Esperanza Pintor Martinez, MPHEsperanza Pintor Martinez, MPHClinic Administrator at La Clínica de la EsperanzaClinic Administrator at La Clínica de la Esperanza

January 26, 2013 January 26, 2013

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History of La Clínica de la Esperanza

1995 Iowa Health – Des Moines family residency program Iowa Health – Des Moines family residency program At United Mexican-American Community Center –

now Hispanic Educational ResourcesOB focus

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History continued

2001Grant Partnership with DMU Partnership with DMUMove to 2679 Maury Street building Additional staff hired Expanded services offered Logo created

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Maury location

DMU studentsDrake pharmacy studentsDrake pharmacy students Shared space Free services – donations acceptedpRange of services offered

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Needed changes

Deteriorating Maury building Patients’ needs Patients needs Focus groups and patient surveys

Additional services requiredqChanges in health care Continued partnership

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Relocation

2012 DMU continued partnership DMU continued partnership Planning August 13, 2012 g ,

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Sliding Fee Scale

Reasons to transition to a sliding fee scale Patient and community reactions Patient and community reactions Staff reactions August 13, 2012g , Process of sliding fee scale and billing insurances

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Current services

Family medicine Pediatrics

Mental healthReduced cost-

Women’s health Adult medicine

Mental health

Reduced cost-vasectomies*

ClassesMental health Care management Financial assistance

Prenatal care Breastfeeding Famil planningapplications

Questions with bills Specialty care

Family planning Nutrition Diabetes p y

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Staff

Visiting providers from East Des Moines Family Care CenterCare Center

Visiting providers from Penn Avenue OB/GYN 14 staff; 10 bilingual (Spanish & English) Schedules

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Common Questions

How does one access La Clinica?Do you only serve Latinos?Do you only serve Latinos? Specialty Care Barriers encountered

Any other questions?

Cultural Competence

vs.

Cultural Humility

“Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the to self evaluation and self critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutuallly beneficial and non-paternalistic clinical and advocacy partnerships with paternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.”

~Tervalon & Murray-Garcia, 1998

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Culturally Humble Strategies

Dangers of assumptions and stereotypes Work with already established groups Be aware of wording you use when speaking to patients Be aware of wording you use when speaking to patients

Wording regarding sex Wording regarding authorities

Being aware and respectful of different cultures and how they impact the beliefs and attitudes of the individuals within those culturesthe beliefs and attitudes of the individuals within those cultures

Having an open mind and being willing to learn about and understanding the culture(s) you are working with and being able to act in a respectful, non-offensive manner

Groups that appear homogeneous are not composed of individuals who are the same; differences exist within groups, as well

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Cultural considerations

What are some cultural considerations you have encountered or think you may encounter?

It begins with YOU B i f lt l b li f d ttit d Being aware of our own cultural beliefs and attitudes

and how they influence our treatment of those who are different than us

Why its important

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Questions

Esperanza Pintor MartinezOffice: 515-271-4450Office: 515-271-4450Cell phone: 515-402-2683 Email: pintorex@ihs.orgp g

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References

http://www.wishard.edu/our-services/obgyn Tervalon M & Murray-Garcia J 1998 Cultural Tervalon, M. & Murray-Garcia, J. 1998. Cultural

humility versus cultural competence: A critical distinction in defining physician training outcomes i l i l l d i J l f H lth C f in multicultural education. Journal of Health Care for the Poor and Underserved, 9, 2.