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Article Review: Changing Provider Behavior

Article Review: Changing Provider Behavior

Article Summary

The article by Horner, Salazar, Geiger, Bullock, Corbie-Smith, Cornog, and Flores (2004) examined how healthcare professional’s behaviors can be changed particularly in an endeavor to eliminate disparities within healthcare sector. The authors observed that the communication process between healthcare providers and patients, especially minority population, is characterized by immense challenges. They noted that there is a noticeable racial and ethnic disparity while offering healthcare services within American context. According to the authors, disparities in healthcare utilization among the minority groups in United States are extensively documented across diverse health conditions. There is an increased public awareness of the situation especially with the numerous reports of disproportionate access to healthcare (Horner et al., 2004). According to the authors, the causes of such disparities as well as their effects on the health status of the patients have become a major area of inquiry among healthcare researchers and stakeholders. Article Review: Changing Provider Behavior

Horner et al. (2004) argued that healthcare professionals’ behavioral problems are the root cause of the disparities even within healthcare systems that offer equal access to both the whites and minority groups. In programs such as Medicaid and Medicare, which are equally accessible to all Americans, patients from minority groups are considerably “less likely than whites to receive either key diagnostic procedures or effective therapies after adjustment for important clinical indications” (Horner et al., 2004, p. 12). These inequalities have distressing effects on the health status of the minority patients. In an endeavor to address this problem, several suggestions have been presented.

Horner et al. (2004) identified healthcare provider as one of the key intervention points in the efforts to correct the disparities in health utilization. The authors identified the need of training health providers to be sensitive to the language and cultural needs of the minority groups in an endeavor to change their behaviors. They also recommended the need of modification of healthcare services so that they can be more culturally acceptable. According to the article, as much as patients exercise some control over the process of clinical decision-making, healthcare providers have the principal role of determining a particular condition’s clinical management. Drawing from some previous studies, the authors acknowledged biasness in offering healthcare services. Appreciating the need of behavioral change, Horner et al. (2004) noted the prevalence of provider-focused interventions, which adversely affect the minorities’ healthcare status.


In their study, Horner et al. (2004) revealed that one of shortcomings of healthcare providers is cultural incompetency in offering healthcare services to their patients. They researched several strategies that could be used in behavioral change among healthcare providers in heightening cultural sensitivity. Such strategies included educational programs, administrative change, active participation, reward and penalty system, and use of feedback. The authors identified educational outreach as one of the most effective behavioral change approach for healthcare providers. Their study identified several interrelated initiatives that have proven productive in improving cultural competency among healthcare providers, including: Article Review: Changing Provider Behavior

  1. Training in cultural competence,
  2. Monitoring of healthcare processes and outcomes,
  • Certification and accreditation requirements,
  1. Diversity in the membership of governing boards,
  2. Enhancing and retaining diversity in the healthcare workforce.

Personal Opinion about Raised Issues

I agree with the authors that numerous disparities witnessed in utilization of healthcare services are caused by healthcare providers. Although some of these healthcare providers are ignorant of their actions as well as their subsequent effects on the health of the minorities, it is apparent that such behaviors are common, have very destructive effects, and thus need to be addressed. Considering that many practitioners are unconscious of their destructive activities and behaviors, it is important for the major stakeholders such as the government to introduce intervention measures that would seek to enhance and heighten cultural sensitivity, thus discouraging the destructive behaviors. Thus, the authors are right in suggesting the need for behavioral change intervention among the healthcare providers as one of the ideal ways of dealing with the problem.

Horner et al. (2004) suggested one of the interventions to improving cultural competency as training healthcare providers on cultural competency. This approach can be very effective because it involves introducing the problem as well as its effects to health status to the students early before they get into the profession. Although cultural competency training should also be introduced to practitioners in the field, acknowledging its importance is critical for its early introduction among scholars in the field of healthcare. The authors also recommended that this training “should be continuous throughout the formal training period and during practices” (Horner et al., 2004, p. 14), a position which I fully support because it will help the students acknowledge the significance of cultural competence not just as another item in their learning but as a central part of their profession.

Equally admirable in Horner et al. (2004) recommendations about cultural competency is the need to monitor healthcare processes and outcomes. The scholars advised that elimination of inequalities need to be measurable so that one can determine whether they are making any progress towards the desired position. I particularly agree with the authors on the use of patients in gauging progress towards increasing cultural sensitivity. The patient-satisfaction feedback from members of minority groups can be an ideal tool for measuring individual healthcare provider’s cultural competency. Through such feedbacks, the management of a healthcare facility can assess their quality-assurance programs and determine whether any adjustments are necessary in improving the quality of services offered to their clients, including the minority groups.

Horner et al. (2004) posited that certification can play a critical role in enhancing cultural competency and minimizing disparities in acquisition of health services. The authors posited that accreditation and professional certification of individuals for having proven to be culturally sensitive or competent can go a long way in overcoming the problem of disparities. However, I have my reservations about certification in an endeavor to change healthcare providers’ behaviors in relation to dealing with their patients from minority groups. Accreditation can only be effective if the stakeholders have follow up programs and measures geared towards assessing individual’s application of their acquired skills. One might have the necessary certificates indicating cultural competency but fail to exercise the requirements of the certification. Article Review: Changing Provider Behavior

Application to My Position in Healthcare Industry

The works of Horner et al. (2004) is very resourceful in my contemporary and future career within healthcare sector, particularly in dealing with the minority. The very understanding that the problem cultural insensitivity is so widespread is a great resource to me. I may have exercised my profession ignorantly and contributed to the disparity unknowingly. However, the article has widely examined the issue and created a new awareness. The authors have examined the role of training about cultural competency in an endeavor to minimize problems that are triggered by cultural incompetency. The information is relevant in learning how to effectively communicate with patients from diverse populations in a way that would not affect their opinions about healthcare services or me as a healthcare provider.

The information about the need of enhancing diversity in healthcare sector is indispensable in my future position as a healthcare professional. The diversity encompasses balancing the cross-cultural competence needs with the demands of patient care. With this understanding, I will no longer take the need of cultural diversity as a secondary need in providing healthcare services to my patients but as an important element in provision of healthcare. If I were to run a healthcare facility in the future, I will be sensitive to the cultural needs of the patients, thus ensure a balance in hiring healthcare providers and in the approaches they employ in dealing with their diverse patients. Recruitment of the minorities in healthcare facilities at all levels of staffing will go a long way in minimizing the disparities’ problem. Article Review: Changing Provider Behavior

The authors of the article recommended that stakeholders and players in healthcare should consistently monitor healthcare processes and outcomes as one of the strategies of eliminating inequalities. This information is very important in my current and future position as a healthcare worker because it exposes me to the human weaknesses of possible regression in realizing the goal of cultural competency. With frequent evaluations of the progress, I will be able to determine when am failing or the healthcare providers I supervise are retrogressing in the pursuit of cultural competency.


Horner, R., Salazar, W., Geiger, J., Bullock, K., Corbie-Smith, G., Cornog, M., & Flores, G. (2004). Changing Healthcare Professionals’ Behaviors to Eliminate Disparities in Healthcare: What Do We Know? How Might We Proceed? The American Journal of Managed Care, 10, pp. 12-19.Article Review: Changing Provider Behavior



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