Putting Patients First: Personal Experience from Phillips Neighborhood Clinic
By Jihyeon Karen Shin, Pharmacy Student P3, University of Minnesota College of Pharmacy
I almost lost a family member in an accident immediately after immigrating to America. Countless tubes and IV lines went in and out of my uncle’s fragile body while he laid quietly in a coma. For someone who couldn’t even distinguish ‘How are you?’ from ‘How old are you?’ verbal communication with the health care team was a lost cause. I still cannot explain how hopeless and desperate I felt decoding a written diagnosis with a dictionary due to the language barrier. No matter how impeccable the health care team or the service is, it carries no weight if it isn’t delivered properly in a patient-specific manner. As health care providers with such a vast pool of knowledge, do we fully understand the concept of patient-centered care? Where does cultural competency come into play? My family’s literacy and language barriers were not accounted for during my uncle’s hospitalization and I made a commitment during the nadir of my life to serving patients, guided by their values, needs, and preferences.
My childhood trauma and frustration at the lack of putting patient’s needs at the forefront propelled me toward pharmacy. It puts me in direct patient contact and with volunteer sites through which I can impact the lives of my patients from diverse backgrounds. I serve several leadership roles and a pharmcare clinician role at the Phillips Neighborhood Clinic, which is a student-run free clinic. As a pharmcare clinician, I work with a team of other health professional students and preceptors to make therapy decisions based on patient-specific needs and values. A major responsibility is to identify drug therapy problems by assessing safety, efficacy and patient adherence to treatment plans and dosing schedules. In order to maintain continuity of care, each patient seen at the clinic is also followed up via phone or in person regarding the chosen therapy.
An instance when my role as a pharmcare clinician impacted a patient was when I met a Korean immigrant patient who had been coming to the clinic for many months. Despite his monthly visits to the clinic, it had been my first time seeing him. While I translated for the care team of health professional students and preceptors, I found out he was on several medications, most of which he had no idea of their intended purpose or how to take. There I was, once again, in the midst of health care professionals with various areas of expertise delivering a message to the patient who smiled and nodded along despite the internal chaos due to the language barrier. Despite his attempt to come across as though he understood, I knew precisely what he really felt underneath his façade. This expression on his face was the expression on my father’s face when he was handed the written diagnosis 10 years ago. This time, though, I was part of the health care team and the patient. Rather than feeling hopeless as I once felt, I stood strong by my patient and translated every detail. To someone who speaks perfect English, a team of healthcare providers may feel like the freeway to recovery. To my younger self or my patient who did not speak English, this same group of people is intimidating pairs of eyes scrutinizing the way words are pronounced funny or how a nod rather than an answer accompanies a question. That night, I advocated for my patient as part of the care team and made changes to his medication list. I sat with him and went through each medication to explain the use and potential side effects that can occur. I will never forget the way he looked me in the eye and said thank you.
It doesn’t take much to show you care for your patients. However, it takes time and interest in a patient to learn about the person-specific needs and values. This Korean patient and many others I see while volunteering give value to what I do and what I aspire to do as a future pharmacist. I have seen the impact my small action had in getting to know my patient’s story and what that advocacy meant to him. I came into pharmacy to help patients from feeling unheard and having unmet needs because I know how that feels. It’s truly a privilege to be part of this community and develop strong therapeutic relationships the way health care should be.