Walk in My Shoes: Accessing health care is often no walk in the park

September 20, 2011 by Jessica Goldberg

On Friday, September 16, 2011, around seventy individuals (including myself) participated in the Walk in my Shoes (WIMS) healthcare access simulation at Brandeis University in Waltham, MA. The event, developed by Community Catalyst, hosted by the Listen and Learn Project and funded by the Blue Cross Blue Shield Foundation of Massachusetts, aimed to open the eyes of those that participated to the everyday, and often seemingly insurmountable, challenges that face uninsured and underserved families trying to access and navigate the U.S. healthcare system.

The WIMS simulation is broken down into two hour-long segments: The first hour consists of a live-action role play in which all participants are assigned “roles” with a given set of characteristics that affect their access to health care. These include health concerns, employment status, insurance coverage (or lack thereof), race/ethnicity, immigration status and other relevant characteristics. Participants then attempt to obtain health services either as an individual or as a member of a family by visiting “stations” representing local hospitals, doctors’/dental offices, government offices, health insurance agencies, pharmacies, etc. “Staff” at each station use real applications, eligibility guidelines, and current policies to determine who gets or does not get services. The second hour of the simulation features a facilitated discussion to help participants discuss their experiences and emotional reactions, connect these with facts about health system gaps, and consider initiatives to improve community health access.

The simulation truly provides an opportunity for insight and reflection from a powerful collective experience. My ‘role’ was as a 57 year old African American man with severe back pain, and my wife in the simulation suffered from diabetes. By the standards of the simulation, my wife and I were very privileged: we were small business owners with a decent income, a reliable car and we spoke English as our primary language. We did not have health insurance at the beginning of the simulation and our challenge was to obtain it and then to seek out the medical care we both needed. By the end of the simulation, my wife had not been able to see a doctor or to obtain a prescription for her diabetes medication due to inefficiencies and “red-tape” in the system, despite all of our advantages. The experience of participating in WIMS had a profound and unexpected impact on me. I found myself experiencing feelings of actual fear: fear that my wife would not get the care she needed, fear that I would lose my job and what little resources I had. Those emotions stayed with me long after the simulation ended.

During the discussion that followed, I heard my feelings of fear and frustration echoed by other participants that, in their roles, struggled with acute illnesses, medical emergencies, economic distress and language and transportation barriers. As a group, we then brainstormed purposefully about the gaps we witnessed in the healthcare system in our simulation as well as those that exist in Waltham and across the state and country.  We also identified ways in which we each could strive to improve the system in our daily work, including streamlining interagency communication and educating patients about available support services.  

WIMS is an opportunity for those of us that work in health care, community health practice and other related sectors to experience first-hand just how difficult it can be to obtain medical services in the hopes that the experience will energize us to work collaboratively across agencies and sectors to improve our health care system. The experience has already brought a richer context and understanding to my work as a Community Health Specialist, and has renewed my commitment to addressing the gaps in our health care system while simultaneously promoting the power of prevention.

WIMS is a service of Community Catalyst, a national nonprofit organization that builds consumer and community participation in the U.S. health system to secure quality, affordable health care for all. If you would be interested in learning more about the Walk in my Shoes project, a more detailed description can be found online at http://www.communitycatalyst.org/doc_store/publications/walk_in_my_shoes_description.pdf  or by contacting Emily Bhargava, Director of the Metrowest RCHC at ebhargava@healthier-communities.org.