Immigrants new to the U.S. face a ton of issues. Some of us are lucky enough to receive help with those issues. For my part, I’m hoping to help you with the medical side specifically. Today I want to talk about the American healthcare system, which includes nurses, psychologists, etc. The main difference between Haiti and the U.S. is the U.S. healthcare system and how it’s organized based on need. It can initially be confusing, so I want to guide you through that.
The healthcare system in the U.S. is split up in categories, the first category being the emergency rooms. Some people think that going to the emergency room will get them access to care quicker but that is not the case. Emergency rooms are specifically for people who have life-threatening injuries or are dealing with severe trauma. These people need to be taken care of immediately or they may die.
Now second, we have Urgent Care rooms, which are places designed for people who have health care issues that are urgent but cannot access their primary care physicians for whatever reason. It’s important to keep in mind that the physicians or providers in an Urgent Care Room are not necessarily equipped to address all sorts of illnesses
Now, the third, we have what we call a Healthcare Centre, a place where several specialists and providers are present to provide healthcare to patients. This group includes doctors such as internal medicine doctors, nurse practitioners, specialists, and physician assistants. You’ll also find dentists in a center such as Cambridge Health Alliance, as oral health is very important.
When you first call, the front desk receptionist will answer your call and schedule an appointment, but if your healthcare issue is too complicated, they’ll transfer you to the nurse who will then decide whether or not you need to be sent to the emergency room. Otherwise if your issue needs immediate care but doesn’t require a trip to the emergency room, they’ll see who is available and schedule you an appointment as soon as possible. You also have the option to call your primary care provider’s clinic even after hours in case of an urgent healthcare issue.
I want to remind everybody the importance of being on time for their medical appointments because, once again, the healthcare system in the United States is very different from Haiti. In Haiti, if you are late for your appointment, the doctor will still see you. But in the United States, you will have to reschedule your appointment if you are more than 15 minutes late.
When you arrive at the healthcare center you will first be greeted by the front desk receptionist, after being checked in you will then be seen by the physician assistant who will ask you a number of questions. At that point they may also check your blood sugar and vitals depending on your issue. It may sound like a lot but this is how it works to be efficient. When you speak to your provider, they’ll ask you what the purpose of your visit is, among other things, to get a clearer picture of your health and the issue at hand. In Haiti we don’t have primary care providers so it’s understandably confusing to some Haitian patients who are used to a family medicine doctor doing something like a pap smear but be assured, these doctors are trained and will refer you to a specialist if your health issue requires them to do so.
Often on the first visit, providers will do what is called an intake. This involves a lot of questions, often very personal, that the provider needs to ask to get a full picture of your health status. It may feel like the provider is being intrusive but this is for your benefit. Of course, everything said between you and your provider is confidential. All providers have to sign a HIPAA, a confidentiality agreement ensuring the provider may not share any of the patient’s information without their consent. Violating this agreement can lead to the provider being sued and facing legal issues.
Furthermore, the intakes I mentioned before can be quite extensive. They’ll ask about your family history, what sort of illness runs in your family, whether you smoke, drink, etc. Depending on the intake, the questions may differ. Understand once again that this is not the providers trying to be intrusive. This is necessary information to provide the best care possible.
Depending on your issue, your healthcare provider may refer you to a specialist, and I may also insist on you coming back after that visit. This may be necessary for your primary care provider to discuss the specialist’s diagnosis with you in greater detail or to explain anything unclear to the patient.
During your visit your provider may also offer vaccines to you, which are especially important for people who are going to start a new job or school. A couple of examples are the hepatitis B vaccine, the Covid vaccine, the influenza vaccine, and the Tetanus vaccine. Another very important vaccine is the HPV vaccine, especially important for us because in Haiti this vaccine isn’t available and a lot of patients have cervical cancer.
During your visit, there is a physical exam, which may include a pelvic exam and pap smear to look for the HPV virus in female patients. A pap smear is a screening test and during your visit, you may need to do a couple of different screening tests depending on your age. These include a TB test, an HIV test, or a Hepatitis test. These are important to screen for because the earlier they’re screened for, the better the chances they can be cared for effectively.