YesCare
3 Jun 2024
When Dr. Gregory Ladele, YesCare’s Chief Medical Officer, began working in medicine approximately two decades ago, he placed cultural humility at the foreground. It’s a staple element of his medical practice, and also is interwoven throughout his preferred leadership style.
“Cultural humility is one of the most crucial traits that a great provider should encompass,” he says. “Especially providers in the correctional sector, to cultivate better experiences with their patients.”
The concept of “cultural humility” was developed in 1998 by Melanie Tervalon and Jann Murray-Garcia, pediatricians and public health practitioners, to address existing inequities in the healthcare field. In the context of healthcare, cultural humility is a framework through which care providers seek a deeper understanding of a patient’s culture and viewpoint while simultaneously examining and questioning their own internalized biases and beliefs about that patient, regarding their background. It differs from the better-known concept of “cultural competency” in its two-sidedness — cultural competency also seeks understanding of the patient’s background but does not require the care provider to examine his or her own beliefs and biases.
“Cultural humility allows one to utilize emotional intelligence while also employing empathy for individuals who may not have the same cultural beliefs that I do regarding medicine. There’s no place for ‘morality rants,’ or the belief that just because somebody is incarcerated, they’re undeserving of care. That is not our job,” Ladele says.
“In making the transition from community practice into correctional healthcare, I have found that many people view incarcerated patients as ‘undeserving.’ In reality, these patients represent a significant sub-population of the ‘underserved.’ Some of them were not previously able to access healthcare, or didn’t receive a great start with care as children. As the CDC suggests, justice-involvement also leads to family and community instability: Adverse childhood events affect 1 in 28 children who have an incarcerated caregiver.”
The field of correctional healthcare is rife with these sorts of dichotomies. Providing healthcare to inmates presents unique challenges, but also unique opportunities. Correctional healthcare professionals are often able to provide life-transforming change to patients who previously were medically unserved or underserved.
While the majority of the incarcerated population is healthy, about 20% of the population have serious and/or chronic conditions. For many inmates, being in the correctional system represents the first time in their lives they have had access to consistent medical care. Those with previously undiagnosed conditions are more likely to be at a more advanced stage of their condition than people who have received routine medical care and screenings, requiring more serious therapeutic interventions on the front end. But providing follow-up care and monitoring is easier, in some ways.
“As an example, preventative care is key in detecting asymptomatic presentations of disease, commonly seen in the population we serve,” Ladele says. “However, it feels great to provide resources such as CT scans for lung cancer screening, or using mobile units to perform onsite mammograms to assist in screening for breast cancer, which represent the top two cancers diagnosed in the U.S. This kind of preventative care starts with our use of cultural humility to better understand the risk factors of our patients, not just to detect disease, but also to provide earlier interventions that will give our patients more time to live longer and healthier lives.”