February 9, 2015
By Margie Coloian
“Patients need to trust their doctor,” insists America Bracho, MD. “Without trust, the level of influence that a provider has is limited.” Bracho believes that good doctor-patient relationships promote healthy lifestyles, the basic foundation for good health. Many medical conditions are often linked to unhealthy lifestyles—like poor nutrition and lack of physical activity.
At the same time, many unhealthy lifestyles are linked to socio-economic determinants and the policy decisions surrounding income, housing, open spaces and more. Providers who have good relationships with their patients may have a chance to influence their decision-making. Good relationships, therefore, are keys to good health.
But many physicians today are employees of healthcare institutions that focus too heavily on their bottom lines and not so much on fostering these relationships. As a result, clinicians are tied to tight appointment schedules and rigid adherence to protocols.
“Our healthcare system is too expensive. It’s too confusing. And patients don’t have the navigation for it,” she says. There are many segments of the system that need a do-over, according to Bracho.
Bracho, who heads Latino Health Access, worries that healthcare—even for those with coverage—remains unaffordable, given the new co-pays and deductibles. In California, nearly one-quarter of Latinos are uninsured, a year after the implementation of Obamacare. “When someone earns $400 a week, it’s hard to buy (or contribute to) health insurance,” she says, and many plans don’t cover prescriptions. Families must often choose between the high cost of drugs and buying groceries and paying for utilities. Too many patients, insured or uninsured, forgo going to the doctor at all.
The World Health Organization defines health as a state of physical, mental, spiritual and social wellness and not just the lack of disease. “Unfortunately, health continues to be just the lack of diseases or disease management. We rely on very expensive providers and drugs and very little on prevention and the many factors that influence health and wellness,” Bracho says.
“Some people blame the sick for not eating more fruits and vegetables to stay healthy. But there needs to be a grocery selling fruits and vegetables where people live. Fruits and vegetables cost more, and you need more money to buy them. So there are circumstances in one’s life that do not allow people to make the right choices.”
In her view, addressing some of the most pressing social determinants of health, like “food deserts,” may prevent illnesses from taking hold in the first place. Bracho underscores the alarming statistics from the newly issued findings from the Report on the Conditions of Children in Orange County. The County is considered a somewhat affluent region, although pockets of the population do not enjoy prosperity. Child poverty (percent of students receiving free and reduced lunches), for example, has increased from 39 percent about 10 years ago to 50 percent today. Over the same period, the number of homeless school children rose from close to 4,000 to 30,500 today. She asks: In a country so rich, in a region so wealthy, how can this be?
Bracho is a keynote speaker at the third annual Lown Institute Conference, Road to RightCare: Engage, Organize, Transform, March 8-11 at the Omni San Diego Hotel. She is looking forward to speaking and hearing others.
“When like-minded people get together, they share ideas that will energize our leadership. They can propose ideas that are different, and they will collaborate. Something good will happen.”
Hear more from Bracho at the meeting. If you have not registered yet, do so today. Seating is limited, and registration closes soon.