BackgroundHealth services research of Latinos with limited English proficiency (LEP) have largely focused on studying disparities related to patient-provider communication. Less is known about their non-provider interactions such as those with patient registration systems and clinic front office staff; these interactions precede the encounter with providers and may shape how comfortable patients feel about their overall health services experience. This study explored Latino patients with LEP experiences with, and expectations for, interactions with patient registration systems and front office staff.MethodsWe conducted 20 in-depth interviews with Latinos with LEP (≥18 years of age) who seek health services in the Piedmont Triad region, North Carolina. We analyzed participants’ quotes and identified themes by using a constant comparison method. This research was conducted by a community-academic partnership; partners were engaged in study design, instrument development, recruitment, data analysis, and manuscript writing.ResultsQualitative analysis allowed us to identify the following recurring themes: 1) inconsistent registration of multiple surnames may contribute to patient misidentification errors and delays in receiving health care; 2) lack of Spanish language services in front office medical settings negatively affect care coordination and satisfaction with health care; and 3) perceived discrimination generates patients’ mistrust in front office staff and discomfort with services.ConclusionLatino patients in North Carolina experience health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services. Healthcare organizations need to support their staff to encourage patient-centered principles.
Catholic medical professionals face increasing challenges to adhering to the faith in the exercise of their professional functions. Growing opposition to traditional Church teaching—particularly with regard to issues of human sexuality and end-of-life care—threaten faithful Catholic clinicians with a form of “white martyrdom,” characterized by loss of professional standing. Threats to rights of conscience come from various segments of contemporary society, including professional medical societies and publications that increasingly resemble strident activists rather than dispassionate and measured consensus-builders. Reflection on the relationship between counter-culturalism and joy can be a source of strength for those Catholic physicians facing opposition based on their adherence to the faith in their practice. A review of the historical developments of Christian medicine highlights its counter-cultural stance in contrast to the ancient Greco-Roman traditions that preceded it. Counter-cultural figures such as Ss. Cosmas and Damian, St Basil, and St Philip Neri serve as examples of courageous Christian counter-cultural witnesses in their times. Additionally, St Philip Neri’s cheerful ministry in Rome also exemplifies Christian joy as a means of evangelizing in the midst of a culture in decline (as was the Eternal City in the 16th century). The lives of saints who suffered for the Faith remind us that being counter-cultural has consequences. While being called to “speak the truth in love” (Ephesians 4:15), Catholic medical professionals are to show compassion in words and actions as the singular signs of a faithful Christian.
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