Eliminating Disparities in Breast Cancer | Tips for Navigating Inequities

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Eliminating Disparities in Breast Cancer: Tips for Navigating Inequities from Patient Empowerment Network on Vimeo. 

How can breast cancer patients and healthcare providers advocate for underrepresented  patients? Expert Dr. Demetria Smith-Graziani discusses how some providers are working to reduce care disparities and shares patient advice to help ensure optimal care.

Demetria Smith-Graziani, MD, MPH is an Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Learn more about Dr. Smith-Graziani.

[ACT]IVATION TIP

“…get your list of questions together about your concerns about your diagnosis and your treatment, and if you are feeling like you’re not heard, look for other doctors to talk to to get a second opinion.”

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Transcript:

Lisa Hatfield:

What are some of the actions being taken to combat or eliminate disparities in breast cancer? How can those in marginalized communities best advocate for themselves?

Dr. Demetria Smith-Graziani:

That’s a great question, and I want to start by saying that the true burden should be on healthcare providers of those within the healthcare system to reduce and eliminate disparities in breast cancer, because patients already have enough to deal with and are receiving discrimination and structural racism from society at large and within the healthcare system. So for providers, it’s important for us to really take a good hard look at our practices with patients, think about the way that we are relating to patients, are we making any assumptions about treatments our patients may or may not want, or may or may not be a candidate for. Are we making those assumptions based on something not related to factual data, like their breast cancer itself or other health problems they have, are we making those assumptions based on their insurance status, based on where they live, based on other social factors like race.

It’s important for us to really reflect on that and think about how we can be more equitable in the way that we deliver our care. It’s also important for us to advocate for our patients to make sure that they are receiving the treatment that they need, and sometimes that means advocating to their insurance company, advocating to our health system, our health care employers advocating to the government to make sure that our patients are all receiving high-quality care no matter where they are, and no matter who they are, now, knowing that we live in this unjust society, what can patients do to navigate these disparities and these inequities.

I think it’s important for patients to be as informed as possible to make sure that they are getting all of their questions answered by their doctor, and if you don’t feel like your questions are getting answered, if you don’t feel like your concerns are being appropriately addressed or acknowledged, please make sure that you get a second or a third opinion and talk to another doctor to see if they can answer your questions.

No oncologist is going to be upset with you getting more information from another oncologist about your treatment options, and it’s important for you to pick the doctor that you are comfortable with, that you have a good relationship with and that you feel like you can speak to honestly, and that will give you honest answers, so my activation tip for patients is to get your list of questions together about your concerns about your diagnosis and your treatment, and if you are feeling like you’re not heard, look for other doctors to talk to to get a second opinion. 

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Will Telemedicine Be an Equalizer for Patients Experiencing Bias?

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Will Telemedicine Be an Equalizer for Patients Experiencing Bias? from Patient Empowerment Network on Vimeo.

Some breast cancer patients may experience in-person bias during visits. Expert Dr. Regina Hampton from Luminis Health Doctors Community Hospital explains her perspective on situations when telemedicine can provide benefit to the patient experience.  

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Transcript:

Dr. Regina Hampton:

Yeah, I think it takes away that, that in-person bias that that providers may have, you can kind of put on whatever you want and put on your face, and then I think that gives some providers just a different view of who that person is without looking at them in-person. And creating that judgment that we all do, we all do it, and that’s just a part of human nature. But I think it’s great for those patients who…I have a lot of patients who are caregivers where they’re caring for their elderly patient, and they can’t leave that patient alone. Well, they can continue to do their doctor’s visit provided they don’t need a physical exam and be able to keep that. It may be helpful for that patient who is stuck at home, it allows them that access. So I think it does help to decrease the barriers, especially for patients who may live in a rural area, who may not be able to travel back and forth to the big city to see their doctor, and being able to jump on a telemedicine visit to be able to get their concerns heard, and then they can figure out if they need an in-person visit, so I think it’s just going to open up the world. 

I think it will give those patients more access, and hopefully it will help to just break down some of these barriers that we see as we move forward. 

Is Telemedicine an Advantage for Low-Risk Breast Cancer Patients?

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Is Telemedicine an Advantage for Low-Risk Breast Cancer Patients? from Patient Empowerment Network on Vimeo.

 For low-risk breast cancer patients, is telemedicine an advantage? Expert Dr. Regina Hampton from Luminis Health Doctors Community Hospital shares her views on when telemedicine makes sense for low-risk patients and the benefits she’s seen for patients’ quality of life.

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Transcript:

Dr. Regina Hampton:

I think it helps to eliminate a lot of those in-person visits, which then means they can enjoy life. We want them to enjoy life after surviving their breast cancer diagnosis and treatment. So maybe they’re doing their televisit while they’re on vacation or while they’re out of the state, visiting with relatives. So it really allows them to be able to stay in tune and in touch with their healthcare providers, stay on top of their visits, but allow them the flexibility to continue to live life. I often tell patients, “Look, after we’ve treated you, we don’t want you in our offices all the time. We want you out there living life.” And if we can make that easier by doing a quick tele visit, especially if there’s not something serious going on, then I think that’s a great advantage. And I think as we move deeper and deeper into the telemedicine world, I think patients are going to appreciate that, and they’re going to actually demand it and say, “Well, you know, I’m doing fine, I just need you to look at my mammogram and us to have a quick discussion while on a cruise or while I’m on the beach in Hawaii enjoying some time with my family.” So, I think it’s opened up a new world, and it’s just going to get better and more easy, and I think patients are going to shift their brains to say, “You know, if I don’t have to be in an office somewhere, I’d rather be on a video or a phone visit.

Which Breast Cancer Patients Benefit Most From Telemedicine Visits?

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Which Breast Cancer Patients Benefit Most From Telemedicine Visits? from Patient Empowerment Network on Vimeo.

Dr. Regina Hampton  from Luminis Health Doctors Community Hospital provides her perspective on care situations when patients can benefit the most from telemedicine – and when in-person visits can provide an advantage.

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Transcript:

Dr. Regina Hampton:

So, I think when we look at new patients, newly diagnosed, I think an in-person visit is certainly advantageous, I think people certainly want to meet their doctor in-person, what I found personally is after that initial visit, then we’ll convert the rest of the visits by telemedicine. As the patient is willing, if they want to come in, I’m happy to have them come in, where I think it’s really beneficial is in survivorship after the patient has gone through treatment, and she may still be following with her medical oncologist, because she’s on hormonal therapy. Or she may be on some form of chemotherapy, and maybe she wants for me to be able to take a look at her mammogram. Well, I can still do that because I can remotely access those films, and then we could do that television, and if she’s not expressing any concerns, then we can do that as a television, so this helps, especially for those patients in survivorship where they’re not going to three and four different doctors on a regular basis. They’re going to that one doctor, they’re getting that in-person visit, and then some of the other providers are part of the team can maybe move theirs to telemedicine visits, so again, I think it helps to keep patients with that connection to some of those without again, having the burden of taking time off of work, having to arrange childcare, they can do those other visits by telemedicine. And that’s something new that we weren’t doing pre-COVID, patients were having to come into the office and see every single provider for every six months for the first two to three years after their diagnosis, so I think that really has made it more convenient for the patients, and it’s really allowed us to really streamline our operations on the provider side, which then allows us to be able to serve more patients.  

What Opportunities Does Telemedicine Present for Breast Cancer Patients?

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What Opportunities Does Telemedicine Present For Breast Cancer Patients? from Patient Empowerment Network on Vimeo.

Does telemedicine present certain advantages for breast cancer patients? Expert Dr. Regina Hampton from Luminis Health Doctors Community Hospital shares benefits that she’s seen in the breast cancer community and her perspective about the future of telemedicine. 

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Transcript:

Dr. Regina Hampton:

I think telemedicine has been great for the breast cancer community. I found in my personal practice, I do quite a number of visits and conversations prior to starting the first treatment. So, what’s nice is because we know the patient may be seeing several different providers, I do my initial visit and then the subsequent visits leading up to, say, surgery, we do by telemedicine. And what’s great about that is it allows us to dial in another support person, you can usually dial in at least two or three more people who can be a part of the conversation and hear the discussion, it also allows the patient to really…if they’re working full-time to be able to save that time, because maybe there’s another provider that they have to go see or they have to get their pre-op work-up. So it really just provides more access. And then if they just have a simple question, they don’t have to make a whole visit, take off half of their day and travel. We can either jump on the phone or jump on a quick video call, so I think it really has just opened up for not only the patients, but also the providers, and just given more access to care and really allows, I think us as providers to really meet people where they are. I’ve had people who’ve traveled or they had to go take care of a sick loved one, and we could jump on a call to do our office visit, and they could still do the things that they needed to do that may have come up unexpectedly. So, I think telemedicine is here to stay, and I think it’s only going to grow and grow and really provide more patients with access to providers.