Global Transformers

 

America has always been a distinction for individuals seeking prosperity. After the Civil War, America’s growing economy required more workers. This needed was filled by immigrants. Between 1866 and 1915, approximately 25 million immigrants arrived on its shores. These immigrants came from diverse backgrounds (such as England, Germany, Poland, Russia and Scandinavian countries). The additional labor force helped fuel the American economy.

Yet, this diversity was not without its own problems. Due to the culture differences and language barriers among ethnic groups, there were frequent conflicts to resolve. Furthermore, most of these workers were poor and uneducated; this created pressures on government and nonprofit services to fix or minimize these problems.

Today, we face similar problems. Globalization has connected us with the rest of the world. Cultural awareness bears down on us. Immigration is the hot topic. Federal and local governments struggle to deal with this politically sensitive issue. Many experts feel there are millions of illegal immigrants flooding our borders.

Some fear terrorist attacks while other people are just anxious. Many local governments, such as Arizona, try to fight back. For example, there are about 30 states with English-only laws. Yet, can anyone really stop demographic shifts? A recent Department of Labor report, Futurework: Trends and Challenges for the Work in the 21st Century, notes the following:

  • By 2050, minority groups will makeup half of the population
  • Immigrants will account for almost two-thirds of the population
  • One-quarter of the population will be of Hispanic origin
  • Almost one in ten Americans will be of Asian or Pacific Islander decent

As American businesses expand globally, today’s managers need to understand how diversity will impact their organizations. Given the winds of the future, leaders must forge their organizations into global transformers. Unfortunately, an individual’s biases, prejudices, and stereotypes can often cloud his or her decision-making. Anne Tsui and Barbara Gutek, authors of Demographic Differences in Organizations, further argue individuals within a particular category may have a different experience in a similar situation. These demographic changes will reshape organizational culture.

In fact, it speaks to disruptive change in society. Many critics of implementing diversity initiatives argue that the market should dictate who gets medical services, employment, and education. Therefore, effective leaders will need to integrate cultural and global awareness into their overall organizational strategies.

What impacts will these demographic changes outlined in Futurework produce? How do occupations such as physicians turn these demographical changes into opportunities?

© 2010 by Daryl D. Green

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35 thoughts on “Global Transformers

  1. The major abundance of immigration in the United States will create opportunities for businesses to spread the awareness of their products to other ethnic groups. If correctly managed, this will ultimately lead to a greater market share for the businesses that choose to do so. We will begin to see a greater number of advertisements in multiple languages and dialects so as to appeal to a wider variety of consumers. Products will begin to be tailored towards certain ethnic groups. Ultimately, I believe this will not only allow, but force a wide variety of ethnic backgrounds into each level of the business structure. The glass ceiling metaphor will become less and less common since the promotion of minorities will be pertinent in the success of many future businesses.
    For physicians that are bilingual or from a different ethnic background this will offer many opportunities. They will be able to offer healthcare to patients that otherwise would have a difficult time receiving it. Physicians will be able to openly communicate without having to go around language and cultural barriers that others would struggle with.

  2. “Difficulties in the provider-patient relationship arise from many sources, and pose various challenges to the integrity of the medical encounter. When these issues are especially sensitive or important to the patient’s health and well-being, a complete breakdown in the therapeutic relationship may result. The goal of the emerging field of cross-cultural healthcare is to improve providers’ ability to understand, communicate with, and care for patients from diverse backgrounds. We should weave the concepts of cross-cultural care into the ethics of caring if we truly hope to have a positive impact on the health status of diverse patient populations,” (Betancourt et al).
    A physician that is sensitive to the needs of a diverse population in terms of culture and language will attract a larger patient pool. They will also be more effective in gaining the trust necessary for a patient to follow the advice and treatment plan given by the physician. Some ways a physician can accomplish this is through language services, such as translators. This will not only put the patient at ease, but will also enable the physician to get a better history and convey clearer instructions to the patient in terms of the diagnosis, treatment plan, medications, etc.

    Betancourt JR, Green AR, Carillo JE. The Challenges of Cross-Cultural Healthcare – Diversity, Ethics, and the Medical Encounter. Bioethics Forum. Vol 16 (3).

    • Taralyn, excellent! I especially found this interesting: “A physician that is sensitive to the needs of a diverse population in terms of culture and language will attract a larger patient pool.”

      Let’s go a little deeper as a class. If we follow this cultural awareness model, physicians will need to spend more time understanding the components of this process. How will this happen when a doctor is confronted with healthcare mandates, patient care, and maintaining a personal life? Why bother with diversity and cultural awareness, given these constraints?

  3. The demographic changes discussed in Futurework show more than just a change in the composition of the American population. It shows a shift in culture. Physicians will have to become knowledgeable about other cultures so that they can treat their patients appropriately and with respect. It will be important for Physicians to have bilingual offices and a diverse staff. Paperwork and billing will need to be in English and Spanish at a minimum. Patient’s records should be electronic by 2050, but Physicians will likely have to locate these records from other countries and in other languages. Physicians must implement these changes or they will not be as successful as they could have been in the future.

  4. The changes in demographics will alter the way physicians practice medicine. First, language barriers must be emphatically addressed. Many hospitals currently offer translation services, but those are fairly rare in non-metropolitan areas. The demographics change will necessitate more translators and patient forms of varying languages, but even those aren’t sufficient. I think that this will go a step further and medical foreign language (especially Spanish) classes will be integrated into medical school curricula.
    Cultural differences regarding religious affiliations and gender role beliefs must also be tackled. Dr. Camphina-Bacote writes, “To meet the needs of culturally diverse groups, healthcare providers must engage in the process of becoming culturally competent.” We are fortunate at DCOM to have already had lectures introducing how to treat patients of certain religious backgrounds, i.e. things that may offend them/scare them, etc.
    As Professor AnnaLee Saxenian noted in the video lecture, “The world really is smaller” due to globalization. The U.S., accommodating the majority of the diversification, will need to help physicians acquire skills to attend to patients of different cultures so as to better serve the nation’s healthcare goals as well as to help eliminate healthcare disparity rooted in cultural boundaries.

    References
    1. Campinha-Bacote, J., (January 31, 2003). “Many Faces: Addressing Diversity in Health Care”. Online Journal of Issues in Nursing. Vol. 8 No. 1, Manuscript 2. http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No1Jan2003/AddressingDiversityinHealthCare.aspx
    2. “Globalization and the Flow of Knowledge.” Youtube video. Online video clip. Accessed on June 8, 2010. http://www.youtube.com/watch?v=h8XDceL8jd0

  5. As the years pass, the implications of globalization, which is a very complex and dynamic, are going to affect every aspect of our society. In an article entitled “The Health Impacts of Globalization: A Conceptual Framework,” the authors state that “the health effects of the globalization process requires a more holistic approach and should be rooted in a broad conception of both population health and globalization.” With this said, these effects of the United States becoming more globalized will have many implications upon the approaches we take towards healthcare. To improve the accessibility of healthcare, the demand for physicians that are bilingual or trilingual is only going to increase, resulting in medical school admission committees factoring this element into the equation. Many cultures have different beliefs towards medicine as well as different societal norms that physicians must be know about. What we as Americans consider normal, could be offensive for other cultures. Being able to understand these cultural differences could be the deciding factor on picking one physician over another. All in all, it is critical to understand that medicine and demographics are constantly changing, and that to be a successful physician, one must take into account these changes in their practice.

    References:
    1) Hilderink, Henk. Huynen, Maud. Martens, Pim. “The Health Impacts of Globalization: A Conceptual Framework.” Globalization and Health 2005, 1:14doi:10.1186/1744-8603-1-14.

  6. Great start!!!

    At this point, I will decrease my physical input to the conversation. Let’s see what happens!

    I ask that you stretch yourself and your peers. Review the threads. Can you add an opposing view?

    Challenge the underpinning logical of the discussion… while not attacking the person.

  7. The demographic changes in the U.S. should not only be seen as an opportunity but also as an obligation in the healthcare profession. I believe the healthcare field should turn the demographical changes into opportunities for it has failed to provide quality care to the diverse patient population, especially to minorities-soon to be the majority of patient population.

    The gap of healthcare disparity is present and growing wider than ever as the population turns brown with no change in the image of the healthcare providers and student body of medical institutes across the U.S.

    To merge with the pace of globalization and close the gap of healthcare disparities, medical institutes should focus on increasing the number of minority students so to produce high number of minority healthcare providers. This will ensure that the needs and wants of minority patients are met and most importantly will decrease the pressure off of non-minority cultural sensitive physicians who have to address patients from variety of cultures/backgrounds.

    It is our obligation to care for the wide spectrum of patient population and the healthcare field should take this opportunity to diversify its healthcare providers in order to provide quality care.

    Imagine the profit the healthcare profession would experience-decrease in number of chronic patients, decrease the use of emergency rooms- when patient seek care at the moment of ill-feel because there is actually a physician who can understand their exact pain without confusion, without miss-interpretation, etc.

    Reference: Mizelle,, Kristi V. “Minority Health Disparities Position Statement.” Student National Medical Association (SNMA). Web. 09 June 2010. .

    • I absolutely agree. If we had physicians that were able to fully understand their patients, the level of health care would drastically improve. The exact place and or cause of the patient’s pain or illness could be pinpointed, instead of just guessing. I previously worked as a nurse on a labor and delivery floor. I had patients who spoke another language almost at least once a week. Hand gestures and facial expressions were our way of communicating unless there was a translator present. If they wanted an epidural, a translator legally had to be present in order for the consent to be signed. That isn’t efficient patient care. Language barriers have a significant detrimental effects on patient care.

      Timmins, C.L. (2002). The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. Journal of Midwifery & Women’s Health, 47(2), 80-96.

  8. Specifically in the health care industry, the changing demographics will have large effects and if considered appropriately, should be seen as an opportunity. It’s important for a physician to be aware of such changes because it means our patient base will be changing. Physicians should seize this opportunity to increase and diversify their clientele. However, there are numerous considerations that must be considered. The language barrier could become increasingly problematic. Thus, physicians should consider altering their practice to make office visits easier for those who do not speak English. This can also impede the process of taking a history so translators even learning prevalent languages such as Spanish may become necessary. Another major consideration is the different type of risks and diseases that accompany certain ethnic group.1 I think the first step in confronting these considerations that will confront future physicians is in the classroom. LMU-DCOM has taken some steps to confront such changes as we have had classes instructing us in cultural issues and identifying different risk patterns for ethnic groups. However, training will need to be altered even more to make these demographic changes an opportunity to treat patients more effectively.

    References:
    “Changing Demographics and the Implications for Physicians, Nurses, and Other Health Workers.” U.S. Department of Health and Human Resources: Health Resources and Services Administration.

  9. 47 million U.S. residents speak a language besides English in their home. This is about 18 % of our population. Half of these either cannot speak English or have a hard time doing so. This is a huge barrier to the health care profession, and it is only increasing. It is now understood that people in this category are less likely to understand healthcare diagnoses, medication plans, and plans for following up on treatments.
    There is one very controversial solution which would effectively make it possible in the long run to provide better care to these culturally diverse individuals. This solution is to make it mandatory for all immigrant applicants to speak English before citizenship is granted. In 2007, a poll by Hart/Newhouse boasted an overwhelming majority of 89% of Americans supporting such a law. Despite this new law, there would still be a large number of individuals seeking medical care with inferior English speaking abilities. This solution therefore would ameliorate but not completely annihilate the problem.

    References:
    Green, Alexander R Et. Al. “Cross-cultural care and communication” From Uptodate online. January 2010, accessed June 2010.
    Angus Reid Global Monitor (Angus Reid Public Opinion), “Poll and Research,” All in U.S. Should Speak English, Say Americans. http://www.angus-reid.com/polls/view/all_in_us_should_speak_english_say_americans/

  10. Since half of the population will be comprised of minority groups in 40 years, the word minority may become nonexistent in the future. While most statistics emphasize the growth of minorities in certain large cities and states, it is important to remember that the rising population of minority groups is growing all over the US and not only affecting large cities. It is becoming apparent that with this demographic increase of minorities, there will be impacts. One example of a change being made is in the state of Indiana which is experiencing a large growth in its Spanish population. In order to accommodate this growth, Indiana is distributing various types of information in English and Spanish. With a growing population of minorities there will be a need for new jobs, more private and public transportation, more education and changes in infrastructures. Not only do these changes need to be made, they need to accommodate the different cultures. In Indianapolis, for example, they have noticed that Hispanics frequently use bikes as their main mode of transportation to/from work. Since growing numbers of minorities will work and receive an education in the US, we will most likely begin to see minorities in corporate positions and minority owned firms.

    To turn these demographical changes into opportunities, physicians will need to embrace the different cultures and increase their awareness toward differences other cultures may value or need in healthcare. Doctors will need to be even more educated on how to treat different minorities in a healthcare setting to make them comfortable and respect their beliefs. Doctors will also need to make sure that minorities are receiving the same optimal health care that they are giving to every other patient that is not considered a “minority.”

    Dunn, William. Nation’s Business, Jul92, Vol. 80 Issue 7, p39
    Hagel III, John; Brown, John Seely; Davison, Lang. Harvard Business Review, Jul/Aug2009, Vol. 87 Issue 7/8, p86-89.

    • Since half of the population will be comprised of minority groups in 40 years, the word minority may become nonexistent in the future. It is important to remember that the rising population of minority groups is growing all over the US and not only affecting large cities. It is becoming apparent that with this demographic increase of minorities, there will be impacts. One example of a change being made is in the state of Indiana which is experiencing a large growth in its Spanish population. To accommodate this growth, Indiana is distributing various types of information in English and Spanish. There will be a need for new jobs, more transportation, more education and changes in infrastructures. Since growing numbers of minorities will work and receive an education in the US, we will most likely begin to see minorities in corporate positions and minority owned firms.
      To turn these demographical changes into opportunities, physicians need to embrace the different cultures and increase their awareness toward differences other cultures may value in healthcare. Doctors will need to be more educated on how to treat different minorities in a healthcare setting to make them comfortable and respect their beliefs. Ju

      Dunn, William. Nation’s Business, Jul92, Vol. 80 Issue 7, p39
      Hagel III, John; Brown, John Seely; Davison, Lang. Harvard Business Review, Jul/Aug2009, Vol. 87 Issue 7/8, p86-89.

  11. In the acclaimed book The Spirit Catches You and You Fall Down by Anne Fadiman, the author conveys a patient scenario involving culture clash and illustrating the importance of implementing culture into the patient provider relationship. The increase in diversity in the United States presents an exciting opportunity for physicians and our entire economy. Throughout history an increase in cultural diversity has brought about exposure to new ideas, new products and new ways of thinking. All cultures must strive to create a dialogue that promotes understanding and embraces similarities and appreciates differences. Physicians must embrace this new opportunity as our nations patient population grows and diversifies. This change brings about a challenge of new needs and demands to the patient population and our nations physicians must embrace and meet this challenge in order to remain competitive. Those physicians that ignore culture and every culture unique view of health will find themselves isolated from a large group of patients and perhaps involved in litigation from a failure to understand patient wishes and needs.
    Source:
    1. Fadiman, Anne The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures New York, Farrar, Straus, & Giroux, 1997

  12. In an ever changing social atmosphere, it is very important for physicians to understand the cultural background of their patients. These changes will certainly bring about a population base with a varied cultural background. Without a clear understanding of these cultural considerations, there is little a physician can do to help a patient in certain situations. An unconscious Korean man was brought to the ER with red welts on his chest. His family spoke no English and the staff focused on the welts to look for the cause of his unconsciousness. They belatedly found the cause of his condition. Had they known that the welts are from a form of traditional Asian healing, they may have saved crucial minutes and his life 1. This shows that cultural practices can impede correct diagnosis and treatment. Every culture has its own traditions and for a physician to be an effective healer in a globalized planetary village, it is important he/she understands the patient’s culture. Some states have now passed laws tying cultural competence to medical licensure. A recent publication from the American Academy of Orthopaedic Surgeons found that cross-cultural education is key to improving quality of care for all Americans 2.
    Sources:
    1-Galanti, Gerry-Ann. “The Challenge of Serving and Working with Diverse Populations in American Hospitals” The Diversity factor. Spring 2001.
    2-American Academy of Orthopaedic Surgeons (AAOS). Fact Sheet: Culturally Competent Patient Care: Cross-cultural Education for Health Care Providers Key to Improving Quality of Care for All Americans.

    • Yaya makes some excellent observations, and I would like to expand upon the point regarding states putting into effect medical cultural competency laws. California passed the first law of this type in 2003, requiring interpreters, translated materials, and data collection of race, language, and ethnicity to track disparities. Interestingly, the law did not go into full effect until 2009.

      Currently, there are six states (California included) with either already-passed into law or pending bills that require medical school students complete cultural competency training prior to sitting for state medical licensing exams. I think this sends a clear message that this is an issue that must be addressed in order to increase both the quality of patient care and the quantity of patients that can access medical care. Although resulting from legal processes, these requirements will actually help physicians to capitalize on the demographic changes and turn them into opportunities.
      Reference
      1. “Medical Cultural Competency Legislation and Regulation.” National Consortium for Multicultural Education for Health Professionals. 2009. Accessed Jul 8, 2010. http://culturalmeded.stanford.edu/news/laws.html

  13. We are undeniably in a rapidly evolving world and the United States is one the major cultural melting pots of the world. Our future as Americans will require us to embrace all lifestyles and cultures more than ever before. The change in demographics in this country will push us to be more conscious of unique expectations and interpretations of medical services from various minority groups. As well, the shift might impact the way in which physicians themselves are viewed, which could be due to cultural/ethnic or differences in physician practices. One study found that within primary care setting, Asians rated physician performance significantly less favorably than whites, Latinos rated physician accessibility less favorably than whites, and Blacks rated physicians’ psychosocial and lifestyle health promotion practices higher than whites.1 These differences may be representative of physician weakness in dealing with what are currently minorities and/or unaddressed differences in the needs of these groups. Interestingly, another study found that Black physicians cared for significantly more Black patients and Latino physicians cared for significantly more Latino patients.2 It will become even more vital that all future physicians take time to understand the needs of minority groups to build better relationships through cultural reception.
    References:
    1) Jann L. Murray-García, Joe V. Selby, Julie Schmittdiel, Kevin Grumbach, Charles P. Quesenberry, Jr. Racial and Ethnic Differences in a Patient Survey: Patients’ Values, Ratings, and Reports regarding Physician Primary Care Performance in a Large Health Maintenance Organization. Medical Care, Vol. 38, No. 3 (Mar., 2000), pp. 300-310
    2) Komaromy, Miriam, Grumbach, Kevin, Drake, Michael, Vranizan, Karen, Lurie, Nicole, Keane, Dennis, Bindman, Andrew B. The Role of Black and Hispanic Physicians in Providing Health Care for Underserved Populations. N Engl J Med. 1996 334: 1305-1310

  14. Demographic changes constantly mold the way in which workplace environments operate. For instance, medical schools are now teaching future physicians the customs of different religions. A physician would behave differently in the presence of a Protestant, than in the presence of a Muslim woman, and this is out of respect for the integration of cultures here in the US, a large part why the US is the US. With the US becoming more globalized, physicians’ patient demographic is becoming more diverse and physicians have to be familiar with customs and traditions of these patients, thus contributing to the art of practicing medicine.
    Also due to globalization, many employers are seeking bilingual employees to disintegrate the language barrier amongst customers, and amongst mangers and their staff. As the article has stated, by the year 2050 one fourth of the US population will be of Hispanic origin. It would be beneficial to know English and Spanish by the year 2050, to better serve consumers, and to better communicate with employees in the workplace, becoming a more effective manager.
    Globalization is inevitable, and physicians can turn globalization into opportunities by learning an extra language to provide quality health care to more individuals of diverse backgrounds within a community. I think language is the main issue that needs to be tackled when turning globalization into an opportunity because medicine is somewhat the same world-wide-some places more advanced than others, but the same. So if physicians can better communicate with staff, and patients, then physicians can increase the amount of patients they provide health care for.

    .::Literature Cited::.

    Holmes TE. Diversity in the workplace: Healthcare industry dives deep into Diversity. 2007

  15. According to Futurework’s predictions; by 2050 half the population will be minority, two-third of the population will be immigrants, 25% of the population will be Hispanic, and people of Asian or Pacific Islander descent will account for ten percent of the population, the composition of the American population is going to change dramatically. Persons’ with a higher educational level are more accepting of immigrants than those with a lower educational level.1 As physicians we will have the unique opportunity to encourage not only the immigrants, but our entire patient population to advance their education. There are certain economic advantages for the educational advancement of immigrants; the net present value of the fiscal impact of an immigrant with less than a high school education is negative $13,000 while the net present value of an immigrant with more than a high school education is $198,000.(1) There are also other advantages research. Most of the research done in the medical field is done on white males. The influx of immigrants will lend itself to gathering information about different ethnicities and the effects of medications through completion of adverse reaction forms. This way we can determine if there are major differences between the ethnicities in respect to the actions of medications. Preparations should be made now to prepare for the change in the American population’s ethnic and cultural diversity. To better serve our patients it would be advantageous to learn another language. As immigration increases there will be a greater pressure placed on the urban community hospitals that usually serve a greater population of the non-English speaking population.(2) Ultimately the response to the increased number of immigrants will depend on the willingness of the American- born population to adapt and work collectively with immigrants to increase the value of America as a whole.
    References:
    1.The National Academies Press; “The New Americas: Economic, Demographic, and Fiscal Effects of Immigration” (1997).
    2.HRSA; “Changing Demographics and the Implications for Physicians, Nurses and Other Healthcare Workers.” The US Department of Health and Human Services.

  16. Globalization, the world being made smaller, is an explosion of opportunity on many levels. Globalization inspires demographic shift. The rising minority groups and the ethnic and social diversity that comes with this shift have been vastly overlooked by larger social serving systems within this country, especially healthcare. Ineffectively preparing for these shifts will undoubtedly leave healthcare providers scrambling to catch up to meet the needs of the rising populations. The market has opened up for forward thinking, diverse doctors whose minds, hearts, and lifelong learning base is focused on this impending change and the lives it affects. Change will need to be on many different levels such as an increase in language skills, an increase in medical knowledge based on geographically based endemic illnesses, and cultural awareness and practices to name a few. Focus will have to be on how to provide healthcare in this shifting market and to provide effective and adequate healthcare to many new specific needs that are dictated by this diversity. The market will also open up for preventative medicine and education to these new groups of people. Physicians have an ethical responsibility to serve the increasingly changing patient population. This may require exploring new ways of thinking about and implementing healthcare. I think the opportunities that the physician has now with regard to this globalization are not necessarily as financially lucrative as they are opportunities to serve mankind in a way that many doctors in the past did not have the chance to do; to serve many different ethnic groups and impact lives in ways that will be meaningful, healthful, and hopeful. The role of the physician is to ultimately touch and change lives for the better. An effective physician will seize the opportunity to impact patients by being mentally, intellectually, and emotionally prepared to serve this ever changing reality of what we know to be “home”. This receptiveness to change should encourage even the most resistant of patients to seek healthcare from one who exemplifies such caring and invests personal time and energy into accepting and evoking positive change through outreach and service.
    References:
    1. “Globalization and the Flow of Knowledge.” Youtube video. Online video clip. Accessed on June 8, 2010. http://www.youtube.com/watch?v=h8XDceL8jd0
    2. Pol, Louis G.; Tymkiw, Douglas R.. “Demographic Change and the Supply of Physicians, Hospitals, and Hospital Beds — Marketing Implications” Journal of Hospital Marketing 4.2 (1990). 09 Jun. 2010. http://www.informaworld.com/10.1300/J043v04n02_07

  17. America is very unique in its history and collaboration of cultures. We have evolved from a country attempting to assimilate to one culture or a “melting pot” to a “truly multicultural mosaic” (culturalsavvy). Most, or possibly even all of us, identify ourselves as American, but also as the nationality of our ancestors. According to the Washington Post, most Americans chose a category of a hyphenated American when asked how they ethnically identified themselves. Immigration is not a new phenomenon to the US and I feel that our country is more prepared than any other to handle the situation. After all, we are a country already made up of immigrants; would it not be somewhat hypocritical to deny other immigrants the opportunity to settle in the US? We should embrace the changes and influx of new cultures and experiences into our workforce. The US has the capability of becoming the most culturally diverse and this is a characteristic that should be used to our advantage. We will be better equipped to tackle the evolving global market than other nations due to our diversity and understanding of consumers around the globe.

    Booth, William. “America’s Racial and Ethnic Divides; One Nation Indivisible: Is it History?” The Washington Post: The Myth of the Melting Pot. http://www.washingtonpost.com/wp-srv/national/longterm/meltingpot/melt0222.htm, 1998.
    Millet, Joyce. “Understanding American Culture: From Melting Pot to Salad Bowl”. http://www.culturalsavvy.com/understanding_american_culture.htm, 2000.

  18. I think physicians can turn these demographical changes into opportunities in many different ways. Since there is a cultural and language barrier, certain demographics will choose to only see physicians that are from the same culture as themselves. Physicians can utilize these opportunities by marketing to these certain demographics. It is much easier for a patient to relay his or her concerns to a physician who has the same cultural background and speaks the same language.

    Next, certain demographics tend to have an increase prevalence and/or incidence of certain diseases or pathologies. For example, African Americans have a much greater risk for hypertension, which eventually leads to premature death from hypertension-related complications (High Blood Pressure). This may eventually lead to an increased supply of patients because they will be more aware of their predisposition. Perhaps, physicians can market themselves towards these diseases while educating the public?

    In addition, certain demographics are biased towards a certain type of treatment. For example, Chinese people lean more towards holistic and homeopathic medicine. If physicians educated themselves on the preferences of certain demographics, they could gain on the market share.

    Works Cited
    High Blood Pressure. (n.d.). Retrieved May 09, 2010, from National Heart and Lung Institute: http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhoIsAtRisk.html

  19. The effects of globalization will inevitably be seen in health care. There are indeed many benefits that arise for the physician in terms of a growing immigrant population such new patients and an expanding revenue base. Nevertheless, swelling immigration does have its possible negative implications for the health industry. If individuals migrate to the United States and maintain dual citizenship with their country of origin, there is always that possiblity that they may choose to go and have medical procedures done in their original country if it costs less. Therefore having a patient base that is heavy in immigrants creates a new competition for the physician. It is no longer just the physician down the street. It is also the physician across the ocean. What this means is that the entire health care system overhaul has to take these considerations into account. If the healthcare playing field is truly global we need to to look at prices world over before deciding to charge certain amounts for certain procedures. With the modern patient becoming a more discerning health care customer, doctor shopping is probably going to become international as well. In fact it already happening. Patients are going to India for instance for procdures as stated by Segoin et al in their article on globalization in healthcare. Therefore immigration becomes a call to a bigger stage in terms of practise and pricing considerations. Physicians therefore need to be more aware of what is going on in the healthcare arena both locally and abroad. When seeing patients from different ethnic backgrounds they need to be aware of the possible ramifications of not being culturally sensitive, overcharging for elective procedures and so forth. Physicians can turn these trends forecasted by futureworks by coming out of the mindframe that healthcare reform is simply a US issue. The future immigrants will be part of the health care bundle that is in progress. The major difference is that they may have an alternative that is across the border. So, finding out more about the cultures of the immigrants and about what is offered where they came from might help a physician position himself better in serving the new immigrants.

  20. As the population of the United States increases along with diversity, the demographic is becoming more intangible. Due to these changes, the needs and wants of business are shifting. Most notably, medicine is an avenue that has been studied immensely to find a way to meet these new challenges while still caring for the aging “baby boomers” needing their portion of care. Cooper et al argues these trends are indicative of an impending physician shortage if current medical education quantity is held constant. This is not only a warning sign, but a motivation for physician self-education to meet these new demands. Learning a second language, studying related cultures and religions, or researching ethnic disease trends could give physicians a great advantage and likely set their practice apart tremendously in the market. Utilizing this disruptive change and adapting to suit, physicians and other occupations could benefit greatly, specifically from those unwilling to change.

    Cooper RA, Getzen TE, McKee HJ, Laud P. Economic and demographic trends signal an impending physician shortage. Health Affairs. 2002;21(1):140–154.

  21. Immigration and ethnic diversity have always been very present in American society. Language and cultural barriers have existed for hundreds of years. The biggest change I believe has only been shifts in the geographical areas from which immigration has originated. As time and generations pass, immigrant populations almost always identify more with being only American than the countries of their ancestral heritage. Eventually after a generation or two, all speak English primarily and have become completely assimilated into American society. The implication of this on the administration of healthcare is fairly straightforward. Healthcare professionals like all business professionals need to have the ability to effectively communicate with all potential clients as well as be aware of relevant cultural characteristics. Hospitals and clinics need to have available bilingual staff to translate whenever the need arises.
    Immigration reform and its relationship to healthcare raise many great concerns. According to the article “Illegal Immigration Enters the Healthcare Debate” by Miriam Jordan (Wall Street Journal, Aug 15, 2009) there are 12 million illegal immigrants in the U.S. without health insurance. I believe the most efficient way resolve this issue is by giving all illegal immigrants citizenship following a mandatory four year period of public service, military or otherwise. Following the attainment of citizenship, with the recent changes in healthcare reform they will all become insured which will greatly reduce the stress on the healthcare system overall.

  22. The culture we live in is going to be even more diversified. English is the primary language, but many more are spoken on a regular basis in the United States. More people are going to learn Spanish in order to make their business more profitable and efficient.
    Physicians could look at this change as an opportunity. Speaking a second language has always been a great skill to have, and by putting that skill into practice, you can improve your business. As a physician, if you have the ability to speak Spanish, you have just opened up your practice to an additional ¼ of the population by 2050. Care from bilingual physicians will be more cost effective because a translator does not have to be used and paid. According to Kuo et al., “pediatricians in states with third-party reimbursement for language services are more likely to report use of professional interpreters”. Physicians could see the need for bilingualism, and as pre-medicine students, or after, take the time to learn Spanish for more effective, less costly care to their future Hispanic patients.

    Kuo, D.Z., O’Conner, K.G., Flores, G., & Minkovitz, C.S. (2007, April). Pediatricians’ use of Language Services for Families With Limited English Proficiency. Pediatrics, 119(4), 920-927.

  23. We live a great country that has been since its conception beautifully morphed by contributing cultures from countless immigrants. As such, centuries of influx of novel ideals have yielded one of the most prolific economies ever built. I believe that the mixed demographics that currently exists will only continue to enrich our society with great ideas and innovations to accommodate the evolving needs. The impacts that an increase in certain sectors or “minorities” of the population will have on our work force are uncertain. Still, I foresee social, political and economical changes to adjust the needs of these population. The enactment of legislation to guarantee educational, medical and occupational opportunities for all sectors of the population will also be a necessity. Moreover, an increase in the workforce is expected since the main reason why America attracts people is because here there is a legit opportunity to progress economically.

    Physicians have a very special role in our American society. They have a set of skills that can be utilized to satisfy the needs of all sectors of the population. As such, their job is not only to be well trained medically, but they also need to understand cultural differences. The simple ability to communicate with patients in their own language enables physicians to capture a great deal of intangible information. Physicians can also utilize these changes in demographics to champion political changes which would benefit a now larger sector of the medically unattended population which before lacked the strength to demand political attention.

    In the end, these changes will make us even a greater nation.

  24. Cultural differences will continue to shape the face of this country. However, when viewed in the short term these waves diversity can be seen as a drastic change that needs immediate involvement. But when viewed over time and through the pages of history, cultural change can be a major indicator in the way we define the USA: the Irish immigration in the early 1800’s, mass Italian immigration in the late 1800’s, the Chinese immigration beginning in the 16th century, and the African influx due to the slave trade. All of these cultures have shaped and formed the US into what it is today and characteristics of these peoples silently exist all around us. Therefore modern managers should not see cultural differences as a threat or impossible challenge but should embrace this change as part of the evolving country we live in.
    Physicians can see this shift as a HUGE opportunity. In my experience, there are many cultural and religious issues that prevent or restrict certain individuals from seeking care. If a doctor catered his/her practice to an emerging demographic/religion and assured these patients that specific details of their culture would be respected, that physician could promote significant success.

  25. Demographical changes are opportunities for emerging organizations to participate in healthcare. For instance, many emergency rooms are not staffed with translators to communicate healthcare with international patients.

    Low-income and uninsured patients are choosing a relatively expensive way to get acute problem care without addressing preventive needs, but because of the inconvenience of office visits, many choose the ER. The Wallace Road clinic’s inception began at a Lipscomb University seminar “aimed at building business ties with local Hispanic residents,” (1) in which access to healthcare was the main topic. The result has been a clinic that sees ~16 patients daily, many of which come straight from the emergency room.

    This isn’t a novel idea; “the Nashville based United Neighborhood Health Services has 14 other clinics throughout Middle Tennessee” (1). The difference for Wallace Road clinic is said to be convenience. As other safety-net clinics open, we may begin seeing economic savings for city and state, as well as a more thorough and closely watched progression of patient care in the Hispanic population and Caucasian population alike.

    References:
    1) “Clinic concept may lower ER costs.”, April Wortham; Nashville Business Journal; March 19, 2010

  26. Scientific research suggests that a big part of healing is emotional healing. This is an integral part of treatment that a physician can utilize to treat their patient. This is important to understand when we talk about culture and the impact it has on physicians in our society because emotional healing results from a patient being comfortable with the situation they are in and this can be effectively understood with good communication. Healthcare should accommodate different cultures to make a better connection with the patient. If a physician understands a patient’s culture, it creates a stronger bond between the physician-patient relationship and it opens avenues to give better care. This will allow the physician to give optimum care which is the primary duty of a doctor. Communication will enhance between patient-physician when a physician understands the cultural background of a patient and the specific diseases related to certain ethnic backgrounds. In doing so, we will gain a competitive advantage and provide higher quality of service.
    Goleman, Daniel. “Friends for Life: An Emerging Biology of Emotional Healing .” Mental Health and Behavior. NY Times, 10/10/2006. Web. 16 Jun 2010.

  27. While globalization and diversification may be ever more apparent in America, America is still a beacon for the world as a land of opportunity and a bastion for freedom. The freedom to choose religion, language, and enterprise are rights that establish American identity. These freedoms are given to every citizen by birth or naturalization (from the Bill of Rights) though they have been diluted by legislation to further social agendas unnecessarily without regard for the original documents. In contrast, there are customs and social governances that establish unity as Americans such as speaking the English language; social governances established so that our historical differences can be transcended as much as understood in the amalgamation of our citizens. There are over 6,000 languages throughout the world and one universal language accepted at least in conducting business. It may be beneficial in America to be proficient in many languages to traverse global cultural barriers, though it serves as much to promulgate a division among global partners when we lose focus on what unites [us] as Americans. It is such an important founding principle in America it is on every dollar bill “E Pluribus Unum”, translated “Out of Many, One”… in Latin, a language whose context does not change and remains uncontestable.

    Works Cited
    Feith, David. “Don’t Know Much About History.” Wall Street Journal 5 September 2008: w11.

  28. The abundance of immigration in the United States creates opportunities for businesses to spread the awareness of their products to other ethnic groups. If correctly managed, this will lead to a greater market share and opportunities for the businesses that do so. We will begin to see a greater number of advertisements in multiple languages so as to appeal to a wider variety of consumers. Products will begin to be tailored towards certain ethnic groups. Ultimately, I believe this will not only allow, but force a wide variety of ethnic backgrounds into each level of the business structure. The “glass ceiling”(1) metaphor will become less common since the promotion of minorities will be pertinent in the success of many future businesses. This should also help the overall wage differences faced by immigrants all over the U.S., especially since “nnegative wage effects of immigration are concentrated among workers with fewer than 12 years of education because recent immigrants tend to be less educated than the U.S. population as a whole.”(2) Bilingual physicians will also have much more of an opportunity to offer healthcare to patients that otherwise would have a difficult time receiving it.
    1.) Jones, Gareth R., and Jennifer M. George. “Chapter 5.” Contemporary Management. Boston: McGraw-Hill Irwin, 2009. 52. Print.
    2.) “How Has Immigration Affected the U.S. Economy?” Federal Reserve Bank of Atlanta. Web. 13 July 2010. .

  29. Demographic changes constantly mold the way in which workplace environments operate. For instance, medical schools are now teaching future physicians the customs of different religions, which contributes to the art of practicing medicine.
    Also due to globalization, many employers are seeking bilingual employees to disintegrate the language barrier amongst customers, and amongst mangers and their staff. As the article has stated, by the year 2050 one fourth of the US population will be of Hispanic origin. It would be beneficial to know English and Spanish by the year 2050, to better serve consumers, and to better communicate with employees in the workplace, becoming a more effective manager.
    Physicians can turn globalization into opportunities by learning an extra language to provide quality healthcare to more individuals of diverse backgrounds. I think language is the main issue that needs to be tackled when turning globalization into an opportunity because medicine is somewhat the same worldwide some places more advanced than others, but the same. If physicians can better communicate with staff and patients, then physicians can increase the amount of patients they provide healthcare for.
    Literature Cited
    Holmes TE. Diversity in the workplace: Healthcare industry dives deep into Diversity. 2007

  30. I believe that one of the major ways that these demographical changes will impact healthcare is through the straining of the doctor-patient relationship. When doctors and patients from different cultures interact, many important barriers tend to arise. The most obvious is the language barrier which is effective to communication. This often leads to each party relying on stereotypes or bias that prevent trust and respect from integrating into the relationship. These problems also will arise not only in the patient-doctor relationship, but the co-worker relationship as well. Far too often in the workplace cliques form separating people based on a wide range of qualities. Shifting demographics in the workplace could cause these cliques to arise and prevent the workforce form reaching their potential. Future managers must be able to integrate incoming workers smoothly to prevent these types of events from happening.

    Grantham, Charles, and James Ware. “Demographics and the Changing Nature of Work.” Corporate Real Estate Leader May (2004): 24-26. http://www.thefutureofwork.net/assets/Demographics_CRE_Leader_May_04.pdf.

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