I had an experience today that I had to share and how what I learned there could improve your patient care.
I was filling out an anonymous research survey I had been sent as an APTA member to help out some poor students. I always answer those if I catch them in my inbox in time and pass them along to coworkers that aren’t APTA members too. I do that because I was a poor student on the other end of a research project many moons ago, begging everyone I knew to participate to get my P at a significant level. Anyway, the first questions were pretty standard questions: gender, race, age and then since it was PT related, what degrees, licensures, certifications I hold. But what struck me was the race question. It asked, “Race: (Select all that apply.)” And then the usual categories.
Select ALL that apply.
Cue the choir of angels!
A little personal background: I was brought up in a white community, so culturally, I identify as white and physically can pass as so, if no one looks too hard. So I usually pick “white” on those race questions. BUT when I do so, I feel like I’m committing an act of treason by not publically recognizing the other races that make up my ethnic background– Latina, American Indian (Choctaw tribe). Although I didn’t grow up in those cultures, they are an inherent part of my being. As an adult, I have sought out to learn about and live amongst those cultures and have integrated them into my own identity. So when I am forced by most race questions to pick just one, its like being asked to cut off my legs and continue on as if everything is perfectly normal, thank-you-very-much.Today was the first time on a form like that I was invited to recognize EVERYTHING I am. And it felt good. Real good. I feel the people on the other side of that form recognized all of me and not just a convenience piece.
So, how does this apply to therapy?
Your intake forms. They are often the first thing your patients see of you, and giving them the freedom to just be themselves, EVERYTHING they are, not only makes you look like an enlightened individual; I guarantee it will also make your patients more comfortable with you as you ask them a bazillion detailed questions in your evaluation.
It’s not just the race question, like for me. The gender question has become an angst filled question too. Remember this article from PT in Motion earlier this year? It suggested having 2 questions instead of just asking “gender? Male or Female” Instead ask, “What was your gender assigned at birth?” and, “What is your current gender identity?” Another place in the article suggests asking the person who indicates that the answers to those questions are different (transgender) what their preferred pronoun is, so you’re not referring to them as “it.” Some people I know aren’t comfortable going there. (I live in Podunk Nowhere, Capital of Conservatism… I KNOW.) But knowing this information is important like the article states, “‘If someone who identifies as a woman comes in reporting hip pain and I don’t know that she is biologically male, I’m not going to screen for something like prostate cancer,’ [Daniela] Mead explains, ‘because that’s not going to be on my radar.'” Not knowing these things may hinder your treatment and you may be unknowingly putting your patients’ life at risk.
Then there are the words themselves. Consider that the majority of Americans read at a second grade level. Your form questions shouldn’t be too difficult or long winded. There are also plenty of people who have poor eye sight and others that are simply illiterate. I have plenty of patients that are not quite all there cognitively too. To cover these, please instruct your front desk staff to state with each patient, “Let me know if you need help filling it out,” and to really mean it. Then if the patient is taking a little extra time to fill it out, ask if they’re getting along ok. Maybe they need help, maybe they’re just an over analyzer like me. How about those other races in your town. Perhaps English isn’t their first language. Do you have forms in the most widely spoken languages in your area? Many immigrants can converse perfectly well in English, but never learned to read it. Or I get a lot that feel more comfortable speaking Spanish, as that’s what they speak at home, but they attended school on this side, so they prefer to read English.
Take a look at your forms. Make sure they are as open ended and inclusive as you can make them.