Last month in our monthly email Sandy Hoar in his "Words of Wisdom from the Feild" article began a discussion about cultural beliefs and its influence on patient care. He states " The more familiar you are with a community's belief system and using simple terms and ideas to match a patient's understanding the easier it is to form a healing partnership with the patient. "

I'd like to invite everyone to discuss this topic and present examples.

What I'd like you all to think about is:

• How does a provider go about learning about patient beliefs?
• How do you provide culturally competent care?
• Are there different cultural beliefs and medical beliefs between different ethnicities within the states? 
• how do you deal with time restraints, resource restraints and still provide education to your patients?

I have a particular interest in culturally competent healthcare as this is what my Masters Thesis topic was about. One example I like to point to is a Hispanic American patient whom I treated. He hand CML and needed to take Gleevac but the medicine was expensive and he said he did not "feel sick". He was spanish speaking and a migrant worker. When I tried to explain to him in spanish that he had too many WBCs. He did not understand. Spanish has a word for cells- globulos, but this patient did not know that his blood was made up of cells.  So I in very basic language I explained the microanatomy. And used the term globulos of which he had never heard before but I explained they were things he could not see. I used examples from his environment. I also explained that he would not feel sick until the blood "clogged" up his body and El cuerpo (the body) would lose strength from making too many globulos. He understood and took the Gleevac- once we found him assistance.  This example may be more exemplary of socio-economic and educational differences rather than culture.

Another similar example related to Hispanics is that there is a principal called "respecto" in Hispanic culture that may not be present in Anglo American culture.  Hispanic patients feel that a doctor/PA is someone in a position of authority and our judgement should not be questions. (How many of your patients question your judgement in your work in the states? - Its more acceptable to speak up in American culture!) So if a Hispanic patient is not taking the medication prescribed- they may not tell you because they don't want to disobey or disagree. So I always try to ask all patients if my treatment plan is something they can do or not.  

 Post your thoughts and experiences on this topic! Be looking for similar topics on the PAGH Yahoo!Groups site in the future.

Harmony Johnson PA-C, MMS , President Physician Assistants for Global Health, harmoniousness@...

"One person can change the world and everyone should try"  JFK

Welcome to the group.

  CME will be offered  at the October meeting, and it will be an excellent way to
network with other PA's with similar interests.
Please formally join the PAGH membership. THe fall meeting should be great.
Please register early. See you there

Bruce Bowman





Bruce E. Bowman MHS, PA-C
>>> "amelah50" <amelah50@...> 07/16/08 12:05 AM >>>
I am a new member of the site and plan on joining the PAGH also.  Can anyone
tell me if
there are any CMEs for this conference? I've been wanting to steer my career
toward global
work and did not how to go about it (without the religious group thing) and am
thrilled to
have found you guys!!  Please post if you know...

amy b-c, PAC

I am a new member of the site and plan on joining the PAGH also.  Can anyone
tell me if
there are any CMEs for this conference? I've been wanting to steer my career
toward global
work and did not how to go about it (without the religious group thing) and am
thrilled to
have found you guys!!  Please post if you know...

amy b-c, PAC

Hello, I am a first year PA student in Portland, OR. A small group in
our class is researching the current international use and spread of
Physician Assistants. Thank you for putting this page together- it is
a wonderful resource! To supplement our research, we are interested
in doing a phone or email interview with a PA who has practiced
abroad, who could share a little about the realities of practicing
under a health care system outside the US. If anyone is interested,
please contact the above email address.

Hello, I am a first year PA student in Portland, OR.  A small group in
our class is researching the current international use and spread of
Physician Assistants.  Thank you for putting this page together- it is
a wonderful resource!  To supplement our research, we are interested
in doing a phone or email interview with a PA who has practiced
abroad, who could share a little about the realities of practicing
under a health care system outside the US.  If anyone is interested,
please contact the above email address.

Hello everyone,
I am a practicing PA in a cardiothoracic surgical ICU currently, since
graduating from PA school 2 years ago. I'm looking into quitting my
job and doing some overseas volunteering, anywhere from 3-6 months,
before returning and re-evaluating my next career move (ICU is burning
my spirit out:). I'd ideally like to go to either Africa, India, or
Nepal. I've been researching various organizations but there are SO
many posted different places and its very difficult to sort them out
and know if they really know how to use a PA effectively, and if it
would be a good experience for me. Does anyone know personally of a
good organization or person that does overseas work that could utilize
a PA for 3-6 months? I am more interested in a grassroots initiative,
and in more of a rural setting preferably.
Thanks for any information!
Jennifer

Hello,

This email message is a notification to let you know that
a file has been uploaded to the Files area of the PAGH
group.

   File        : /PAGH October 2008 Meeeting.doc
   Uploaded by : bbowman813 <bbowman@...>
   Description : Global Heath for Physician Assistants Conference , October 2008

You can access this file at the URL:
http://groups.yahoo.com/group/PAGH/files/PAGH%20October%202008%20Meeeting.doc

To learn more about file sharing for your group, please visit:
http://help.yahoo.com/l/us/yahoo/groups/original/members/web/index.htmlfiles

Regards,

bbowman813 <bbowman@...>

Greetings-

I'm sure we all thought this went without saying, but our intent with
this Yahoo Group is to facilitate communication amongst peers and for
promoting the utilization of PAs in medically underserved areas.

It is NOT for soliciting.

These posts have been removed, and steps taken to (hopefully) keep
similar posts from happening again.  My apologies to all.

Thanks for all the hard work!!

Happy Holidays!

Hello,

This email message is a notification to let you know that
a file has been uploaded to the Files area of the PAGH
group.

   File        : /Nexus Newsletter October 2007.pdf
   Uploaded by : careypryal <careypryal@...>
   Description : PAGH October newsletter

You can access this file at the URL:
http://groups.yahoo.com/group/PAGH/files/Nexus%20Newsletter%20October%202007.pdf

To learn more about file sharing for your group, please visit:
http://help.yahoo.com/help/us/groups/files

Regards,

careypryal <careypryal@...>

Hello everyone,

Sorry to take up space in your inboxes, but I was hoping some of you
might be able to help me. My name is Justin Thibeault and I am
currently a student in the PA program at the George Washington
University. I am contacting you regarding a study I am attempting to
undertake, with the hope of having it published. I am trying to survey
as many PAs working internationally and domestically(specifically in
medically underserved/rural areas) as I can, but am having obvious
difficulties establishing contact. If any of you would be willing to
participate in the survey (it's very short) or perhaps know of anyone
who would be willing to do this I would be indebted for life! Let me
know at your earliest convenience. Thanks so much for your time.

Sincerely,
Justin Thibeault

Hello everyone,

Sorry to take up space in your inboxes, but I was hoping some of you
might be able to help me. My name is Justin Thibeault and I am
currently a student in the PA program at the George Washington
University. I am contacting you regarding a study I am attempting to
undertake, with the hope of having it published. I am trying to survey
as many PAs working internationally and domestically(specifically in
medically underserved/rural areas) as I can, but am having obvious
difficulties establishing contact. If any of you would be willing to
participate in the survey (it's very short) or perhaps know of anyone
who would be willing to do this I would be indebted for life! Let me
know at your earliest convenience. Thanks so much for your time.

Sincerely,
Justin Thibeault

__________________________________________________
Do You Yahoo!?
Tired of spam? Yahoo! Mail has the best spam protection around
http://mail.yahoo.com

Hello everyone,

Sorry to take up space in your inboxes, but I was hoping some of you
might be able to help me. My name is Justin Thibeault and I am
currently a student in the PA program at the George Washington
University. I am contacting you regarding a study I am attempting to
undertake, with the hope of having it published. I am trying to survey
as many PAs working internationally and domestically(specifically in
medically underserved/rural areas) as I can, but am having obvious
difficulties establishing contact. If any of you would be willing to
participate in the survey (it's very short) or perhaps know of anyone
who would be willing to do this I would be indebted for life! Let me
know at your earliest convenience. Thanks so much for your time.

Sincerely,
Justin Thibeault

My cell isn't working today. And I don't have a landline. I went down
to a pay phone with my calling card, which was expired. I am sorry I
missed the call. I will FWD an email about the 501c3. Sorry
Harmony

Laura,

I am at Oklahoma Univeristy and we have 2 students going to Zambia this summer. 
If you are interested, I can get more information for you.  Just let me know.

Cameron

---- pnut3535 <dubendla@...> wrote:
> I attend PA school at Seton Hall University.  Currently, we are unable
> to do any rotations at sites outside of the sites that our school
> "contracts" with.  I know there are multiple people in our class that
> would be interested in doing some overseas work, so we were wondering
> how we could go about setting up something for us to do over the
> summer.  We would want this like a rotation, but wouldn't need to
> worry about credits or anything.  If anyone is going on a mission in
> july or august, and a few of us could go with you, that would be
> great.  Please let me know of any suggestions.
>
> Laura Dubendorfer
>

http://web.mac.com/stephentower/iWeb/Liberia/Let%27s%20Go%20Liberia%
20Introduction.html

Sorry...you cannot click on the link on my previous posting...it is
the longest address known to mankind!   You will need to copy BOTH
lines and paste and then, hopefully, the site will appear.
Thanks,
Cathy Youngstrom

My name is, obviously, Cathy Youngstrom.  I've been working as a PA
for 21 years; 12 in the ER and 10 in family practice.  I had a
unique opportunity to go to Liberia to work with a team of
orthopedic surgeons with the goal of teaching physicians internal
fixation techniques.  Please click on the link to see the work we
did and read my account of this venture..click on Cathy's Tale
http://web.mac.com/stephentower/iWeb/Liberia/Let%27s%20Go%20Liberia%
20Introduction.html

Dr. Robert Dennis is a surgeon who was born and raised in Liberia.
He was educated in the US and is a practicing plastic surgeon in the
DC area.  He has volunteered 2 years to the development and delivery
of healthcare in Liberia.  As "Cathy's Tale" relays, the state of
healthcare in Liberia is dreadful but it is a country of great
hope.  Under Dr. Dennis' direction the education of healthcare
providers is being reborn.  There is a very pressing need for
midlevel providers.  There currently is a PA program in Monrovia but
it  requires extensive revitalization.  I have offered to work with
Dr. Dennis to develop and implement a midlevel/PA/NP program with
the goal of providing regionally-appropriately trained healthcare
professionals.  Again, the needs are great but the contribution is
so vital.  I would appreciate your insight, ideas, resources and
support.  I think the PAGH is the perfect platform to the support of
our fellow PAs in a project of global importance.

I'm not sure even where to begin!  develop a committee?
Please forward this e-mail to any and all!  I hope for many replies.
my best to you and yours,
Cathy

Cathy Youngstrom
cyoungstrom@...
EarthLink Revolves Around You.

I went to PA school in Omaha, NE. we had lots of foriegn rotations.
they go during the summer also because the med students have off. the
contact person for international rotations is Sara Pirtle. her email is
sepirtle@.... you might want to email her about going to
guatemala. it is a spanish immersion for 3 weeks with a week of
medicine. good luck. carey

--- In PAGH@yahoogroups.com, "pnut3535" <dubendla@...> wrote:
>
> I attend PA school at Seton Hall University. Currently, we are unable
> to do any rotations at sites outside of the sites that our school
> "contracts" with. I know there are multiple people in our class that
> would be interested in doing some overseas work, so we were wondering
> how we could go about setting up something for us to do over the
> summer. We would want this like a rotation, but wouldn't need to
> worry about credits or anything. If anyone is going on a mission in
> july or august, and a few of us could go with you, that would be
> great. Please let me know of any suggestions.
>

> Laura Dubendorfer
>

I attend PA school at Seton Hall University. Currently, we are unable
to do any rotations at sites outside of the sites that our school
"contracts" with. I know there are multiple people in our class that
would be interested in doing some overseas work, so we were wondering
how we could go about setting up something for us to do over the
summer. We would want this like a rotation, but wouldn't need to
worry about credits or anything. If anyone is going on a mission in
july or august, and a few of us could go with you, that would be
great. Please let me know of any suggestions.

Laura Dubendorfer

I went to PA school in Omaha, NE. we had lots of foriegn rotations.
they go during the summer also because the med students have off. the
contact person for international rotations is Sara Pirtle. her email is
sepirtle@.... you might want to email her about going to
guatemala. it is a spanish immersion for 3 weeks with a week of
medicine. good luck. carey

--- In PAGH@yahoogroups.com, "pnut3535" <dubendla@...> wrote:
>
> I attend PA school at Seton Hall University.  Currently, we are unable
> to do any rotations at sites outside of the sites that our school
> "contracts" with.  I know there are multiple people in our class that
> would be interested in doing some overseas work, so we were wondering
> how we could go about setting up something for us to do over the
> summer.  We would want this like a rotation, but wouldn't need to
> worry about credits or anything.  If anyone is going on a mission in
> july or august, and a few of us could go with you, that would be
> great.  Please let me know of any suggestions.
>
> Laura Dubendorfer
>

I attend PA school at Seton Hall University.  Currently, we are unable
to do any rotations at sites outside of the sites that our school
"contracts" with.  I know there are multiple people in our class that
would be interested in doing some overseas work, so we were wondering
how we could go about setting up something for us to do over the
summer.  We would want this like a rotation, but wouldn't need to
worry about credits or anything.  If anyone is going on a mission in
july or august, and a few of us could go with you, that would be
great.  Please let me know of any suggestions.

Laura Dubendorfer

Hello,

   My name is Olivia Bockoff.  I'm a PA student at Saint Francis
University.  I am coordinating a mission to Dangriga, Belize for my
elective rotation.  The trip is scheduled for March 17-April 21, 2008.
  I am in need of licensed professionals to serve as preceptors during
our time there.  Belize mandates one licensed professional for every
four students.  Harmony has expressed interest in joining us for a
week or so and I have an MD who also has agreed to join us for a week.
  Would any of you be interested?  Please let me know.  I'm working
with an organization called peacework (www.peacework.org).

Olivia

KAISER PERMANENTE  is having there NATIONAL TRAVEL MEDICINE CONFERENCE.
It will take place on Friday and Saturday NOVEMBER 2 AND 3 at the Fairemont
hotel in Neport
beach california.
Everyone is invited to attend

WEB: kpsymposia.com

Contact:
Symposia Registrar - Physician Education
100 South Los robles suite 101
626-564-5338

I have attended the conference before and highly recommend it.

Cyril

KAISER PERMANENTE  is having there NATIONAL TRAVEL MEDICINE CONFERENCE.
It will take place on Friday and Saturday NOVEMBER 2 AND 3 at the Fairemont
hotel in Neport
beach california.
Everyone is invited to attend

WEB: kpsymposia.com

Contact:
Symposia Registrar - Physician Education
100 South Los robles suite 101
626-564-5338

I have attended the conference before and highly recommend it.

Cyril

Does anyone have a list of recipients, or know who to ask, so that we
have a complete list?
Bruce

Does anyone have a list of recipients, or know who to ask, so that we
have a complete list?
Bruce

Harmony,
is there anyway you could ask them if we could link our 2 web sites together. 
The more
link we have the more coverage.  I just sent an E mail to one of our local
organization
asking them the same questions
Cyril

--- In PAGH@yahoogroups.com, "Harmony" <hamster11996@...> wrote:
>
> I spent a month in Puerto Escondido Oaxaca Mexico. Oaxaca is the
> poorest state in Mexico. You can check out my trip blog
> http://harmsblogs.blogspot.com/ If you want to read more about Puerto
> and my experiences.
>
> CFHI Application Fee: $65
>
> Program Fee 2007/2008: $1935 + airfare but each site is different cost.
> CFHI has 12 rotation sites around the world.
>
> I recieved a grant from my school because I am spanish speaking so part
> of my trip was paid for.
>
> You fill out you application for whichever rotation you want and
> request a date and CFHI takes it from there. They are very organized
> and prepare you well for spending time abroad. The webiste is very
> helpful and has all the information about the rotations.
>

I spent a month in Puerto Escondido Oaxaca Mexico. Oaxaca is the
poorest state in Mexico. You can check out my trip blog
http://harmsblogs.blogspot.com/ If you want to read more about Puerto
and my experiences.

CFHI Application Fee: $65

Program Fee 2007/2008: $1935 + airfare but each site is different cost.
CFHI has 12 rotation sites around the world.

I recieved a grant from my school because I am spanish speaking so part
of my trip was paid for.

You fill out you application for whichever rotation you want and
request a date and CFHI takes it from there. They are very organized
and prepare you well for spending time abroad. The webiste is very
helpful and has all the information about the rotations.