Immigrant’s Guide to the U.S. Healthcare System
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 be confusing at first, so I want
to guide you through that today.
The healthcare system in the U.S. is split up into 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
cared for immediately, or they may die.
Second, we have Urgent Care rooms designed for people with urgent health care issues who
cannot access their primary care physicians for whatever reason. It’s important to remember
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. In this group, you’ll find 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 for you, 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 of the importance of being on time at your medical appointments
because, once again, the healthcare system in the United States is very different from Haiti. If
you are late for your appointment in Haiti, the doctor will still see you. But in the United
States, you must 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 be seen by the physician assistant, who will ask
you several 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, which is 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.
And 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, this is not the
providers trying to be intrusive. This is necessary information to provide the best care
possible.
Now, depending on your issue, your healthcare provider may refer you to a specialist,
and I may also insist you return after that visit with the specialist. It 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 a new 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, which is vital for us because in
Haiti, this vaccine isn’t available, and many patients have cervical cancer.
During your visit, a physical exam 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.
