Assignment

Two: Secondary Research & Inquiry

How are Our Healthcare Providers Affected by the Various
Characteristics of Discrimination?

As we go through our everyday lives, we

Introduction

never really realize the importance of our

healthcare or the problems that go on with it. Our
healthcare field is surrounded by numerous of

I am sure you have been to a hospital,

doctors, nurse practitioners, physician assistants,

doctors office, an outpatient clinic, or some place

and registered nurses that are in various

to seek medical attention at some point in your life.

specialties; these occupations are also known as

When you visited at least one these places Im sure

our healthcare providers. As a society, we also

you noticed that not all of the medical providers

generally do not understand the complexity of our

were of the same race, gender, or ethnicity as you.

healthcare providers and how each differs or

Sitting there, observing this, have you ever once

relates to one another. A nurse practitioner and

thought or felt that the quality of your medical care

physician assistant both work underneath a doctor

would be any different because of those factors or

which arouses some patient skepticism of their

others? What if you are seen by a physician

work and intelligence. This is one of the many

assistant or nurse practitioner rather than a

factors that are discriminated upon to our

doctor? Would these discriminative factors of our

healthcare providers. Other factors may include

healthcare providers make you think less of them

ethnicity, gender, race, spoken language, visual

or assume they were not qualified enough to do

appearance, etc. Throughout this paper I will be

their job?

researching patient skepticism and how they

discriminate upon our healthcare providers.


Before progressing further into this paper it is necessary that I state my relationship to this

topic I have chosen to research and I should also include any biases that I may have with it as well.

This topic does have a significant importance to me because I am wanting to eventually pursue a


career in the health field, specifically a Physician Assistant. With this being such a personal interest

could also bias my research of the other healthcare providers. I grew up being introduced to the



medical field when I was young. With my mother being Registered Nurse, at times she would allow

me to tag along with her at work and I enjoyed every minute of it. Seeing what she did at work and


helping people in ways others could not really inspired me. Looking up to her motivated me to

eventually become a Physician Assistant. For a couple of my sources used in my inquiry, I included

an interview with Wendy Wrenn, RN and an observation of Amy Berry, PA. This is where another


bias could step in. Wendy Wrenn, RN is my mother and Amy Berry, PA is my godmother; my

connections with these people is what could also bias my research. With my research involving


patients and peoples opinions of their healthcare providers and discriminations upon them could

cause some readers to believe I have written in favor of my chosen career path rather than


proportionately to the occupations discussed.




The focus for my research will involve gathering opinions from people inside and
outside of medical facilities. Reasons why I plan to gather opinions from random people
outside of a medical facility is to discover if prejudice acts and judgments are still made
upon society to our medical professionals than just patients. This research I am
interested in conducting is in seeing how patients in various medical treatment
situations respond to the health care providers treating them. The average person may
not think a topic like this is important but as you continue to read, you will learn the
similarities and differences of our healthcare providers and how people judge them
whether their inside or outside of a medical facility from the study .

Medical Professionals

Literature Review

In todays society, we depend on healthcare for

various reasons. Whether we are getting a cold, yearly
check ups, prescription refills, emergency needs, etc.

We always go to some type of clinic or hospital to find

answers to resolve our medical problem. In order to
Majority of the time when we go to

receive these answers, we must rely on a doctor,

physician assistant, nurse practitioner or a nurses
decision of diagnoses. With such a developing field,
there are also a diversity of races, ethnicities, religions,
genders, spoken languages, body appearances, etc. All
of the factors can play a role with each other in the
opinion of patients and people. There are going to be
people who are would rather been seen by a doctor as
their healthcare provider versus a nurse practitioner
or a physician assistant; and theyre are some who
simply do not have a preference. Also, there are going
to be patients or people who are going to questions
ones ability and qualities of their profession because
they are a difference race, ethnicity, gender, religion,

the clinic, we normally are seen by a nurse

first then a doctor or sometimes a physician
assistant or nurse practitioner. The
expectation is that the substitution of PAs or
NPs will reduce costs and doctor's workload
while maintaining quality of care (Van
Vught, Hettinga, Denessen, Gerhardus,
Bouwmans, Van Den Brink, & Postma 2015).
This is one of the many important factors of
a physician assistant and nurse practitioner.
They are both very qualified professionals
that not only help increase the quality of
care of patients but to help doctors. With the
idea of substituting a doctor is the thought

etc.

that inclines people have judgments of

distrusting PAs and NPs.

A physician assistant and nurse practitioner are similar but are also different. Both

occupations require a masters degree but while in school, a nurse practitioner is allowed to alter

his or her clinical experiences to their chosen specialty while a physician assistant just requires a


clinical rotation through all specialties without a chosen specialty (Freda 2000). This is also a

factor that could cause people not to want to substitute a doctor. If people choose to believe a PA


or NP arent as specialized as a doctor, then they choose not to trust their judgments. This is one

reason why we need to teach society the importance of a physician assistant or nurse


practitioner and how significantly qualified they are to make medical decisions with or without a

doctor. These occupations are very helpful in our healthcare field. From observing a physician

assistant, I learned what they do during the day. Physician assistants normally work with doctors


and have patients like they do. They also refill prescriptions, diagnose patients, provide care and

can receive help from their supervising doctor if need be (Berry 2016).





A registered nurse is only a two year
This is where a physician
assistant and nurse practitioner can
begin to differ. A nurse practitioner is an
academically advanced and experienced
registered nurse and is not required to
work under a doctor like a PA but they
are allowed to (Cresswell 2013). Thus,
nurse practitioner programs are based
off of a nursing foundation, which makes
them similar to a registered nurse in
certain ways. Each of these occupations
strive to ensure better patient outcomes,
as so do other medical professions.

accredited nursing program (Wrenn, 2016).

Registered nurses only require two years of
nursing school because they are not of a higher
level like the other careers mentioned. Since
registered nurses are at a lower level, they arent
allowed to diagnose their patients but they are
skilled to check vitals, fill out lab requests, calling
in prescriptions, and helping assist doctors
(Wrenn, 2016). A nurse practitioner and
physician assistant can both be under the
supervision of a doctor, which can make them
seem skeptical to their patients. Some might think
since they do not have the label of a doctor could
mean they do not have enough experience or
education, especially if the person has no clue

what a PA or NP is.

Stethoscope

A physician/doctor obviously has the
most education out of all of these professions.
In order to become a doctor one must earn their
doctorate degree, go through several years of
residency, and take their board exams. This is
what allows them to be at the top because they

have more education and experience. This is the

It is likely for healthcare providers to gain

main reason for patient skepticism with

trust if they spend more attentive time with their

healthcare providers. Further more, could there

patient. This will also lead to less confusion with

be other factors that play a role besides their

patient diagnosis and treatment, which indicates

education and experience? On average, a nurse

positive feedback. Patient treatment is a very

practitioner or physician assistant will spend

important quality in healthcare. How and what

about 12 minutes face to face with there patient

the patient are treated with is very important

which is more than the averaged 7.5 minutes

among their diagnosis. For instance, a registered

from the doctor, they also spend more time

nurse could have a patient with specific

diagnosing and filling out prescriptions

symptoms of a sickness. The RN is allowed to

(Venning, Durie, Roland, Roberts, & Leese

make assumptions but are not allowed to

2000). Although patients tend to prefer a doc

diagnose them; this is what a doctor, physician

tor, they often do not know that PAs and NPs

assistant, and nurse practitioner is for. The RN

spend more one on one time with their patients

could then send their patient to some type of

than a doctor. This is one major characteristic in

medical practice where he or she would be seen

receiving positive patient outcomes.

by one of those three medical professionals. If

this scenario had gone different, the patients

treatment outcome could have been greatly

affected. This is one reason why all healthcare
affiliations provide greater quality monitoring
(Madison 2004).

 Another factor that plays a role in patient skepticism is discrimination. We as people tend to


discriminate people in unmannerly ways. For instance, some patients tend to discriminate against a


healthcare providers race or ethnicity assuming he or she is not as intelligent as their race, gender,

or ethnicity. This tends to be more seen in hospital settings. Many spoken languages from different

cultures surround our healthcare field; this allows us to have access to people with multiple


linguistic abilities. Even though patients tend to judge a book by its cover at times, these linguistic

aspects of cultural competence have been associated to decreases in racial/ethnic disparities in


health and health care (Johnson 2004). These negative stereotypes and discriminations are deeply

embedded in the culture and institutions of our society (Williams & Mohammed 2008). Any cultures


will more than likely continue to discriminate on others for several decades because; societies seem

to have a natural instinct to judge others. All of these characteristics of skepticism definitely affect


patient gratification. The development of positive ethical conditions is important to the evolution of

quality work environments and quality patient outcomes (Pauly, Varcoe, & Storch 2009). Whether or

not a patient would be more satisfied with being treated from a doctor versus a nurse practitioner or


physician assistant, their providers race, gender, ethnicity, religion, should not be of any concern

unless it affects their medical tendencies in a negative way.




Eyes

Entering the Conversation

Over the past several decades, our healthcare field has seemingly grown in the
amount of people that are becoming physician assistants and nurse practitioners over a
doctor. Even though they are highly qualified healthcare providers, patients seem to believe
that since they do not have as much experience or education as a doctor, there are not as
intellectual as a doctor. Although a doctor does have more education and experience, a
physician assistant and nurse practitioner are both qualified to diagnose, prescribe
medications, perform minor operations, etc. People also tend to discriminate against their
healthcare providers or nurses age, body appearance, ethnicity, hygiene, gender, race,
religion, spoken language etc. What factors do patients tend to discriminate on more than
others? Do patients judge their health providers label more or less than discriminating
their qualities? I would like to propose a study to determine if consumers would prefer a
doctor over a physician assistant or nurse practitioner. I would also determine if this Also to
determine if consumers discriminate and what factors they discriminate on more than
others.

This study will be conducted in three different settings in order to receive opinionated
answers to these questions. These different settings will be various hospitals, outpatient clinics,
and random people outside of the other two settings. In order to gather answers, interviews
must be taken place. There will be 12 different interviewers, four in the hospital, four in the
outpatient clinic, and four in the city outside of the clinic and hospital. Since we are asking two
different questions in this study, two of the four interviewers in each group will be asking about
their opinion on having a physician assistant or nurse practitioner as their healthcare provider
and the other two interviewers will be asking about what they tend to discriminate on with
their healthcare provider or nurse. While we are trying to find these answers, the interviewers
will be dressed very professionally but they will be of various races, genders, ethnicities, body
appearance, etc. since we are asking discriminative questions. Reasons to split the four
interviewers into two groups and have different settings is to avoid biased answers and to
receive different opinionated answers. More specifically:

Each group of four interviewers has two subgroups of two interviewers. One subgroup will be
asking the Interview Questions A (see questions bulleted below) about their opinion on having a
physician assistant or nurse practitioner as their healthcare provider versus a doctor and the other
subgroup will be asking Interview Questions B (see questions bulleted below) about the
discrimination of healthcare providers and nurses.

All of the patients being interviewed must be ages 18 and up because younger patients may not
understand the questions or why theyre be interviewed. Two interviewers must ask 50 random
patient Interview Questions A and the other two must ask 50 random patients/people Interview
Questions B as well but they cannot be the same person asked for Interview Questions A.

The four interviewers inside the outpatient clinic will be interviewing random patients that is either
waiting in line or leaving the clinic from their appointment. Two interviewers asking 50 random
patients Interview Questions A will be at a different outpatient clinic than the other two who are
asking 50 random patients Interview Questions B. This is being done so we can have a variety of
people and not asking one person two sets of questions.

The four interviewers inside the hospital will be interviewing random patients that are just in the
general care unit. Two interviewers asking Interview Questions A will be asking 50 random patients
and the other two interviewers asking Interview Questions will be asking 50 random patients as well
but they must be different from the patients than the ones asked for Interview Questions A.

Lastly, the other four interviewers will be going to other places in the same county as the clinic and
hospital to interview 50 random people Interview Questions A and 50 random people Interview
Questions B that are not currently being patients inside a facility.

1.

2.
3.

4.
5.

Also, people are going feel very strong about their opinion and some are going to care
but not feel strong on their opinion. When a patient or person states their judgment,

the interviewer cannot change their facial expression or states their opinion. This

could create tension between the interviewer and the applicant. As for the healthcare
provider being discriminated upon should make their statement on how qualified and

determined they are before their patient decides if they want a new provider or not.





Interview questions A:

In todays society our healthcare providers are not just doctors; there are physician assistants and


nurse practitioners. Knowing that nurse practitioners and physician assistants tend to work

underneath a doctor and have less education and less experience, would you trust having a nurse


practitioner or physician assistant as your healthcare provider versus a doctor?

When going to an outpatient clinic and your temporary provider is a doctor, would be feel less

uncertain since he or she is not a physician assistant or nurse practitioner?


Now, if you are a patient staying the in hospital and your healthcare provider is a doctor but you

have a physician assistant to come and do check ups, would you feel like you are not receiving the


same level of care?

To continue from question three, would you feel any different if you had a nurse coming to do your


check ups and take your vitals even though they are trained to do so?

If you were skeptical to having a nurse practitioner or physician assistant as your healthcare


provider versus a doctor, explain why that is even though they are trained to do so. Also, if you were

uncertain about having a nurse take your vitals or draw blood, explain why having a nurse to do

these duties makes you feel that way.

Interview Questions B:
1. If your healthcare provider were of a different race or ethnicity of you, would you feel like you

are treated with the same level of care as a provider of the same race or ethnicity as you? If they


were not fluent in your language, would you be less trustful of them?

2. If your healthcare provider were of a different gender, would you feel like you are treated with


the same level of care as a provider of the same gender as you?

3. If your healthcare provider were apart different religion, would you feel like you are treated with

the same level of care as a provider of your religion?



4. If your healthcare provider had a difference appearance than you, for example is covered in

tattoos and looks different than any other provider youve had before, would you feel like you


were treated with equal level of care?

5. If you answered yes to any of these questions, could you explain why you would discriminate


that factor with their level of intelligence and providing equal care?


After conducting all of these interviews we now compare the results of each question in each
category. First, we will divide the answers to the questions according to setting where they we interviewed.
Next, we will categorize the answers for each question into sections with the same answers. Then, we will
calculate the same answers in each question and divide that number by the total number of people who
answered that question. Doing this will give us the percentages for each question according to setting.
Lastly, before calculating the percentages, separate the patients interviewed by category with their age.
Dividing the answers according to the interviewees age will determine if the ages of the patients affect how
they respond to their healthcare professionals in various medical treatment situations. Once the
percentages for all of the answers are found, you can then compare the answers to one another. From this,
you can discover the percentages of which discriminating factor is used more than others. You can also
determine the percentages of how many people prefer a doctor, nurse practitioner, or physician assistant,
or if they simply do not have a preference. Calculating all of these differences will develop a reasoning as to
why people discriminate on certain factors, and why people tend to trust the label of a nurse practitioner or
physician assistant less than a doctor. Once these calculations are finished, a module could be created in
various languages. This module could be kept with the medical professionals to have when the time is
needed, will be at any medical facility for the public, and will be available online for the public to access.

Conclusion

Throughout this paper, I have researched the similarities and differences

of our our healthcare providers they are discriminated upon. These
discriminative factors include diversity of races, ethnicities, religions, genders,
spoken languages, body appearances, etc. All of the factors can play a role with
each other in the opinion of patients and people. I also researched if patients tend
to prefer a doctor versus a nurse practitioner or physician assistant.


I discovered that there are going to be people who are would rather been seen by a
doctor as their healthcare provider versus a nurse practitioner or a physician assistant; and
theyre are some who simply do not have a preference. The results I found for Interview
Questions A, the amount of people who had no preference in their healthcare provider and
the amount who preferred a doctor were fairly even. I also discovered that younger
generations are more likely to not have a preference where as older generations were more
likely to feel more skeptical of having a nurse practitioner or physician assistant. As for the
results from Interview Questions B, I found that patients are more likely to judge their
healthcare providers quality and intelligence if he or she is not fluent in English as their
spoken language regardless of their race. This was seen more in the older generation. The
younger generations were not far behind them but, they were more likely to trust their
judgments even if they were not fluent in English. This was the number one discriminative
factor I found at all locations (outpatient care, hospital, and city). The factor that was
discriminated the least was gender. Out of all the locations and generations interviewed,
gender was only mentioned a few times as a factor they discriminated on.

This research conducted is really important to release to our society. It could be a major

role in leading our society to decrease or stop these prejudice acts within our healthcare field.


It is important for our public to have easy access to this module rather than having it just at

one place. They will be available online, in medical facilities, and all healthcare providers will


have to carry it with them at all times when doing their job. This way anyone can learn about

the results and know why it is important to stop prejudice acts to our healthcare providers.


Our patients who do make these verdicts may come to realize that they their prejudgment

remarks to their healthcare provider treating them are redundant.



There will always be research involving patient skepticism with medical professionals and
treatment. Further research I would like to propose is if patient skepticism affects the
performance of our healthcare providers. Lets say if a patient refuses treatment from a physician
assistant because he/she wants to be seen by a doctor, would this affect the PAs performance in a
negative way at work? Another question I would like to propose is how can our societys
knowledge of healthcare and medical professionals be improved so that patent skepticism will
decrease? A way I have thought to conclude this is for everyone in high school and college to take
a mandatory course about healthcare, medical professionals, and ethics that revolve around
them. This could possibly improve our societys knowledge involving healthcare. The medical
field is full of new opportunities and new technologies and I hope that there will be continuous
research involving the topics I have mentioned.

The End