I have always been passionate about traveling and learning about different cultures.
I would like to describe how my potential future role is going to contribute to overcoming societal influence that is often a source of challenges for healthcare providers in terms of establishing healthy behaviors. The role I envision for myself is a health services administrator (HSA) at a healthcare facility. An HSA is involved in hospital bureaucracy daily since the main responsibility of such a professional is overseeing the facility’s administrative operations. However, this post is going to focus on another key aspect of an HSA’s professional tasks, which is hiring and training new staff, as well as supervising general personnel.
My passion has always been travel as it is the most exciting way to learn about new cultures first-hand. In healthcare, cultural competence is essential to ensure that all individuals receive the highest quality of care possible (Henderson, Horne, Hills, & Kendall, 2018). According to Lin, Lee, and Huang (2016), cultural competence is “the ability to acknowledge, appreciate, and respect the values, preferences, and expressed needs of clients” (p. 174). Young and Guo (2020) emphasize that diversity training is a determinant of positive changes in healthcare. Abrishami (2018) points out that culturally competent staff is crucial to battle disparities in the delivery of care. Like an HSA, I will collaborate with clinicians to make changes in the facility’s organizational culture (Beidas et al., 2018). At first, I will have to gain experience in staff training and then apply for the position of administrator.
It is important to acknowledge that the student has managed to share a lot about their experience working in the military. However, the post lacked a concise explanation of how a current or future role would battle societal and structural influences. Instead, the student thoroughly described their military career. I would suggest shifting the focus and talking more about their current position as healthcare administrators. Surely, as administrators, they have to collaborate with colleagues to make changes in organizational culture and deliver the highest quality of care possible (Beidas et al., 2018; Henderson et al., 2018). The post could benefit from an in-depth discussion of the ways a healthcare administrator can address social influences on risk behavior in their practice (Bartel et al., 2020). In addition, there was no discussion about the tasks the student had to undertake or the link between their job and passion.
The purpose of the gatekeeper system in healthcare is to ensure that primary care physicians are a patient’s first point of contact with the medical facility. After seeing a general practitioner, the patient gets referred to secondary care and non-emergency medical specialists. Velasco Garrido, Zentner, and Busse (2011) point out that “one of the features of primary care-based health systems is the requirement to visit a generalist – acting as gatekeeper and coordinator of care – before accessing further specialty care” (p. 28). Thus, a primary care physician is responsible for assessing the patient’s condition, which makes coordination of care much faster. The gatekeeper system contributes to the cost-efficient allocation of resources as a result of avoiding unnecessary medical interventions.
Gatekeeping achieves its purpose and ensures that primary care physicians coordinate referrals and follow-up interventions. A cross-sectional study by Li et al. (2017) indicates that the gatekeeper model makes medical care more accessible, reduces inappropriate resource utilization, and promotes primary care institutions. Despite that, it is crucial to acknowledge the imperfections that the model possesses. Firstly, gatekeeping negatively affects consistency and continuity of care, according to Liang et al. (2019). Secondly, unconscious bias may result in restricted access to specialty care for ethnic minorities and vulnerable socioeconomic groups (Drewniak, Krones, & Wild, 2017). To ensure none of this happens, hospitals need to invest in primary care systems being more flexible (Rotar, Van Den Berg, Schäfer, Kringos, & Klazinga, 2018). They also have to develop appropriate primary care training for new employees.
The student manages to articulate the purpose of gatekeeping and thoroughly explains what the process looks like in practice. The student admits that it is evident that the gatekeeper system leads to time- and cost-efficient care, which is beneficial for both patients and doctors. Liang et al. (2019) argue that gatekeeping has various positive effects on the quality and coordination of primary care. However, the strongest part of the post is a discussion of the model’s imperfections. I agree that it is crucial to have a secondary system of care to ensure that patients can express their concerns to multiple medical professionals (Rotar et al., 2018). However, the problem is not the lack of a secondary system (it already exists) but the fact that the gatekeeper model is inflexible (Drewniak et al., 2017). It gives patients no opportunity to seek specialty care without the approval of a general practitioner.
References
Abrishami, D. (2018). The need for cultural competency in health care. Radiologic Technology, 89(5), 441−448.
Bartel, S. J., Sherry, S. B., Smith, M. M., Glowacka, M., Speth, T. A., & Stewart, S. H. (2020). Social influences on binge drinking in emerging adults: Which social network members matter most? Substance Abuse, 41(4), 480−484. Web.
Beidas, R. S., Williams, N. J., Green, P. D., Aarons, G. A., Becker-Haimes, E. M., Evans, A. C., … Marcus, S. C. (2018). Concordance between administrator and clinician ratings of organizational culture and climate. Administration and Policy in Mental Health and Mental Health Services Research, 45(1), 142−151. Web.
Drewniak, D., Krones, T., & Wild, V. (2017). Do attitudes and behavior of health care professionals exacerbate health care disparities among immigrant and ethnic minority groups? An integrative literature review. International Journal of Nursing Studies, 70, 89−98. Web.
Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community, 26(4), 590−603. Web.
Liang, C., Mei, J., Liang, Y., Hu, R., Li, L., & Kuang, L. (2019). The effects of gatekeeping on the quality of primary care in Guangdong Province, China: A cross-sectional study using primary care assessment tool-adult edition. BMC Family Practice, 20(1), 93. Web.
Lin, C.-J., Lee, C.-K., & Huang, M.-C. (2016). Cultural competence of healthcare providers. Journal of Nursing Research, 25(3), 174−186. Web.
Li, W., Gan, Y., Dong, X., Zhou, Y., Cao, S., Kkandawire, N., … Lu, Z. (2017). Gatekeeping and the utilization of community health services in Shenzhen, China. Medicine, 96(38), e7719. Web.
Rotar, A. M., Van Den Berg, M. J., Schäfer, W., Kringos, D. S., & Klazinga, N. S. (2018). Shared decision making between patient and GP about referrals from primary care: Does gatekeeping make a difference? PLOS ONE, 13(6), e0198729. Web.
Velasco Garrido, M., Zentner, A., & Busse, R. (2011). The effects of gatekeeping: A systematic review of the literature. Scandinavian Journal of Primary Health Care, 29(1), 28−38. Web.
Young, S., & Guo, K. L. (2020). Cultural diversity training: The necessity of cultural competence for health care providers and in nursing practice. The Health Care Manager, 39(2), 100−108. Web.