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Elise R. Osborne

Professor Carlos Chism

Pre English

30 July 2017

How Do Doctors Treatments Differ Depending on the Perceived Socioeconomic

Standing of the Patient or Their Own Parental Status?

When it comes to children with disabilities living in a low income homes,

insurance does not tend to cover what those kids need in order to understand the world

around them. Health care officials did not want to treat special needs kids because their

low income could not cover the bills that were required for their care services. My own

experience relates to this because when my sister was a baby, she was diagnosed with

Autism. My mother had a difficult time finding a behavior specialist for her since health

insurance limits the coverage for her behavioral therapy. With that being said, with

limited coverage, there is limited access to providers unless you pay out of pocket -

which can get very expensive, very quickly. So since we are a low income family, it was

hard for us to find a care provider in this specialty who accepts our insurance plan.

However in January 2017, laws mandated that insurance companies cover the behavioral

therapies so now more providers will accept the insurance that we have. Now, it is easier

for us to provide for my sister. Even though the law has made it so that insurers have to

cover behavioral therapies, does that mean all health care physicians follow the law?

Should health care providers treat patients differently based on their economic status?

According to the article A Qualitative Examination of Physician Gender and

Parental Status in Pediatric End-of-Life Communication, all of the participants, both

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those who were parents and those who were not, felt that physicians' parental status

influenced their care of dying children (Bateman et al. 5). Thus, providing a sound

structure for the question does parental status matter when it comes to physicians child

care? When it comes to empathizing with families about their children, most physicians

can not relate on a certain level because one their kids do not have disabilities and two

the kids are not their own. Once physicians have children of their own, some would

emphasize that it actually became easier to empathize with families once they had

children (Bateman et al. 5). Doctors would even go as far as saying Whoa, that could

have been my child" (Bateman et al. 5). This enables them to see how much pain the

family is going through and makes their job easier. This brings into light the physicians

who can still relate to the children without having children of their own. A few doctors

have mentioned that they can still eject empathy even without having kids. Relating on

personal level can be tricky. Although it does make the doctor want to push more for the

care of that child, does that mean that the physician is withholding care in some

instances where it gets expensive?

This ties with the argument that Carbone et al., author of the article Parent and

Pediatrician Perspectives Regarding the Primary Care of Children with Autism

Spectrum Disorders, made in regards to the mental status of children with disabilities.

The author states how unfortunate it is that only half of children with special health care

needs (CSHCN) receive care within a medical home, and children with autism spectrum

disorders (ASD) are even less likely to receive this type of care (Brachlow et al. 1). This

is due to the fact that low income parents lack the strong parent-provider for the medical

fees that come with medical home treatment/therapy sessions. With that being said,
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parents need to have a strong united front so they can get their child the care that they

need. However, it is mentioned that there is evidence about how pediatricians lack the

confidence it takes to care for children with ASD. Does that mean without the proper

motivation and positivity, are physicians not giving low income kids the medical care

they need? Or is it the pressure of the child being in a low income home overwhelming

the physician to be 'perfect'?

Besides the parental status of physicians and the low income status of families,

the article Evidence-based Prescribing of Antibiotics for Children Role of

Socioeconomic Status and Physician Characteristics by Kozyrskyj et al. combines both

ideas on a more complex level. The article mentions that the study that they were

enduring was a way to determine the child (with/without disabilities), household, and

physician factors in caring and prescribing medicine for children (Kozyrskyj et. al., 1).

Based on their results, 45% of physician visits resulted in prescribing and 20% of

antibiotics prescriptions were for second-line antibiotics (evaluation of the first-line

drugs). Their statistics showed that there was a link between the children and the

location of their sessions. Furthermore, it implies the idea that parents have a very

important role in how the child performs. However, the likelihood that an antibiotic

would be successful was 0.99% in $10,000 increase in the household income, meaning

that with every success, the higher the income.

In contrast with the socioeconomic status of families, the article Race,

Socioeconomic Status, and Health The Added Effects of Racism and Discrimination by

David R. Williams, shifts the discussion to racism and social discrimination in the

overall argument. The author explains that racism has restricted socioeconomic
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attainment for members of minorities. Williams also notes that white men at the age of

45 have a life expectancy that is roughly 5 years more than their black counterparts and

white women at the age of 45 have a life expectancy that is roughly 4 years greater than

their black peers (paragraph 6). The author compares these results with the

socioeconomic status of each group. Thus, providing reasonable interest towards the idea

that race does play a part in the socioeconomic status of how low income vs high income

can receive fair and equal medical care.

When it comes to socioeconomic status and health care, there is a lot that many

people do not know. Authors Nancy E. Adler and Joan M. Ostrove of the article

Socioeconomic Status and Health What We Know and What We Don't, touch base on just

how these two topics play a big role in low income children who do or do not have

disabilities. In the data collected, it explains that the socioeconomic status was not

included in the health aspect as a variable. The authors came up with two alternative

explanations for the association of socioeconomic status and health. One of them is that

socioeconomic status (SES) does in fact influence health status of patients. Second is

that social interactions could be affecting the health care for kids and/or adults (Adler

and Ostrove, paragraph 10). Showing that it is not only a discussion about the parental

status of the primary care physician, socioeconomic status of the patient, or even the race

of the family. This is about outside influencers as well, meaning the environment they

surround themselves in.

As a result, does only the socioeconomic status of a patient differ how primary

care physicians treat them? It does come down to the statistics in the end. Should doctors
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discriminate against race and withhold care to children with or without disabilities based

on their personal experiences?

Work Cited Page

ADLER, N. E. and OSTROVE, J. M. (1999), Socioeconomic Status and Health What We Know

and What We Don't. Annals of the New York Academy of Sciences, 896 3 15.

doi10.1111/j.1749-6632.1999.tb08101.x

BATEMAN, L. B., et al (2017) A Qualitative Examination of Physician Gender and

Parental Status in Pediatric End-of-Life Communication, Health

Communication, 327, 903-909, DOI 10.1080/10410236.2016.1196412

Accessed 27 July 2017

CARBONE, P. S. et al. (2012) Parent and Pediatrician Perspectives Regarding the

Primary Care of Children with Autism Spectrum Disorders, 43964972 DOI

10.1007/s10803-012-1640-7 Accessed 27 July 2017

KOZYRSKYJ, A. L, et al. (2004) Evidence-Based Prescribing of Antibiotics for

Children Role of Socioeconomic Status and Physician Characteristics, doc

10.1503/cmaj1031629 Accessed 27 July 2017

WILLIAMS, D. R. (1999), Race, Socioeconomic Status, and Health The Added Effects of

Racism and Discrimination. Annals of the New York Academy of Sciences, 896 173

188. doi10.1111/j.1749-6632.1999.tb08114.x