How a family physician gets to know her newly arrived refugee patients

The reason for Chandra’s office visit is to fill out form N-648. Chandra* is a fifty-nine-year-old Bhutanese refugee who has been my patient for the last nine months. Form N-648 is a six-page bureaucratic nightmare that is guaranteed to bring my clinic day to a grinding halt. My refugee patients bring me this form to certify that they are unable to take the test to become a U.S. citizen due to a severe, permanent neurologic disability. My job is to document the extent of their disability and provide a detailed account of all of the factors that led up to it.  The first question on the form reads: “Provide the clinical diagnosis and DSM-IV code (if applicable) of the applicant’s disability and/or impairment(s) that form the basis for seeking an exception to the English and/or civics requirements.” This is followed by five more pages of repetitive and equally baffling questions. The Department of Homeland Security is not easily placated. Successful completion of this form requires starting with the patient’s birth history and meticulously documenting an iron clad medical story to explain why they cannot learn to read and write in English or learn U.S. history. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Primary care Source Type: blogs