The Health Workforce An Interview with Professor Des Gorman

Summary

In this Rural Health Education Foundation program, Professor Des Gorman discusses the maldistribution of healthcare workforce in New Zealand, particularly focusing on Indigenous communities. As a Maori physician, Gorman emphasizes the cultural disconnect between healthcare providers and Maori patients, highlighting the need for culturally sensitive practices. He addresses the challenges faced by Maori in accessing healthcare due to language barriers and cultural differences. Gorman also stresses the importance of training more Maori doctors and incorporating Indigenous health perspectives into medical education to bridge the gap.

Takeaways

• 🌍 The interview discusses the maldistribution of healthcare workforce in rural communities, particularly focusing on the gap in healthcare access for Indigenous populations.
• 🏥 Professor Des Gorman, a Maori physician and Dean of Medicine at the University of Auckland, highlights that New Zealand has a slightly better but still insufficient healthcare gap compared to Australia.
• 🏛️ There is a significant cultural disconnect between the healthcare providers and the Maori community, with only 2.5% of the health workforce being Maori, despite them making up 15% of the population.
• 🚑 The conversation emphasizes the subtle but significant barriers to healthcare access, such as cultural understanding and language, which can greatly affect health outcomes.
• 💼 Professor Gorman argues for the necessity of training more Indigenous doctors and incorporating Indigenous health perspectives into medical education.
• 🏫 The importance of having a healthcare workforce that reflects the community it serves is stressed, as it can lead to better understanding and treatment of patients.
• 🌱 The concept of 'kaupapa', or Indigenous concepts and philosophies, is introduced as crucial for understanding and addressing Indigenous health.
• 🌐 The interview points out the challenges faced by overseas-trained doctors in understanding and connecting with Indigenous communities they serve.
• 💼 There is a call for a more culturally appropriate and sensitive approach to healthcare, including the need for economic incentives to attract healthcare professionals to rural and Indigenous communities.
• 🌱 The discussion suggests that the role of community health workers and nurse practitioners could be expanded to bridge the gap in healthcare services, particularly in rural and Indigenous areas.

Q & A

What is the main topic of discussion in the interview?

The main topic of discussion is the maldistribution of the health workforce in rural communities, particularly in relation to Indigenous populations in New Zealand and Australia.

What is the significance of the 'one-eyed man' aphorism mentioned by Professor Des Gorman?

The 'one-eyed man' aphorism is used to illustrate that while New Zealand may be doing better in addressing health workforce gaps, it is still not fully meeting the challenge and is only comparatively better, akin to being the most capable in a situation where everyone is disadvantaged.

What is the gap in life expectancy between Indigenous New Zealanders and non-Indigenous New Zealanders?

The gap in life expectancy is about nine years, which is greater than the gap between whites and American Indigenous peoples.

Why does Professor Gorman believe that many health professionals may not feel responsible for health disparities?

Professor Gorman suggests that many health professionals, such as doctors and pharmacists, may feel that factors like housing, finance, economics, and employment have a greater impact on health disparities, thus they see their role as limited in addressing these issues.

What is the cultural disconnect mentioned in the interview, and how does it affect healthcare?

The cultural disconnect refers to the significant difference between the cultural backgrounds of healthcare providers, many of whom are trained overseas, and the communities they serve. This can lead to misunderstandings and barriers in healthcare access due to differences in health perceptions and practices.

Can you provide an example of a cultural barrier to healthcare mentioned in the interview?

One example is a Maori woman's reluctance to seek medical help from non-Maori doctors due to cultural discomfort, such as the embarrassment of undressing in front of doctors from a different cultural background.

What is the role of language and communication in healthcare according to the interview?

Language and communication play a crucial role in healthcare as subtle differences in language can lead to misunderstandings and incorrect diagnoses. Effective communication that respects and understands cultural contexts is necessary for proper healthcare delivery.

How does Professor Gorman suggest improving the cultural competency of healthcare professionals?

Professor Gorman suggests that healthcare professionals should be trained to understand the cultural concepts and philosophies of the communities they serve. This includes integrating Indigenous health as a core part of medical education and continuing medical education.

What is the role of community health workers in addressing health disparities as discussed in the interview?

Community health workers can serve as a bridge between healthcare providers and communities, helping to articulate needs and cultural understandings. They can also provide a pathway for young Indigenous individuals to enter the health profession, potentially leading to more advanced roles.

What does Professor Gorman suggest about the future of medical education and the role of doctors?

Professor Gorman suggests that medical education should focus on the roles that justify the extensive training and cost of producing a doctor, such as patient differentiation and complex problem-solving. He also suggests that the future may see a greater role for other healthcare providers in primary care.

How does the interview discuss the issue of incentives for healthcare professionals?

The interview discusses that incentives, such as remuneration and status, play a significant role in determining where healthcare professionals choose to work and what specialties they pursue. There is a need to realign incentives to better serve areas of need and to value the roles of generalists.