While certain politicians pontificate about building a wall to separate the US from surrounding countries, people passionately debate the issue. Doctors are included in this and arguments sound out from both sides of the issue. As healers, we are trained to treat all patients equally. While we may hold our own personal beliefs, sometimes we need to leave them on the threshold of the exam room. Whether we agree with building a national wall, the truth is that many immigrants are already in our country, legally and illegally. We cannot build walls in medicine.
As doctors, we all swore to uphold the Hippocratic oath, or some variety of it. This promise does not draw lines based on nationality or ethnicity. We need to treat all patients the same. There can never be a wall built to medical care.
“You may be passionate about building that wall, but keep that passion for Facebook and twitter, not the exam room.”
Where I work, I see many recent immigrant, most of whom are here legally but some are not. I do not question them regarding their status because it does not affect the decisions I make about their medical care. Nor should it affect anyone else’s. We all need to see the patient in front of us and treat them as such. If we cast judgements, we surely cannot be providing the best medical care to these patients. You may be passionate about building that wall, but keep that passion for Facebook and twitter, not the exam room.
I heard many doctors who suggest that if they treat illegal immigrants, they should be reported to immigration and returned to their country of origin. That is not our job: we are physicians, not border control. If a patient told you they didn’t pay their taxes, would you report them to the IRS? If another patient tells you they smoke weed illegally, do you call the police on them? No, because that would be a HIPAA violation. We are only allowed to breech a patient’s confidentiality when they are a danger to themselves or others.
How can we provide the best medical care to recent immigrants?
♦ Treat them like any other patient. They are human first and that must be respected.
♦ Understand that they may not understand our medical system here and try to help them by directing them to appropriate agencies that can guide them.
♦ They may make decisions that we don’t expect based on cultural beliefs. Try to understand how their culture impacts their medical thoughts.
♦ According to law, we must provide a translator. This does not have to be someone physically in the office. There are many phone translators these days.
♦ Many patients are on medications prescribed in their own countries. I often don’t recognize the names, but when I look at the generic names, they are the same as we prescribe here. Ask them to bring all the packages because many of them will have the generic name printed in English. This saves time compared to doing a Google search.
♦ Don’t make assumptions! They are not their culture but unique individuals.
♦ Don’t worry about their immigration status except as it affects their medical care.
As doctors, we are in a unique position in which patients entrust us with many secrets. That trust should be honored, no matter where the patient is coming from. Once we sacrifice our patients’ humanity for the sake of politics, we will lose our humanity as well. Do we really want to build walls at the cost of sacrificing our ethical obligations?
Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.