Ex-inmates face barriers to booking medical appointments: UBC study
Former prisoners in B.C. are struggling to access health care because of a stigma attached to those who spend time in jail, say UBC researchers.
A report, published this week in the Annals of Family Medicine, found people who disclose that they have been in prison before asking for an appointment with a family physician are significantly less likely to be offered that appointment than other patients.
For the study, researchers called the offices of 250 family physicians listed as accepting new patients on the College of Physicians and Surgeons of British Columbia website.
In half of the phone conversations, callers said they had been released from prison a few months ago before asking for an appointment with a family doctor. The other half of the callers (the control group) asked for an appointment with a family doctor without providing any background information.
The researchers found the control group of callers were nearly twice as likely to be offered an appointment than those who mentioned that they had recently been released from prison.
The report concludes that discrimination on the basis of imprisonment is a major barrier for ex-inmates trying to access physician care.
One of the study’s authors, Dr. Ruth Elwood Martin, a clinical professor in the school of population and public health at UBC, said the researchers were unable to determine who in the physician’s office was discriminating against the former inmates.
“Sometimes an office manager would say, ‘I’ll just go check with the doctor,’ ” she said. “So if the physician says they’re accepting new patients but there’s this response that, ‘Well, we’re not ac- cepting you,’ we assume it must reflect the practice as a whole.”
The researchers didn’t aim to single out any physician as being discriminatory, so as not to shame anyone, and informed all offices that they were part of a UBC study.
“We were horrified by the difference between the two groups,” she said, adding that there was no difference in whether the caller was male or female. Rural and urban family practices were found to have an equal amount of offices declining former inmates an appointment.
Elwood Martin said more research is needed to understand why inmates are being discriminated against, and to provide policies and programs to support both those who have been incarcerated and health care providers.
She believes the reason patients are turned away has to do with a stigma and fear.
“Family doctors are probably frightened of people coming out of prison, and there may be this sense that if things go sideways, they won’t have the skills to handle the situation.”
This study arose from earlier work Elwood Martin has been involved in that looks at how men and women cope after being released from a provincial prison.
UBC researchers have developed guidelines that have been adopted by the B.C. College of Family Physicians to help doctors understand the health challenges facing inmates. For example, inmates have a higher incidence of mental health illness, addiction, and blood-borne infections such as hepatitis C and HIV than the general population.
She said while gains have been made in treating patients while they’re in prison, there needs to be much more focus on how to follow up with patients once they’ve been released.