Patient partners

MASSACHUSETTS General Hospital and Partners HealthCare are adding a new soldier to the battle against racial and ethnic disparities in health care: pledging $3 million to start the Disparities Solutions Center. The center joins Mayor Menino and many researchers in the effort to promote equal health -- from more-timely diagnoses to consistent testing and treatment, especially of heart problems.

The center has to open doors, make sure everyone gets first-class care, but also change patients' hearts and minds.

People have many reasons for avoiding healthcare. There's mistrust of doctors, which can be personal or based on bitter history, such as the infamous Tuskegee case, when blacks with syphilis were studied instead of cured. Poverty gets in the way. Taking off time from work can seem too onerous and putting food on the table more important. Language, culture, and transportation can be barriers. Some people rely solely on faith for medical protection. Others rely on denial.

These human causes are real and deserve understanding as well as equally human solutions. So it's good news that Mass General's new center will focus on patients.

One plan is to build on the successful model of patient navigators, people who guide patients through the long corridors of cancer care. Good navigators have warm, outgoing personalities and knowledge of healthcare systems. The MGH Chelsea Health Center has two navigators who accompany women through breast and cervical cancer treatment, typically serving Latina women. Navigators go with patients on shuttle bus rides to the hospital, call patients who miss follow-up appointments, and are available throughout treatment. They also help cut the financial losses incurred when patients miss appointments. The challenge is to expand, hiring more navigators to work with more patients, especially men who shy from medical care.

The center will also work on ''patient activation," encouraging people to be engaged consumers who can comfortably ask questions. Otherwise, some patients don't fully understand their doctors, don't ask questions, and don't take their medication -- a poor outcome for those with chronic diseases such as asthma, high blood pressure, and diabetes.

Dr. Joseph R. Betancourt, the center's director, wants to put research on disparities into action, from large programs to helping doctors build more trust during office visits.

The center and other efforts will need more funding to expand the best programs. Chelsea supports its navigators with grants and donations. Creating permanent change requires long-term resources.

The center must help build smarter, more compassionate delivery systems that close the social gaps in healthcare.