This thesis explores the role of the practitioner on Aboriginal health outcomes, by examining influential factors on the decision-­‐making process and engagement in this field. This topic became an interest after working as a medical student and junior medical practitioner, where differences in the decision-making process for Aboriginal peoples were experienced.
International and local studies have explored the role of the practitioner in maintaining ethnic health disparities. Proposed ways in which providers do this include; the decision-making process, implicit and explicit beliefs about patients, feelings toward and expectations of patients, practitioner interpretation of symptoms and interpersonal behaviour. Setting characteristics such as time and respect for diversity are also key factors that play a role in this field.
A qualitative approach to the topic was implemented, using semi-structured interviews with 16 medical practitioners from the Perth Metropolitan region and the Kimberley region. Participants had a diverse range of clinical expertise and experience. Interview data was transcribed and analysed using thematic networks.
The interview analysis found that unequal treatment and institutionalised racism play a role in health disparities experienced by Aboriginal people, which were also influenced by key setting factors such as time, staff, case-load and resource availability. The importance of communication was highlighted when looking at the need for patient-centred care as a way to work towards improved health outcomes for Aboriginal peoples. Having accurate representations of patient reality in addition to minimising negative perceptions of adherence was found to be a critical aspect potentially impacting health outcomes. The acceptance of the normalisation of poor health resulting from immersion and reduced resource allocation is an area in need of attention if Aboriginal health outcomes are to see an improvement.
Aboriginal health is a dynamic field encompassing people with unique contexts, realities and ways of life. Having an understanding of the broader issues relating to Aboriginal health, and implementing this in a patient-centred context, was viewed to be the key in providing effective healthcare to Aboriginal peoples. Core notions of self-determination and patient empowerment were found in this research. Medical practitioners hold the responsibility to enable their patients right to health; working closely with Aboriginal patients, empowering them in decision-making processes and realising their individual priorities is a step toward equitable health in our society.
|Award date||1 Jun 2016|
|Publication status||Unpublished - 2016|