What is Good Health Care?


What does a good health care experience look like? If you brought a good care checklist with you every time you went to the doctor, what would be on that list? Here is our list. We welcome feedback and further additions.

General
LGBTQ
Drugs & alcohol
Mental health
Gynecology
Obstetrics
People with disabilities
Survivors of abuse
Youth
Body Size
Immigrants

General:

  1. Did the practitioner agree to an informational first visit?
  2. Did the practice have an answering service? Were after-hours/emergency calls to the answering service returned promptly?
  3. Was the information that you needed provided in an accessible way (understandable, literacy, braille, …)
  4. Did the provider speak to you on your level (i.e. sitting, face-to-face)?
  5. Did you feel respected? / did they respect your requests?
  6. Did you feel the practitioner treated you as an expert in your health and was willing to listen and learn from you?
  7. Was the practitioner willing to be contacted outside of your appointment – and in various mediums (i.e. phone, email)?
  8. Did the practitioner deal with you as a complete whole person – recognizing the multiple facets of your health and life?
  9. Did you feel that the provider genuinely cared about your well-being?
  10. Could you opt out of answering questions that felt too personal or irrelevant?
  11. Did it feel like you were having an actual conversation with the provider (i.e. provider actively listened)?
  12. Did you feel comfortable? / did they check in with you about your comfort level throughout the visit?
  13. Would you recommend this practitioner to others in your similar situation to yourself?
  14. Did you feel the staff was warm and welcoming?
  15. How did the practitioner treat your appointment companion if you had one?
  16. Did the provider explicitly ask for your consent on any procedure or plan of action?
  17. Did the provider’s/clinic’s intake forms give you options that spoke to your experience/body?
  18. Did you feel that the provider/staff valued your time?
  19. If you decided not to take their advice, how did they react?
  20. Did they offer other opinions or resources?
  21. How willing did you feel the practitioner was to answer your questions?
  22. Did the practitioner ask what would make an appointment ideal and responded to those requests?
  23. Did you feel validated by the practitioner?

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LGBTQ:

  1. Did the provider ask you about relevant sexual history without assuming sexual history/practices?
  2. Did provider demonstrate knowledge of/comfort with LGBTQ issues/terms? (i.e. using words like “partner”, asking pronoun/name preference, etc.)
  3. Did you have to spend more time than you wanted to educating/explaining things to your provider? (about your body, your gender, your community)
  4. Does provider suggest HIV/STD testing for everyone? (ex. not just gay men)*
  5. Did provider respect pronoun/name preference and/or body part reference throughout once you made your preference clear and throughout your time together?
  6. Were there visual clues that the practice was queer-friendly? (Queer-specific health brochures, posted non-discrimination policy, queer symbols/stickers, etc.)
  7. Were the intake forms inclusive?
  8. Did the practice have gender-neutral, single-occupancy restrooms?

*Sometimes this is a matter of funding for HIV prevention.. sometimes community clinics are only funded to test the most “at-risk” populations such as sex workers and MSM
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Drugs/Alcohol:

  1. Did the doctor’s office provide information about drug/alcohol addiction and local meeting times?
  2. Did the provider ask you about your drug/alcohol use (current and past)? Did you feel comfortable answering honestly without feeling judged?
  3. Did the provider ask your preference about medications/treatments (i.e. if history of prescrip. pill abuse)?

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Mental Health:

  1. Did provider ask about current/past psychiatric treatment/diagnoses?
  2. Did you feel comfortable answering honestly?
  3. During primary care visits, did the provider ask questions regarding mental health and follow-up during the next visit?
  4. Did provider speak to you in a way that validated your feelings (i.e. “it sounds like you are under a lot of stress”)?
  5. Did the provider help you explore variety of ways to treat mental health issues? (i.e. not just writing a prescription)

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Gynecology:

  1. Did the provider do most talking while you were clothed?
  2. Was the provider conscious of keeping you covered during exams?
  3. Did the provider give a verbal warning or a warning touch on your leg before inserting the speculum or touching your genital area?
  4. Did the provider talk about contraception and reproductive choice in a way that empowered you to choose whatever works best for you and your life?
  5. Did the provider have an empowering approach to menopause?
  6. Did the provider ask you especially before the speculum or internal exam if there’s anything they should know to make the experience better for you?
  7. Did the provider have the sheet positioned in a way so that they could see you and communicate with you while you were in the stirrups?
  8. Did the provider expose just one breast at a time when doing the breast exam?
  9. Did the provider teach you to do self breast exams if you didn’t already know how to do them?

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Obstetrics:

  1. Did the provider include your partner well if he or she was present?
  2. Did the provider provide birthing/labor options you asked for – e.g. balls, stools,…?
  3. Was the provider able to be very present during birth, or to fade into the background, as needed? (Balanced presence in room)
  4. Did the provider provide good info and print material related to birth preparation, emergencies, what to expect etc.?
  5. Did the provider anticipate needs during delivery and check in with mom about needs as related friends or family in the room?
  6. Did the provider treat you as though they trusted your abilities and opinions?
  7. Did the provider support your choice about whether to breastfeed or bottle feed?

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People with Disabilities:

  1. Did the practitioner have experience dealing with your disability? Did other doctors in the practice?
  2. Did you feel the practitioner speak to you or past you to your family/care takers?
  3. Do you feel you received age-appropriate tests and treatment? How willing did you feel the practitioner was to answer your questions?
  4. Did the practitioner check in about where you prefer to be tested for blood, pressure, etc., and did they ask what your pain level was?
  5. Did they ask what your pain level was?
  6. Did the practitioner ask about your possible triggers?
  7. Did they respond to requests to change things because of triggers/cues (i.e. not wearing a lab coat)?
  8. Did the practitioner ask what would make an appointment ideal and responded to those requests?
  9. Was the office space set up to be easily maneuvered by you? By someone in a wheel chair?
  10. Did the examining room have accessible exam tables?
  11. Did it have other accessible equipment you need? Please list.

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Survivors of Abuse:

  1. Did the practitioner ask about your history of abuse?
  2. Did you feel validated by the practitioner?
  3. Did you feel they were sensitive in their language?
  4. Did the practitioner check in with you about what your triggers/cues may be?

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Youth:

    1. Questions TBD

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Body Size (includes both good health care markers and causes for concern):

  1. Do they insist on weighing you?
  2. Do they consider seriously and address the medical causes and concerns you bring to them that are not related to your size?
  3. Is there a variety of sizes of robes, chairs, blood-pressure cuffs, and other equipment available?
  4. Do they withhold treatment until a condition of weight loss is met?
  5. Do you experience unwanted pressure related to weight loss surgery?
  6. Will BMI be used to determine diagnoses or treatments?
  7. Would your diagnosis or treatment be recommended to a thin person?

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Immigrants:

The US healthcare system can be a very new and different experience than the healthcare system in your home country.  It’s important to feel comfortable with your doctor—here are some questions to help make sure you feel comfortable:

      1. Did the provider offer/provide you with a trained interpreter?  Note: Federal mandate (Title VI of the Civil Rights Act of 1964) require health care facilities receiving federal funds (such as accepting Medical Assistance) to offer language assistance or interpreting services free of charge.   It is a violation of federal mandate to use children (such as sons or daughters of patients under 18) as an interpreter. Source: http://www.dhs.state.pa.us/foradults/healthcaremedicalassistance/limitedenglishproficiencyinterpreterservicesformedicalappointments/index.htm
      2. Was the provider welcoming to you?
      3. Was the provider open to working with you without asking about your immigration status?
      4. Did the provider take time to obtain a thorough medical history from your home country?
      5. Was the provider respectful of your culture, values, and beliefs?
      6. Did the provider explain medical terms to you in clear, easy to understand language?
      7. Did the provider ask you if you had any questions?  Did the provider make you feel comfortable to ask questions?  Did the provider answer your questions respectfully?
      8. Did the provider provide follow-up instructions that were clear and easy to understand?

Here is a really good resource re: best practices/recommendations for medical providers: Immigrant Health Recommendations from the A Call to Action. Minnesota Immigrant Health Task Force, January 2005 http://www.health.state.mn.us/divs/idepc/refugee/topics/immhealthrpt.pdf

Good Providers in Pittsburgh for immigrants:

      1. Squirrel Hill Health Center: Physical, behavioral, and dental health services with interpretation provided—either by phone or from one of the many bilingual staff members (Nepali, Spanish, Arabic, Hebrew).  Sliding Scale services available for uninsured individuals
      2. Birmingham Free Clinic: Saturday clinic is staffed with volunteer Spanish interpretors.
      3. Salud Para Ninos Program @ Birmingham Free Clinic: Free Bilingual Pediatric Primary Care and Immunizations Clinic: Every second Saturday of the month at the Birmingham Clinic in the South Side (appointment and health insurance are NOT required), 54 S. 9th Street Pittsburgh, PA
      4. Midwife Center “Con Mujeres” Program: Walk-in program every first Friday of the month from 1:00-4:30pm for Spanish-speaking women who experience financial and other barriers to quality well-woman care. Women who seek care through Con Mujeres receive a thorough exam by a Spanish-speaking certified nurse-midwife and receive help from our Spanish translator and Spanish-speaking front office staff for help with filling out paperwork and getting referrals.
      5. UPMC facilities: Have access to phone interpreters through the “Blue Phones”, UPMC’s financial assistance programs are open to non-citizens.

If you are an immigrant in Allegheny County and would like assistance connecting to medical care, you can call the Immigrant Services and Connections Program multi-lingual phone line to request assistance: 412-742-4200 or email isac@jfcspgh.org

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