Asterix
Dr. JudyAnn Bigby

I see patients part-time. I only spend two mornings a week seeing patients. And with all my other responsibilities, I keep doing that because my patients are the ones who inspire me. I see mostly women. I have a lot of women of color, who may not be that well off, and you know, they are really incredible people. They have a lot of adversity in their lives—they are very ill, many of them, but they have so much positive that they think about their lives. So that's one thing that keeps me going and inspires me. One of the things that I am trying to do is to try to get physicians to see things from the patient's perspective. Not just how it feels to have a heart attack, or breast cancer, or something like that. But also how the circumstances of a patient's life impacts everything that happens to them, from the moment they walk into a health care facility. It may determine how comfortable they feel speaking to the secretary. It may determine how comfortable they feel asking a doctor a question. It may impact how comfortable they feel accepting instructions or advice from a doctor. They may decide that because of a past experience, or a family member's experience, that they aren't going to trust that doctor and not follow the advice. In our study, where we were trying to find out what types of things contribute to dissatisfaction with doctors by women of color—Black and Latina women—we found that both doctors and patients make assumptions about each other. The women seemed more aware that they were making the assumptions; they felt that race was a very important issue in the way that they built their assumptions. The doctors did not feel that they were making assumptions based on race, but on other issues. But in the end, what happens is, because of these assumptions, when the two individuals are communicating, they're not communicating about it the same way. Their assumptions are different. It definitely colors the way they interact with the other person. And I think that one of the things that needs to happen is people need to be able to recognize their assumptions and talk about them, so that people can get on the same page when they're communicating. For those people who are worried that healthcare is such a negative field now—because of managed care, or not being paid enough money, or having a lot of pressure to see more patients—I think that we need people to go into medicine who will turn around and say, "Well, if this is not the right way to do it, if this is not best for the patients, then we have to change." And we need more people like that.