Hayden Reed, BS
Medical Student
A.T. Still University, School of Osteopathic Medicine in Arizona
Northfield, Ohio, United States
A 43-year-old Spanish speaking Latino male underwent bilateral transfemoral amputations following a traumatic farming accident.
Case Description:
The patient suffered bilateral transfemoral amputations leading to a complicated rehabilitation process. Like many rural farm workers, this patient was required to travel several hours to each appointment, often delaying care. He couldn’t afford high-end prosthetics, and the low-end products caused such discomfort that he became wheelchair bound. Further, this patient required Spanish language interpretation. Even at a prestigious rehabilitation hospital, the interpretation services were sub-par, and a fluent medical student often corrected the interpreter. The poor communication nearly led to the patient not receiving a prosthesis. Despite all these challenges, this patient was highly motivated to regain mobility, with hopes of running again and playing with his children. However, his rehabilitation process was impeded significantly by communication barriers, socioeconomic status, geographical limitations, and other systemic obstacles.
Discussions:
This case highlights several challenges that are present at disproportionate rates among underserved communities. Rural patients and those with low socioeconomic status go to great lengths to travel to appointments for rehabilitation. These difficulties can be further compounded with language barriers and poor interpretation services. In this case, a combination of these inequities nearly disrupted the patient’s ability to receive a prosthesis.
Conclusions:
This patient’s experience showcases disparities that exist, especially among rural, low-income, non-English speaking patients. Diversity, Equity, and Inclusion (DEI) principles can ensure better outcomes by seeking equity in communication standards, including provision of competent interpretation services. Addressing socioeconomic disparities and expanding care to rural areas are also critical areas to improve rehabilitation care. Ultimately, implementing these changes can ensure adequate treatment is equitable and accessible to all people.
