:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Sunday, August 20, 2006  

Move on out, sharks...

From "The High Cost of Being Poor" by Barbara Ehrenrich, author of the book Nickled and Dimed:
There are other tolls along the road well-traveled by the working poor. If your credit is lousy, which it is likely to be, you'll pay a higher deposit for a phone.If you don't have health insurance, you may end taking that feverish child to an emergency room, and please don't think of ER's as socialized medicine for the poor. The average cost of a visit is over $1,000, which is over ten times more than what a clinic pediatrician would charge. Or you neglect that hypertension, diabetes or mystery lump until you end up with a $100,000 problem on your hands.

So let's have a little less talk about how the poor should learn to manage their money, and a little more attention to all the ways that money is being systematically siphoned off. Yes, certain kinds of advice would be helpful: skip the pay-day loans and rent-to-pay furniture, for example. But we need laws in more states to stop predatory practices like $50 charges for check cashing. Also, think what some microcredit could do to move families from motels and shelters to apartments. And did I mention a living wage?

I love the idea of microcredit/microlending in the United States. LOVE it. For some reason i've been narrow minded in my understanding of the concept - I've always heard of microcredit working in other countries and hadn't thought of it as an option here, although i'm sure it's utilized in various ways in this country. (Microcredit is essentially lending to low-income unemployed folks or folks with no credit, with the idea that a bit of assistance for a small business or a family can allow the people involved to slowly generate income and not spiral further into poverty. Microcredit organizations around the world have been extremely successful, with most or all loans paid back in full, no sharks necessary).

So, anyone down with starting a sustainable microcredit lending organization with me? The gap between hard-working low-income families in Los Angeles and the wealthy folk is ever-widening (as is happening in many communities across the country). And the homeless population in the Skid Row area of Los Angeles increased almost 200 percent in the last year. Maybe this could be a move to turn the tide a bit (and kick out some sharks).

posted by Unknown | 8/20/2006 10:55:00 PM | (2) comments |


Tuesday, August 01, 2006  

Reception Racism - Scandalous

over the past six months my clinic has tried to find an answering service to take calls for us when we are closed or super busy. it's a common service for doctor's offices and other businesses and i had the impression that it would be a simple thing to find a company to answer the phones. how hard can it be? for my clinic, we have simple needs on that level - tell people the hours, basic info about the clinic, and help them with directions. we don't even do appointments.

let me share with you my disappointment and insights.

my main criteria when finding a company was that i needed bilingual services and a fair price. 60% of my patients are monolingual Spanish speakers. another 20% are bilingual but most of them are more comfortable in Spanish.

the first company, the owner told me she spoke spanish but after a few weeks it was clear that her level of Spanish was barely adequate to get a name and a phone number. she had assured me that she spoke the language. when i called to cancel the service she tried to negotiate with me to stay and told me that her house cleaner spoke fluent Spanish and would be able to help out. no thanks.

the seoncd company was more professional. my English speakers loved it for the most part but i was getting reports that my Spanish speakers were getting hung up on and facing angry voices on the other side of the line. i had some bilingual friends call to test the system and they corroborated the stories.

i have called every answering service in New Mexico, from Albuquerque to Las Cruces, and not a single one is bilingual. This is in a state that has Spanish language written into the constitution, that has a heritage of Spanish colonialism and has a very proud Hispanic population...

so what is going on? i see two forces at play.

1. from the many Hispanic owners/receptionists that i talked with, trying to find a company, most of them expressed a certain pride in their Spanish and believed that because it is part of their ethnic heritage, they had a right to claim they were fluent when their abilities were truly inadequate. when i would press the point and ask if each of them were able to SPEAK SPANISH, they would reply, "I'm Hispanic." this confused the difference between Spanish language skills and ethnic background, two distinct things.

2. from a long conversation with the manager of the second company it became clear that there was an element of active hostility that was generated against my patients because of Racism. she was very honest with me about the internal process that was happening and told me that she had a parent from Mexico so she was sympathetic to my cause. here's what happened.

when i contracted with the second company, it was clear to them that they didn't have enough bilingual receptionists, so this manager promised to find and hire them. i did a major advertising campaign amongst friends and patients to get people jobs with the company and they did hire some. the company structured a small raise for bilingual receptionists, above what English-only receptionists would get. the focus on Spanish and the raise caused a ripple of resentment to flow thru the receptionists and they took it out on my patients because they couldn't say anything to their manager... underneathe it all was a sense that Spanish speakers don't belong here, a sort of nationalism/racism, bigotry and anger...

the really sad part of all this is the abuse of power displayed by these receptionists. they stand in a position of power, able to help or harm vulnerable people who are seeking medical care for illnesses. it's unethical and inhumane. i used to have more tolerance but i'm at the point now where if people want to act like little napoleans or bigoted jerks, they can do so without my monetary contribution to their salaries.

even if our electoral democracy is a sham, our economic democracy is still vibrant. money talks and mine is gonna keep walking until i find the company that cares about their work on a professional level from the owners to the managers to the receptionists.

my next step is to look in Southern California...

andru

posted by andru | 8/01/2006 07:34:00 AM | (1) comments |


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