Bridging the Language Barrier Between Patient and Doctor

Lina Guerra used to spend her nights pouring drinks for passengers at Boston’s Logan Airport. The menial job left the 36-year-old single mother of a newborn feeling like she hadn’t realized the economic potential her parents gifted her when they left Colombia in the late 1980s.
During her prolonged hunt for a salaried position, Guerra came across an ad that seemed too perfect. “There’s no way I’ll get it,” she thought. Despite possessing the required language skills, she hesitated, right up to the deadline, before applying. A few weeks later, Guerra received a call to come in for an interview.
The position? A medical interpreter fellowship with Found in Translation, a nonprofit that trains low-income, bilingual immigrant women and places them in jobs at prestigious hospitals in the Boston area. Launched by Maria Vertkin (a Russian immigrant herself) in 2011, the organization has recruited 158 participants that collectively speak about a dozen languages, including Spanish, Haitian Creole, Arabic and Portuguese.
During more than 100 hours of training, fellows learn the rigors of medical interpreting. “You have to be very accurate,” Guerra says. A loose, informal translation could lead to the wrong diagnosis. When a patient describes a stomachache, for example, the interpreter must possess the vocabulary, in both languages, to translate “tummy,” “belly,” “stomach” or “abdomen” to convey the right connotation. On top of that, Guerra adds, interpreters must know the slang for each culture.
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Interpreters act as cultural brokers. During one prep class, for instance, trainees debated the appropriate gender for a gynecologist or urologist. (Arabic speakers believed patients should see a physician of the same gender; those of Spanish heritage believed doing so would imply homosexuality.)
They also learn to advocate, and in a few rare instances, interrupt on the patient’s behalf. “There’s implicit bias and prejudice,” Vertkin says. “It’s the interpreter’s job to say, ‘Wait a minute, are there other options? You’re only offering the cheapest metal filling.’ That might be because of who the patient is and the assumption that they’re poor. The interpreter has the obligation then to intervene.”
With the new commander-in-chief calling for a border wall, mass deportations and an unprecedented Muslim travel ban, times are tough for immigrants like Guerra, who arrived in this country at age 8. She has a message for President Trump: “Please know in your heart that the majority of non-English speaking people have an even greater desire to be American than some people that were born in this country. They are so proud to be in America, regardless of the struggles that they are currently facing,” Guerra says, pleading, “Give them a chance.”
Employed by a translation agency, Guerra makes her living speaking for foreigners. Perhaps it’s time we all starting listening to what she has to say.
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Meet the Women Who Blasted into a Male-Dominated Industry, a Smarter Way to Fight Prejudice and More

 
Onward and Upward, Vogue
In this stunning photo essay, take a look at the women who power NASA and learn about how far they’ve come since the time period depicted in “Hidden Figures.” With job titles ranging from research biologist to mission integration manager, the significance of their hard-found positions within the aeronautics industry is not lost on them. It won’t be on you, either.
In Response to Rising Biased Rhetoric, Muslims Run for Office, NPR
With hate crimes on the rise, some members of the American Muslim community are confronting the problem in a bold way: by running for office. Campaigning inevitably puts them in the spotlight and often brings about further vitriol, but many see it as the only way to move the conversation forward.
Surgeons Were Told to Stop Prescribing So Many Painkillers. The Results Were Remarkable. The Washington Post
The opioid epidemic in the U.S. has killed tens of thousands during the last decade, and the overprescription of drugs is largely to blame. A small trial in New Hampshire uncovered a simple, data-driven solution that could lead to a huge cutback in prescriptions and ultimately, addictions.

Meet the Couple Caring for Uninsured Families

New York City has long been the final destination for incoming immigrant families. Today, that population totals over 3 million people, and nearly 35 percent of them lack access to health insurance. Now one married couple is aiming to provide these families with the pediatric care they otherwise can’t afford.
Dynasty Pediatrics is a private practice with an office in Brooklyn’s Kensington neighborhood. Its founders, Dr. Marina Klotsman and her husband, Schmeil, provide affordable healthcare services for the borough’s newly settled immigrants, many of whom lack health insurance. As a result, the Klotsmans often end up waiving co-pays and other medical fees for those families struggling to make ends meet.
“We put a lot of effort, a lot of time, a lot of our own energy into this place,” says Marina. “It’s not even for business; it’s for the feelings we have. We want to help everybody.”
Schmeil agrees, adding, “The money’s not the main subject in this office.”
Dynasty Pediatrics is open Sunday through Friday, with hours late into the evening. The goal is to make it easier for working-class parents — many of whom support family members living outside the US — to bring in their children without disrupting their work schedules. The Klotsmans also help families explore insurance plans as well as local services like NYC’s universal pre-K program.
That sense of duty goes back to the husband-and-wife team’s own journey to the US from Kyrgyzstan. Schmeil left his home country in 1989 during the dissolution of the USSR, a period he remembers as marred by “chaos.” Marina left eight years later, in 1997, to further her medical career. They would eventually meet in Brooklyn through Marina’s uncle and marry soon after.
Learn more about the Klotsmans’ passion for helping others in the video above.

Every City Should Replicate What This Michigan City Did, A Smarter System for Doctors Making House Calls and More


The City That Unpoisoned Its Pipes, NextCity
The idea of preemptively improving infrastructure long before a crisis hits is foreign to most Americans. An hour’s drive west of Flint, Mich., the entire water system in Lansing (which once contained lead-lined service mains) will be declared lead-free in 2017 after a decade spent switching to copper pipes. Soon, residents will have the ability to swig their H2O without worry.
A New Brand of Doctor Targets the Unhealthy in Rural Tennessee, The Tennessean
In rural areas, there are a lot of benefits to a country doctor who makes house calls: a robust patient-physician relationship, no administration contributing to overhead. But isolation limits those medics’ ability to understand what’s affecting their region. By banding together, a network of primary-care physicians in 50 desolate counties across Tennessee now share knowledge such as health trends among their populations and best practices for dealing with insurance companies.
The Collapsible Helmet that Could Revolutionize Bike-Share Safety, CityLab
Bike-sharing is one of the easiest ways to get around a city and is friendlier to the environment than a short, gas-guzzling car ride. But cyclists often put themselves at risk on roadways by going without a helmet. To improve safety, a Brooklyn, N.Y., commuter created a collapsible helmet made from paper honeycomb and glue, which folds up to the size of a banana, making a bike-share ride even more desirable.
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The Unlikely Partnership That’s Helping the Poor

When low-income patients end up in the hospital with a medical emergency, it might not only be doctors, but also lawyers who save their lives.
Many medical facilities now have onsite attorneys offering free legal aid to such patients. This service makes sense, since issues such as eviction, homelessness and difficulty attaining services for a disabled or developmentally delayed child can negatively impact a patient’s health.
This model of partnership between the medical and legal professions began in Boston in 1993, and since then, it’s expanded to 260 locations in 38 states, according to NBC News.
The Cox family of Cleveland is an example of how these programs are effective. Tony Cox had a heart attack when he fell off a ladder during a roofing job. Out of work, he fell behind on his mortgage payments, and his family was on the verge of eviction when a legal services attorney stepped in and worked with the bank to renegotiate their loan. “We were getting ready to be homeless, to move in with family,” Donna, his wife, says. “We would have been separated.”
Colleen Cotter, director of Legal Aid Society of Cleveland, tells NBC News, “When we really look at the issues in our clients’ lives, there’s almost always a health issue involved. Poverty is unhealthy, and bad health can lead to economic chaos. I see everything we do as increasing the health and communities we serve.”
Pediatrician Robert Needleman of Case Western University Medical School says, “In general, medicine does not spend much time on the parts of patients’ lives that we can’t fix.” Needleman is striving to change that, however, by instructing medical students to chat with patients about stressors in their lives and issuing referrals to free legal aid when appropriate.
Not only do these partnerships between lawyers and doctors save people from eviction and bring about other positive changes in their lives, but they also save money. In Pennsylvania, Lancaster General Hospital established a clinic for “super-utilizers” (i.e. people who come to the emergency room frequently). When they added a lawyer to the services the facility offered, the patients’ use of the health care system declined by half.
As Megan Sprecher, a Legal Aid Society of Cleveland attorney says about one client she helped avoid homelessness by obtaining a tax refund that had been lost in the mail, “It was a very simple issue, but these systems can be hard to navigate if you’re not familiar with them.”
MORE: When it Comes to Helping Homeless Vets, Could Thinking Small be the Answer?

Making the Invisible Wounds of War Visible

How do you treat an illness that you can’t see?
The U.S. Department of Veterans Affairs estimates that 11 percent of soldiers who served in Afghanistan and 20 percent of veterans of the Iraq war come home with PTSD. This ailment, which some refer to as an invisible war wound, has been linked to grave problems, including veteran homelessness and suicide. But now, testing is underway using new technologies that just might enable doctors to see the impact of both PTSD and Traumatic Brain Injury.
In San Diego, the Veterans Research Alliance raised $30,000 to fund a study by the V.A. using the magnetic encephalograph and high-definition fiber tractograph (two devices that allow researchers to view and record electromagnetic waves in the brain), something that has never before been possible.
Gery Schulteis of VA Healthcare Systems tells ABC 10 News, “With a traumatic brain injury, there may be gaps in the neurological connections in the brain. These devices may be able to detect that and in turn help lead to new treatments.”
Steve Lewandowski of Veterans Research Alliance adds, “Before, people were calling this an invisible injury. After this moment, it will no longer be invisible.”
The study is starting small, involving 10 special warfare veterans. Schulteis says, “We’re still going to be a ways away from having a new treatment, but hopefully this will be the gateway to a much larger study.”
With PTSD afflicting 7.7 million American adults, according to the National Institutes of Health, any breakthrough in its treatment would be welcome.
MORE: Meet the Marine Turned Doctor Helping Veterans Overcome PTSD

The Savvy People That Are Saving Prescription Drugs From Landfills and Giving Them to Needy Patients

Most of us are aware that Americans waste a lot of food, which has spurred nonprofits like the Food Recovery Network to avert some of that loss and give it to hungry people. But you may not know that Americans also toss out an astonishing amount of perfectly good prescription drugs as well. These drugs end up in landfills, flushed down the toilet or burnt in incinerators where they can harm people or the environment, keeping them from people who could use them.
Fifty percent of the Americans that the Commonwealth Fund surveyed said that they had failed to fill a prescription ordered by their doctors because of the price of the drug, and according to the CDC, 25 percent of Americans struggle with paying their medical bills.
Which is why several crusaders are working to get unused prescription drugs into the hands of people who need them. George Wang, whose Stanford, California-based nonprofit startup Sirum recovers these drugs, calculates that $700 million worth of prescriptions could be saved each year. He talked with Marketplace about “the absurdity of the waste and how gross it is, the fact that it’s raining down on families where these drugs are being burnt. It’s insane, right?”
One of the big culprits is nursing homes. Residents use a lot of prescriptions, but regulations require these facilities to toss prescriptions instead of sharing them between patients. Larry McCarty, a medical waste hauler who works for nursing homes in California describes, “brand new packages that have never been open and still have the saran over the top of them. Whole packages, just sitting in there.”
Sirum has developed software to make it simple for nursing homes to donate leftover drugs, shipping them to pharmacies that will give them to low-income people or those who don’t have insurance.
In Oklahoma, Linda Johnston, the Tulsa County Director of Social Service, heads up a program that involves retired doctors in collecting unused drugs and delivering them to the needy, saving $16 million worth of drugs so far, and countless lives. Johnston talked with Marketplace about one young man who’d received anti-depression medication from the program. “He wanted me to know he was not going to commit suicide, because he had his medication, he could take it.”
MORE: How Much Food Could Be Rescued if College Dining Halls Saved Their Leftovers?
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The Mobile Health Clinic That’s Been Helping the Poor for 40 Years

In 1976, Dr. Augusto Ortiz and his wife Martha looked to a donated school bus as a means to achieve their dream of providing free medical care to the poor of Tucson, Ariz.
Today, The University of Arizona Mobile Health Program (MHP) visits communities in a big, shiny trailer stocked with all the amenities of a regular health clinic — including an EKG — but the spirit behind it remains the same 40 years later.
The MHP makes regular rounds of communities in southern Arizona, serving about 2,400 uninsured and under-insured people, plus those that don’t have regular access to health facilities. Additionally, since 2003, the MHP has run group prenatal care appointments for expectant mothers, serving many who would never have received the important care otherwise and resulting in the delivery of more than 200 healthy babies.
Still, for all the poor that have been helped by the MHP, the impact on doctors-in-training may even be greater. The clinic is staffed with medical residents and students in public health, pre-med and pre-dental programs at the University of Arizona. Tammie Bassford, head of the Department of Family and Community Medicine at the University, tells Linda Valdez of AZ Central, “It has a profound impact on students.”
Bassford recalls one time when MHP staffers asked a patient if she needed any help with anything besides her health. She told them that she lacked a pot big enough to cook beans for everyone in her family. The MHP was happy to provide her with one.
Dr. Ortiz died at age 90 in 2007, but his wife Martha, now 90, is still involved in fundraising for the mobile health clinic that they founded. She believes in helping the poor for purposes of altruism, but also for the practical reason of preventing the spread of disease. “If somebody is standing next to you in the grocery line and coughing, it’s possible they have tuberculosis, and don’t know because they can’t get to a doctor,” she tells Valdez.
MORE: How A Big Blue Bus is Saving Needy Children Nationwide
 
 

The Innovative Blood-Drawing Technique That’s Pain-Free and Saves Money

Most 19 year olds spend their days hanging out with friends, not revolutionizing American healthcare. But that’s not the case with Elizabeth Holmes who dropped out of Stanford to start the company, Theranos.
During her freshman year in college, Holmes took chemical engineering professor Channing Robertson’s seminar on advanced drug-delivery devices (aka, things like patches and pills). After completing a summer internship at the Genome Institute in Singapore, she hit upon her first idea: a patch that simultaneously delivered medication and collected data about the patient to inform their doctors with.
Holmes dropped out of school to work on a patent for that product and to launch her company using the rest of her college savings.
That invention was the first of many that the now 30-year-old CEO would develop. According to Fortune, Holmes is listed as a co-inventor on 82 U.S. and 189 foreign patent applications. Eighteen in the U.S. have been granted.
When Holmes first told Robertson about her plan to drop out, Robertson told Fortune, “I said, ‘Why do you want to do this?’ And she said, ‘Because systems like this could completely revolutionize how effective health care is delivered. And this is what I want to do. I don’t want to make an incremental change in some technology in my life. I want to create a whole new technology, and one that is aimed at helping humanity at all levels regardless of geography or ethnicity or age or gender.'”
As Holmes set to work on her company, she shifted from her initial idea to one about developing a revolutionary way to run diagnostic tests on very small amounts of blood — just a drop — instead of the full vials most labs need.
She came up with a technique that not only minimizes the discomfort, but also enables doctors to run dozens of tests on just one sample — and it delivers the results efficiently and inexpensively. They’re so affordable, in fact, that no test costs more than half of the allowed Medicare reimbursement for it. Fortune writer Roger Parloff says, “with widespread adoption [this] could save the nation billions.”
And that’s just part of Holmes’s next plan for Theranos. The company is partnering with Walgreens, whose stores currently host 21 patented Theranos blood-drawing facilities. They’re all in Phoenix and Palo Alto for now, but the drug-store chain plans to gradually add them nationwide. Holmes’s eventual goal? For just about every American to have a Theranos facility within five miles.
In addition to the cost savings and the minimized discomfort, Holmes’ technique allows for more frequent blood draws in people with conditions that require it, so that doctors can better monitor the fluctuations in their health.
Holmes said, “Anywhere from 40 percent to 60 percent of people, when they’re given a requisition by a doctor to go get tested, don’t, because they’re scared of needles or the locations are inconvenient or the cost is too high. And if you’re not even getting tested, how is it possible that we’re going to move toward an era of preventive medicine?”
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The Doctor’s Order? Spend More Time in Nature

We’ve all fallen victim to spending too much time cooped up inside, hunched over computers and binge-watching television shows. So in an effort to curb those nasty habits and get young people moving, one innovative Washington, D.C., doctor is teaming up with the National Parks Service to treat sickness with sunshine.
Dr. Robert Zarr is the chief evangelist for Park Rx — a database of parks and greenery that doctors can access when treating patients. The service allows physicians to locate a patient’s electronic record, ask them about what they like to do to keep in shape, and make recommendations to nearby parks based on their preferences.
With the help of the National Parks Service, the D.C. Department of Parks and Recreation and others, Zarr mapped out and rated 380 parks for activities, cleanliness, safety, and transportation accessibility, according to Fast Company. Doctors can print out recommendations with maps and pictures as a sort of natural alternative to prescriptions.

“We wanted to know whether actually prescribing a park during a doctor’s visit would change behavior,” Zarr said. “And the answer was ‘absolutely yes.'”

The program, which launched last July, has already acquired 30 participating doctors at Unity Health Care. The results have garnered around 550 prescriptions and feedback revealed an average increase of 22 minutes of activity per week among 400 children.

MORE: These New York Seniors Are on the Cutting Edge of Telemedicine

Zarr claims his inspiration stems from Last Child in the Woods, a book about “nature deficit disorder” and its impact on our youth’s health. But the idea is also part of a National Parks Service movement to promote the outdoors as a health prevention strategy. Thanks to the doctor’s advocacy, the program is successfully combining medicine with nature.

While encouraging patients to spend more time outside as a means to improve health is nothing new, Zarr acknowledges it can require some convincing.  “Once you get over the conceptual hurdle of prescribing park, and you believe the scientific literature that clearly says being outside is good for health, then all it takes is to push a button on a computer. They have to do that anyway.”

The nature evangelist is aiming to develop a mobile app and one day, hopes to add, “have you been outside recently?” as a primary question in patient pre-interviews when checking vitals. For many of us, that answer is probably be “not as much as I should.” But hopefully, the Park Rx program is helping to change that.