Inclusion in Health Care

I’ve written about the important of inclusivity in a health care setting in the past but the demand for health care workers to actively work to be more inclusive has increased significantly over the last two years, or at least our awareness of it has. As we become more and more aware of the impact of a less than inclusive model of health care on certain groups of patients, it becomes apparent that it can actually be a matter of life or death for some of these folks and thus requires our urgent attention. This is especially relevant for racialized, Black, and Indigenous peoples, those at the lower end of the socioeconomic gradient, women and gender-diverse people, people with disabilities, and other equity-seeking communities. As I build my own small practice in Fernie, I am trying to do my own work to ensure that every aspect of my practice is inclusive but it truly is work. It takes more than just a passive interest in creating an inclusive space and experience for your patients. It takes intention, time, creativity, and a commitment to revisiting your website, forms, office space, etc. and make any necessary changes. It takes advocating for your patients when they are being mistreated. It takes checking your own biases (we all have them) by constantly doing the inner work to see where they may lie.

In an effort to ensure that my approach to creating an inclusive clinic and experience for my patients, I have put together a comprehensive list of items to work through that I plan to review quarterly to create the best and most importantly, safest, experience for them. I encourage everyone to work through this list (or something similar) whether or not they work in healthcare, but it is especially important if you do.

It All Starts With You
What are your biases? What current practices do you currently have that discriminate against marginalized communities such as those listed above? Education is fundamental, beginning with completing coursework in cultural competence, anti-racism, and anti-discrimination. Learn about the different populations you expect to see in your community and in your clinic and find out what may make their health care concerns and experiences different.

Clinic Space and Marketing
Go over every aspect of your clinic materials, including intake forms, website, clinic space, and brochures/information sheets. Do they make everyone feel welcome and included? Is there any terminology that may be considered exclusive? If so, update them and keep doing so as your awareness evolves. Is your staff diverse? Have an awareness of who you are giving job opportunities to, particularly if you are a larger organization.

Do marginalized groups feel welcome by your clinic? Is it apparent on your website or in other marketing information that you welcome diverse populations and have a special interest in working with ALL people? Does everyone have access to your care? Do some outreach to local Indigenous communities and organizations that represent people targeted by non-inclusive clinics and health care and listen to what they say they need and let them know what you have to offer their community.

Give everyone who sets foot in your clinic space an opportunity to provide feedback by way of a structured feedback form. Include specific questions about all aspects of your care and their experience, including diversity and inclusivity.

Institutional Diversity/Inclusivity
In health care we are often using standardized forms and documents and receive results in a pre-set format. It is our responsibility as practitioners to challenge the creators of these documents and forms and hold them accountable when it comes to using inclusive terms and ensuring that all aspects of the forms are applicable to any and all people. It may be helpful to look back further at your school or wherever you received your training. Examine your coursework and syllabi if you have them and provide feedback about potential areas of improvement.

As we are flooded with information about how marginalized groups are receiving inadequate care in many sectors of health care, it is our responsibility as health care providers to not only ensure that we are not contributing to the problem but actively working to resolve it. EVERYONE should have access to the fundamentals of good health, including access to clean water, healthy food, shelter, and health care. None of this has to be done overnight, but start now with some education. Find an online course or seminar. Read a book. Think about one thing that you can do this month to create a more inclusive environment for your patients or even for the people in your life.