How Providers Can Acquire Structural and Intersectional Competencies

AbstractThis piece describes two patients whose external circumstances caused harm to them. One had poor health insurance and lacked financial resources. The other lacked access to optimal healthcare because he was not a U.S. citizen. These external factors are commonly now referred to as "structural" and "intersectional" when they are single and multiple, respectively. This piece initially discusses how providers may better come to identify these external sources of harm to patients and then, hopefully, seek to alleviate them. It then discusses how providers, too, may cause external harm. They may make erroneous presuppositions about their patients based on their having certain impairments or symptoms, not know this, and as a result cause these patients iatrogenic harm. Means to avoid this, drawn largely from The Anti-Ableist Manifesto, a recently published, authoritative text on this subject written by Tiffany Yu, are outlined. Finally, the life of a young man, Mats Steen, is presented. His life most profoundly poses the questions of how we make inferences regarding people based only on how they look and what (little) we may know about them and how this may then affect how we can relate with them. Steen's life story is viewable on Netflix.