there.

This is of course comparing only two hospitals, so take it as you may...
 
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Hurricane95

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    I'm guessing the type of patients you see at both hospitals differs also. At least that's what I've seen from my experience. At public hospitals you will tend to see a greater percentage of uninsured, lower-income patients. Private hospitals will generally have a greater proportion of the opposite type of patient...wealthier and insured. Of course these are broad generalizations and there are exceptions. I know at Jackson Memorial in Miami this is the case. The hospital has a HUGE patient base, and many of them are lower income minorities.
     

    argonana

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      The major advantages of public hospitals seem to be:
      1) as a med student, you can DO more. patients (in general) will not fuss as much about your treating them. this is just the reality.
      2) broad patient base with some rare illnesses/injuries
      3) you can use your spanish skills, etc.
      4) they're great for EM training, as mentioned above

      Potential disadvantages:
      1) overcrowded emergency rooms
      2) lack of equipment; low-quality facilities
      3) higher risk of EXPOSURE TO infectious diseases (TB, etc.). Of course, precautions are taken--such patients are in isolated units--but these diseases are still a lot more prevalent in public hospitals
      4) you will likely be treating some incarcerated folks, etc.

      I'm sure there's a lot more to add. Please feel free to add in!
       

      DropkickMurphy

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        Having to speak Spanish is an advantage? Sure....right..... That should be listed below under disadvantages along with:
        -Disgruntled and underpaid staff
        -Often located in the worst possible part of town you would think to put a hospital (don't leave your car unlocked and certainly don't walk to work)
        -You will be treating a large number of incarcerated or very soon to be incarcerated folks
        -A fair number of your patients will be heavily armed, and a good number of these will be misogynistic or bigoted against you particularly if you're fairer complected than they are (granted I've met some very respectful people from bad parts of town, but most of them were elderly)
        -Most of your patients will have ETOH on board, as well as any number of unlicensed pharmaceuticals, therefore they tend to be uncooperative or even outwardly violent
         

        Rendar5

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          Praetorian said:
          Having to speak Spanish is an advantage? Sure....right..... That should be listed below under disadvantages along with:
          -Disgruntled and underpaid staff
          -Often located in the worst possible part of town you would think to put a hospital (don't leave your car unlocked and certainly don't walk to work)
          -You will be treating a large number of incarcerated or very soon to be incarcerated folks
          -A fair number of your patients will be heavily armed, and a good number of these will be misogynistic or bigoted against you particularly if you're fairer complected than they are (granted I've met some very respectful people from bad parts of town, but most of them were elderly)
          -Most of your patients will have ETOH on board, as well as any number of unlicensed pharmaceuticals, therefore they tend to be uncooperative or even outwardly violent

          if u have mediocre spanish skills and a patient population that speaks spanish, then this is an advantage as it will give u enough of a basis to maintain or improve ur spanish communication w/ patients. course, this depends on the hospital. not all public city hospitals are in hispanic areas, not all are in ****ty areas (majority are, i agree). And if u don't speak spanish? then more of a disadvantage.
           

          Rendar5

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            argonana said:
            good points. i didn't know that some patients are actually armed. the shady neighborhoods of public hospitals just seem like a nuisance, but the fact that one's safety could be at risk inside the hospital is pretty scary.

            haven't heard of complaints from my friends about this before :confused:. That includes friends who go to SUNY Downstate and Temple.
             

            DropkickMurphy

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              OK, so how is that an advantage? I don't see how being required to speak a foreign language and "maintain or improve" your skills in it is an advantage when it comes to practice. Personally it sounds like a huge headache and PITA that could be avoided by looking for a residency in a better area. Granted I'm planning on a career in pathology most likely so my cases won't be hablamos-ing anything...so maybe I'm missing something about how wonderful it is to converse in Spanish with a woman about her fibromyalgia.

              Personally after medical school, if I ever see a public hospital as a staff member again it will be a sign that something has gone terribly wrong. I don't mind earning my stripes in one, but I don't intend to practice at one for all the reason so many of you view as "advantages".
               

              Rendar5

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                Praetorian said:
                OK, so how is that an advantage? I don't see how being required to speak a foreign language and "maintain or improve" your skills in it is an advantage when it comes to practice. Personally it sounds like a huge headache and PITA that could be avoided by looking for a residency in a better area. Granted I'm planning on a career in pathology most likely so my cases won't be hablamos-ing anything...so maybe I'm missing something about how wonderful it is to converse in Spanish with a woman about her fibromyalgia.

                Personally after medical school, if I ever see a public hospital as a staff member again it will be a sign that something has gone terribly wrong. I don't mind earning my stripes in one, but I don't intend to practice at one for all the reason so many of you view as "advantages".


                lol, this is pre-allo, not allo. (after your post, I had to double check which forum this topic was in.) We're talking private vs. public hospital for medical school training, not residency training. A lot of the reasons you list is why I will probably be applying elsewhere for residencies.

                As for spanish, I'm going into EM, I will have spanish patients. It is to my benefit to be forced to deal w/ spanish patients so that my spanish will improve by the time i'm a resident. That is not an advantage for a residency, but is for a med school. It's not like I'm going to enjoy discussing fibromyalgia in spanish, lol.
                 
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                Rendar5

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                  Praetorian said:
                  I saw it on numerous occasions (I'd say 10-12 times) working around Washington DC and Southeast DC

                  damn, I guess King's County and Temple are safer than I thought then :eek:, compared to those places. Remind me not to apply to any residencies in the DC area.
                   

                  DropkickMurphy

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                    Actually I highly recommend the DC area for training. You do see a lot and if you stay to the "nicer side" (west) you won't have that many problems. Just stay out of Suitland, Anacostia, etc.

                    Rendar, I still don't see your argument as holding much water. I am going to take a guess and assume you already speak at least some Spanish and enjoyed learning it?
                     

                    OwnageMobile

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                      Praetorian said:
                      OK, so how is that an advantage? I don't see how being required to speak a foreign language and "maintain or improve" your skills in it is an advantage when it comes to practice. Personally it sounds like a huge headache and PITA that could be avoided by looking for a residency in a better area. Granted I'm planning on a career in pathology most likely so my cases won't be hablamos-ing anything...so maybe I'm missing something about how wonderful it is to converse in Spanish with a woman about her fibromyalgia.

                      Personally after medical school, if I ever see a public hospital as a staff member again it will be a sign that something has gone terribly wrong. I don't mind earning my stripes in one, but I don't intend to practice at one for all the reason so many of you view as "advantages".

                      I'm guessing that you have never spent time learning another language before? I spent half a year in Honduras just to learn how to hablar. Best 500$ I ever spent :laugh: :laugh: :laugh: seriously. The satisfaction that comes with using your jedi trick to communicate with someone who needs your help, or someone in general, is one of my favorite highs. I would enjoy the oppurtunity to keep my spanish skills sharp and work with my mandarin as well. The immediate respect that many hispanics give me when I speak to them in spanish, well 95% ot them, is worth it alone. Plus, by living the the corner of an adobe house the size of my garage and seeing dead dogs being eaten by vultures every day gave me a good look at what these people go through, which unfortunately many in this profession don't quite understand unless they have been there. So maybe I'm just a polygot who likes to see the smiles on peoples faces when I speak to them in their(somewhat broken)language. But what could be bad about learning a language? You are doing med school- don't tell me it is too much learning to spend time on.
                       

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                        I'm guessing that you have never spent time learning another language before? I spent half a year in Honduras just to learn how to hablar. Best 500$ I ever spent :laugh: :laugh: :laugh: seriously. The satisfaction that comes with using your jedi trick to communicate with someone who needs your help, or someone in general, is one of my favorite highs. I would enjoy the oppurtunity to keep my spanish skills sharp and work with my mandarin as well. The immediate respect that many hispanics give me when I speak to them in spanish, well 95% ot them, is worth it alone. Plus, by living the the corner of an adobe house the size of my garage and seeing dead dogs being eaten by vultures every day gave me a good look at what these people go through, which unfortunately many in this profession don't quite understand unless they have been there. So maybe I'm just a polygot who likes to see the smiles on peoples faces when I speak to them in their(somewhat broken)language. But what could be bad about learning a language? You are doing med school- don't tell me it is too much learning to spend time on.

                        :thumbup: nice post.
                         

                        DropkickMurphy

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                          Actually I speak passable French, and I'm getting a degree in German/linguistics and debating learning some Arabic. I can also speak Latin but I don't get much use from that skill. So I don't think the problem is that I'm somehow linguistically deprived . I just find rather repugnant the fact that I have should be more or less expected to learn a language I have no desire to ever speak, just simply because another group has refused to learn our primary language. Add to that the fact that in areas where there are lots of Spanish speakers, chances are pretty good that someone in that ER speaks enough to get by.

                          The reason I learned foreign langauges was not like many here- i.e. I didn't learn them to use as application padding or to make life "easier" in medical practice. I learned them out of genuine interest in the language or because I travel to areas where these are the dominant languages.
                           

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                            Praetorian said:
                            Actually I highly recommend the DC area for training. You do see a lot and if you stay to the "nicer side" (west) you won't have that many problems. Just stay out of Suitland, Anacostia, etc.

                            Rendar, I still don't see your argument as holding much water. I am going to take a guess and assume you already speak at least some Spanish and enjoyed learning it?

                            don't enjoy it that much, but yeah, I speak some spanish. Japanese was my language out of interest. check out my first post on the subject. as i said, if u don't know spanish or won't have to deal w/ spanish speaking patients in residency, then the whole spanish thing is a clear disadvantage, as in your case. Spanish in pathology? :laugh:

                            The whole thing w/ forced exposure is that it is honestly the only way to remember any spanish for u non-fluent speakers. if u don't use it, u lose it. If I'm not put in a situation where I have to talk to a lady in spanish about her blood pressure now, then my spanish will deteriorate so that it'll be useless to me in residency. (and from my own experience, being able to maintain ur spanish skills is extremely useful in the trauma room. I hated having to fetch the nurse when there weren't any attendings or residents in the room). So basics of this argument are: if very little spanish population in hospital, then my spanish will go back from advanced to beginner by the time i'm applying to residencies. if there is a large spanish population, then my spanish skills will be there for me when i hit residency.

                            Oh yeah, and actually talking to a patient about her BP in spanish the other day was pretty cool. never woulda been able to do that a couple years ago.
                             

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                              Praetorian said:
                              OK, so how is that an advantage? I don't see how being required to speak a foreign language and "maintain or improve" your skills in it is an advantage when it comes to practice. Personally it sounds like a huge headache and PITA that could be avoided by looking for a residency in a better area. Granted I'm planning on a career in pathology most likely so my cases won't be hablamos-ing anything...so maybe I'm missing something about how wonderful it is to converse in Spanish with a woman about her fibromyalgia.

                              Personally after medical school, if I ever see a public hospital as a staff member again it will be a sign that something has gone terribly wrong. I don't mind earning my stripes in one, but I don't intend to practice at one for all the reason so many of you view as "advantages".

                              It all depends on how you view things. I think you view having to speak spanish as having to unecessarily adjust even though you are in your home country. Others, who have purposely taken spanish in anticipation of this mass entrance of non-english speaking hispanics/latinos/carribeans...etc see this as an opportunity to apply what we have learned.

                              Do you live in an area where hispanics (illegal or not) make up the majority of your population?
                              just wondering.

                              cya!
                               

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                                Hispanics are not a majority here (probably around 10% of the population I'd guess), but we deal with them frequently due to the farms around the area and also the construction business. I have a great deal of respect for them, I've never seen anyone with the level of a work ethic like they have.
                                 

                                argonana

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                                  Praetorian said:
                                  The reason I learned foreign langauges was not like many here- i.e. I didn't learn them to use as application padding or to make life "easier" in medical practice. I learned them out of genuine interest in the language or because I travel to areas where these are the dominant languages.

                                  ??? How can you just make that assumption?? A lot of us grew up in bilingual households, and it's possible that English wasn't our first language. I started learning Spanish when I was 12 because I was fascinated by the culture. I'm very interested in using it in med school because I enjoy speaking it, appreciate the isolation imposed by language barriers, and want to remain fluent. and i think it's REALLY disrespectful to speak to patients through a "translator."
                                   
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                                  OwnageMobile

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                                    Praetorian said:
                                    Actually I speak passable French, and I'm getting a degree in German/linguistics and debating learning some Arabic. I can also speak Latin but I don't get much use from that skill. So I don't think the problem is that I'm somehow linguistically deprived . I just find rather repugnant the fact that I have should be more or less expected to learn a language I have no desire to ever speak, just simply because another group has refused to learn our primary language. Add to that the fact that in areas where there are lots of Spanish speakers, chances are pretty good that someone in that ER speaks enough to get by.

                                    The reason I learned foreign langauges was not like many here- i.e. I didn't learn them to use as application padding or to make life "easier" in medical practice. I learned them out of genuine interest in the language or because I travel to areas where these are the dominant languages.

                                    No, it doesn't sound like you are deprived.

                                    I just find rather repugnant the fact that I have should be more or less expected to learn a language I have no desire to ever speak, just simply because another group has refused to learn our primary language.

                                    With all respect Praetorian, I find this statement repugnant. You sound naive. So tell me, is it the people who make you detest the language, or is it the language that makes you detest the people?
                                     

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                                      OwnageMobile said:
                                      No, it doesn't sound like you are deprived.



                                      With all respect Praetorian, I find this statement repugnant. You sound naive. So tell me, is it the people who make you detest the language, or is it the language that makes you detest the people?

                                      ...umm...association of two facts does not imply cause-effect relationship. please remember this when reading epidemiological studies in the literature. otherwise u'll be completely fooled by a lot of biases.
                                       

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                                        I think it's far more disrespectful to butcher someone's native tongue. Ever watched the look on an American's face when they watch someone stumble through very broken English?

                                        I make that assumption because there are many people here who continue to breathe only because they have been told it looks good on their app to be off-gassing CO2. Yes, there are a few of us that grew up in bilingual households (*raises hand*) and maybe there are a few more that grew up loving a particular culture, but a good number of us (I'd bet 75%) are learning Spanish for less pure reasons.

                                        By the way, I am far more impressed by someone who has learned English as a second language than someone who learns a Romance language. English is a real bear to learn.
                                         

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                                          OwnageMobile said:
                                          With all respect Praetorian, I find this statement repugnant. You sound naive. So tell me, is it the people who make you detest the language, or is it the language that makes you detest the people?
                                          Actually no it's the expectation from persons such as yourself that because I don't choose to learn a particular language I'm somehow biased or disliking of a particular group. BTW, I never said I detested the language, just that I do not see much purpose in learning a little bit of it.
                                           

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                                            Praetorian said:
                                            Hispanics are not a majority here (probably around 10% of the population I'd guess), but we deal with them frequently due to the farms around the area and also the construction business. I have a great deal of respect for them, I've never seen anyone with the level of a work ethic like they have.


                                            I am not saying they are the majority in the nation. They are the majority in specific states, such as California (55% of the pop...I am from there and can tell you from experience that you really need to know spanish is specif areas of Los Angeles), NY, and Texas.

                                            People who come to this country seeking to improve their status in society will work hard b/c they understand what their hard work can possibly earn them in the long run.

                                            You are right about their work ethic....but I guarantee you the ones you are refering to were not born here in the US. That is how it works. People in the older generation (like my father) are complaining about how we younger americans are letting foreigners come in and take all the jobs. Obviously americans are not even trying to compete with immigrants to take those farming jobs, but that is just a testament to how they are willing to do anything to better their situation.
                                             

                                            DropkickMurphy

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                                              I actually called a radio talk show one time and told the host to shut up because he stated that Mexicans were lazy and just here to sponge off us, and to take our jobs. I told him to get off his butt and go haul sod, or bricks or pick fruit for a few months then he could assess their laziness. By no means do I have any negative feelings towards the Mexican immigrants other than I feel that if they want to be here, they really should learn the language, just as if I were to go to Mexico to live I would have the decency to learn Spanish.
                                               

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                                                Praetorian said:
                                                I think it's far more disrespectful to butcher someone's native tongue. Ever watched the look on an American's face when they watch someone stumble through very broken English?

                                                :laugh: The solution would be to become fluent in the language, but I know what you're saying. There's always that fear that you'll be offending whomever you're speaking to, or perhaps even coming across as condescending. I think that's always a possibility unless your spanish (or whatever) is near-perfect.

                                                I do want to add that as health professionals, it is/will be part of our job to communicate effectively with patients. The opposite does not hold true--patients are not getting paid to learn english well so they can converse with us. i don't think we'd really be in a position to judge their reasons for speaking faulty english. (if we were their employers or something, i suppose it might be a different story.)
                                                 

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                                                  argonana said:
                                                  :laugh: The solution would be to become fluent in the language, but I know what you're saying. There's always that fear that you'll be offending whomever you're speaking to, or perhaps even coming across as condescending. I think that's always a possibility unless your spanish (or whatever) is near-perfect.

                                                  I do want to add that as health professionals, it is/will be part of our job to communicate effectively with patients. The opposite does not hold true--patients are not getting paid to learn english well so they can speak to us. i don't think we'd really be in a position to judge their reasons for speaking faulty english. (if we were their employers or something, i suppose it might be a different story.)

                                                  Just like in German were the word for "humid" and the word for "f-ggot" are about one stuffy nose apart from one another. I'm always concerned in a new language if I'm saying something I shouldn't.

                                                  But I do disagree about it being part of our job to communicate effectively in a language not our own. I pose this question then, are we to each become fluent in Spanish, French, Dutch, Italian, Arabic, various dialects of Chinese, Japanese, Portuguese, Russian, German, and Farsi? Because to effectively communicate with any potential patient (using your standard) I would have to speak those just to converse with the people who live in just this apartment building. So I don't see it as our professional responsibility to be linguists as well as medical practitioners.
                                                   

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                                                    Praetorian said:
                                                    I think it's far more disrespectful to butcher someone's native tongue. Ever watched the look on an American's face when they watch someone stumble through very broken English?

                                                    Yes. Americans who have no understanding of what it is like to struggle with communication do this, it disgusts me. So you think the hispanic mom who I'm trying to help out really gives a damn about how I fumble around a bit with the language? So what now- don't learn speak another language with a foreigner until you are fluent???

                                                    Praetorian said:
                                                    I make that assumption because there are many people here who continue to breathe only because they have been told it looks good on their app to be off-gassing CO2. Yes, there are a few of us that grew up in bilingual households (*raises hand*) and maybe there are a few more that grew up loving a particular culture, but a good number of us (I'd bet 75%) are learning Spanish for less pure reasons.

                                                    I'm learning Spanish and Mandarin because I love to SPEAK the languages with people, because I want to learn a language that I can practice in the states, and because I want to help people. How pure is that? Why the ^$#% does it really matter?

                                                    more...

                                                    I just find rather repugnant the fact that I have should be more or less expected to learn a language I have no desire to ever speak, just simply because another group has refused to learn our primary language.

                                                    "I mean, I think they are great hard-working people, just not important enough to merit my time..."

                                                    Actually no it's the expectation from persons such as yourself that because I don't choose to learn a particular language I'm somehow biased or disliking of a particular group. BTW, I never said I detested the language, just that I do not see much purpose in learning a little bit of it.

                                                    I guess ownage does tend to read between the lines a bit too much sometimes... So you like hispanics- you don't detest the language- right? You just don't want to speak or learn it. The pubic hospital will not be your top choice. To each his own.
                                                     
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                                                      Praetorian said:
                                                      I actually called a radio talk show one time and told the host to shut up because he stated that Mexicans were lazy and just here to sponge off us, and to take our jobs. I told him to get off his butt and go haul sod, or bricks or pick fruit for a few months then he could assess their laziness. By no means do I have any negative feelings towards the Mexican immigrants other than I feel that if they want to be here, they really should learn the language, just as if I were to go to Mexico to live I would have the decency to learn Spanish.

                                                      With all due respect Praetorian, you sound naive, again. I don't want to appear as flaming you with every chance I get, but this just isn't right. I had a friend who went to China for 2 years and didn't learn jack of the language. He stayed with americans and let the few "learners" do the talking. You may not detest Spanish, but something about your posts paint an image of a guy who wouldn't learn Spanish if placed in Mexico. We must also touch on the ideas that America is not Mexico. They are very different places in their very different situations. Your american trip to mexico is not the same as a mexican trip to america.
                                                       

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                                                        Personally I think you're being a bit overbearing in your attempts to prove yourself better than everyone else because you allegedly spent a little bit of time in Honduras. See that it might not be that I am biased, or that you're flaming me but rather that you're making a very public statement that you feel you are somehow a better candidate to be a doctor than I am because of the fact that you watch a vulture consume a dog whilst living amongst the poor in Honduras and because you're fluent in Spanish. That little story (true or not) smacked of personal statement and gross pomposity.

                                                        By the same token as you accuse me of not respecting Hispanics enough to learn the language, then do you not respect other cultures- the ones whose languages I choose to learn and use on a very regular basis through contact with those who speak them- because I don't hear you going out and learning German, French, or any other language. No, it's not because you don't respect them. It's because you choose not to learn them, for whatever reason- good, bad or indifferent. I am not knocking you for being dedicated and a believer in your chosen second language. But I also don't think everyone should be required to speak Spanish in the US as a medical professional, no more than you believe it's right that I suggest that Mexicans residing in the US should at least attempt to learn passable English.

                                                        By the way, I said if I were to go to Mexico, as in if I were going to live there, not as if I were going to Acapulco. I would learn the language because of the necessity of it just for the sake of being culturally accepted. Any accusation of unwillingness on my part is grossly unfounded and probably simply reflects an paltry attempt to make your self look better by trying to make me seem like a bigot such as your statement that I don't believe Hispanics are worth my time simply because I don't learn the language. I hope you honestly remove your head from whatever orifice you have it wedged and realize that there is more to delivering competent cross-cultural care than being fluent in Spanish.

                                                        To the OP, to answer the initial question, it probably has something to do with showing the wide variety of cases presented and also reinforcing the idea that the purpose of medicine is to care for everyone regardless of any criteria you can think of (other than lack of medical necessity).
                                                         

                                                        DropkickMurphy

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                                                          And by the way, there are parts of this country where the public hospitals are not seeing large numbers of Spanish speakers. Actually the rural public hospitals need more help translating the German and Dutch spoken by some of the Mennonite and Amish sects around here than Spanish just so you know.
                                                           

                                                          riceman04

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                                                            Praetorian said:
                                                            And by the way, there are parts of this country where the public hospitals are not seeing large numbers of Spanish speakers. Actually the rural public hospitals need more help translating the German and Dutch spoken by some of the Mennonite and Amish sects around here than Spanish just so you know.

                                                            I am not surprised. I am in Philly right now and it is interesting to see just how relatively few spanish speakers there are up here. My suitemate's father actually grew up speaking pennsylvania dutch. Pretty interesting.

                                                            But those local languages are very different from their ancestral language.
                                                             

                                                            argonana

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                                                              Praetorian said:
                                                              But I do disagree about it being part of our job to communicate effectively in a language not our own. I pose this question then, are we to each become fluent in Spanish, French, Dutch, Italian, Arabic, various dialects of Chinese, Japanese, Portuguese, Russian, German, and Farsi? Because to effectively communicate with any potential patient (using your standard) I would have to speak those just to converse with the people who live in just this apartment building. So I don't see it as our professional responsibility to be linguists as well as medical practitioners.

                                                              Wow yeah I can't believe this discussion is still going on. This'll be my last comment; sorry, princessd3, for digressing.

                                                              I think technically your point is right. so i would revise my standard so that it applies only to the largest, and oftentimes most underserved, non-english-speaking patient population in a given area. and in many public hospitals, i think you would encounter spanish-speaking folks far more frequently than, say, patients who speak only dutch or farsi.

                                                              i'd have less of an issue with the existence of such language barriers in private hospitals (where of course you rarely run into such problems anyway, thanks to the greater level of privilege/education of the patient base). but in a public hospital, where many patients are already facing barriers in access to education, employment, etc., disjointed medical care/communication seems likely to isolate them even further.
                                                               

                                                              riceman04

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                                                                Praetorian said:
                                                                Yeah, I really have to listen closely when I translate for the Amish. It sounds more like Dutch than the German I learn in school. Imagine the Godfather (that mouth full of cotton "Make him an offer he can't refuse") tone, only in German....gives me a headache listening to it.


                                                                It is pretty interesting up here. I am seeing a totally different culture. I never knew of a group called the menonites. I always thought that there were only the Amish who created their own mini society.

                                                                I am still trying to get used to not seeing as many spanish speaking individuals around.
                                                                 

                                                                BooMed

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                                                                  Everybody that I've met from a Europoean country speaks 4+ languages, they see it as an opportunity to connect with other people and have a very practical skill, not as a burden.

                                                                  Americans need to get over themselves. Nobody declared English as the master language of the world.

                                                                  P.S. I bet none of you ancestors spoke English when they immigrated here either.
                                                                   

                                                                  DropkickMurphy

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                                                                    I am actually not sure what, if any, actual difference exists between the Amish and the Mennonites. I only know that I really like them and they will give the shirts off their back to anyone who needs help. When I was younger and a volunteer firefighter at the first department I was on (my hometown), the area I served had a very large Amish population. My parent's garage burned down and the next morning there was a group of Amish men in our driveway asking to help clean up and rebuild as thanks for the service my father and myself gave to the community over the years. I guess that says something about their character.

                                                                    Argonana, having worked in public hospital emergency rooms in areas with lots of Spanish speakers over the years, I've never seen it be that much of a barrier to care. Most hospitals have lists of persons who can translate for any number of languages and Spanish is always the one with the most people listed (for example, one hospital for which I serve (and I have the call list here with me) as a volunteer translator has 3 French speakers and 4 German speakers available, but 34 for Spanish). Personally I believe this barrier is far more hype than reality, because of the large number of medical personnel who already speak Spanish or at least can get by in it.
                                                                     

                                                                    LizzyM

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                                                                    1. Academic Administration
                                                                      Trainees are permitted to "do" more with patients at public hospitals because, in general, there are no "private" patients coming from the attendings' private practices as there are in some/most private hospitals.

                                                                      Keep in mind that the largest public hospital system is, IIRC, the VA Medical Centers and outpatient facilities. It is the rare patient there that does not speak English (I've met a few Polish veterans who are eligible for VA services but they are dying out.) Every VA Medical Center is affiliated with a medical school (and sometimes more than one).

                                                                      That said, private hospitals, particularly those in poorer neighborhoods (I'm thinking of some of the Catholic hospitals, in particular, as well as some private, University hospitals in poor neighborhoods such at University of Chicago Hospital) are not much different in their patient mix than one might find in a public hosptial.

                                                                      On the other hand, a public hospital in a nice suburban neighorhood (I'm thinking UCONN's hospital in Farmington CT) is going to look more like a private hosptial in the patient mix.

                                                                      If you are looking for ER action, you want a hospital, public or private, with a trauma unit.
                                                                       

                                                                      riceman04

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                                                                        BooMed said:
                                                                        Everybody that I've met from a Europoean country speaks 4+ languages, they see it as an opportunity to connect with other people and have a very practical skill, not as a burden.

                                                                        Americans need to get over themselves. Nobody declared English as the master language of the world.

                                                                        P.S. I bet none of you ancestors spoke English when they immigrated here either.


                                                                        I guarantee if we were not such a large country and were bordered by other countries with different languages and a stable economy (this obviously rules out Canada) then many Americans would know different languages also.
                                                                         

                                                                        ShyRem

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                                                                        1. Attending Physician
                                                                          This multilingual thing. I grew up in a bilingual household. I learned to speak passable German and French. In Pennsylvania, these languages were rather common. However, now I'm in Colorado and about the only language here other than English is Spanish. Obviously I have no problems trying learning another language, but I do have a problem with those who to go live in a different country yet refuse to learn the language. Note I didn't say have a hard time with the language, I said refuse to learn. If I went to Switzerland I certainly wouldn't expect that country to change their laws, signs, food labels, magazines, etc. to accomodate my refusal to assimilate into a culture I have chosen to live in. However in this country, I find it appalling that we are actually considering (or already have been) changing the laws to enable people to not have to learn anything. What kind of society have we become when I, who was born in this country, feel in the minority in places because I speak the language this country was founded in? When televisions shows and commercials are broadcast in a language I don't understand? I am not unwilling to be multilingual, but I find myself being shut out of the very country I was born in and that is discouraging at best. Let the flame war begin on that one.

                                                                          Now, unfortunately I don't speak German or French very well at all anymore, and doubt I could converse appropriately without significant refresher - it's been 20 years since I was around anyone who spoke those languages regularly (I do however still try when given the opportunity). However, I have gained a new language with the birth of my children that is absolutely incomprehensible to any child: I now speak Parent. No translation is available at this time to make it understandable to any person under the age of 16. :D
                                                                           
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