The National Council of Asian and Pacific Islander Physicians (NCAPIP) represents physicians committed to the advancement of the health and well being of diverse Asian American, Native Hawaiian and Pacific Islander (AA and NHPI) communities.
Contrary to public perception, AA and NHPI represent a diverse group of communities and suffer barriers to quality health care because of immigration status, the lack of culturally and linguistically competent services, and the lack of access to affordable health coverage.
These barriers are exacerbated by the persistent lack of accessible data that obscures the reality of medical and public health needs of specific nationalities and ethnic groups.
Data from various studies document that AA and NHPI patients confront cultural and linguistic barriers in health care, resulting in worsening clinical outcomes.
While there are dedicated physicians who serve underserved AA and NHPI communities, they are likely to do so in face of scarce resources, fragmented clinical systems, and narrow operational margins
While Asian Americans are a visible part of the physician workforce, NHPI physicians are still underrepresented, and there remains a shortage of AA and NHPI physicians in notable leadership roles.
The inequity in health care faced by AA and NHPI will persist without critical policy and resource support that addresses their unique needs. Physicians who care for the needs of the AA and NHPI communities must be supported in their efforts to assure access, quality, cost containment and leadership development as critical elements of advancing AA and NHPI health.
Access must entail the principle of affordable, universal health care coverage for all Americans, and address cultural and linguistic barriers to care. Therefore, the NCAPIP believes that:
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1. Every patient should receive care that is unencumbered by cultural and language barriers. There must be appropriate provisions and funding to support services as stipulated by Cultural and Linguistic Access Standards (CLAS), and adequate federal reimbursement for medical interpretation and translation services.
2. Immigrants should be provided expanded access to affordable and accessible health coverage.
3. AA and NHPI patients, as all Americans, should have access to a patient centered medical home, which should incorporate principles of cultural competence and linguistic access.
4. Pacific Islanders (citizens and residents of the Republic of Palau, Federated States of Micronesia, the Republic of the Marshall Islands, the Commonwealth of the Northern Mariana Islands and the U.S. jurisdictions of American Samoa and Guam) face particular barriers related to the terms of the Compact of Free Association and territorial administration. These policies should be reformed to provide expanded access to high quality and affordable care to all residents and citizens of the Pacific jurisdictions and nations.
Quality health care must be applied equitably, with due consideration of the diversity of the conditions and needs of the AA and NHPI population. Health equity will not be achieved unless targeted resources are used to rectify persistent gaps in quality and care. Hence, NCAPIP believes that:
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1. The collection of data, critical to the measurement and pursuit of quality, must include metrics related to patient experience, clinical outcomes and epidemiology for the entirety of the AA and NHPI population. Data must be captured for all subgroups in order to identify and address variation in disease prevalence, care and outcomes.
2. Investments for health information technology and adoption of an electronic health record must include provisions that take in account the clinical settings of AA and NHPI providers, many of whom work in small practice situations in underserved communities.
3. Health information technology must address the needs, competencies, and access points of patients who do not use English as their primary language, have limited health literacy and access to internet.
4. Quality and outcome measures that are adopted and promulgated to evaluate performance must account for racial/ethnic, social, cultural, and economic drivers which may affect health outcomes so that providers of underserved AA and NHPI communities are not unfairly penalized or represented.
AA and NHPI are acutely sensitive to the unabated escalation of costs in health care since their communities are disproportionately dominated by small businesses which are effectively priced out of affordable health coverage. Therefore, NCAPIP believes that:
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1. Primary care provider practices should be supported in AA and NHPI communities.
2. Investment in culturally and linguistically competent prevention efforts.
3. The practice of community centered medicine is threatened by escalating malpractice premiums in many states. Consequently tort reform, similar to that adopted by the State of California, should be supported.
Physicians of Asian descent comprise a significant segment of the medical profession, holding positions in academia, research, public health, and patient care. Students of Asian descent are one fifth of U.S. medical students and there are a significant proportion of nurses; allied health professionals of AA & NHPI descent. Nonetheless, these health professionals are not proportionately represented in medical and health care leadership and executive levels that can impact health care policies. Therefore, NCAPIP believes that:
1. AA and NHPI physicians, as well as other minority physicians, must be actively identified, supported and developed to take on significant and visible leadership roles throughout the health care system.
2. The diversity of the AA and NHPI communities should be reflected and supported in the composition of our allied health professional and nursing workforce.
3. Policies must be adopted which promote the placement of culturally proficient providers in underserved AA and NHPI communities.
The NCAPIP believes that quality, access, cost containment, and leadership are critical to the future of health and wellness of AA and NHPI. As physicians we are dedicated to assuring our patients are provided the foremost in medical care and that they afforded the full spectrum of prevention and wellness promotion. We are committed to attaining equity and will work to remove barriers that result in disparities in health and health outcomes in our communities. | top |