JANUARY 2017 Featured Interview |
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Interview with
Deborah Gilboa, M.D. (a.k.a. Dr. G)
Parenting Expert, Author and Founder of AskDrG.com
About Deborah:
Deborah Gilboa, M.D. (a.k.a. Dr. G) is a respected parenting expert, author, speaker and founder of AskDrG.com. Deborah is a board certified, attending family physician at Pittsburgh’s Squirrel Hill Health Center. She has received multiple awards for clinical excellence in teaching, including the Alpha Omega Alpha Volunteer Clinical Faculty Award as a clinical associate professor for the University of Pittsburgh School of Medicine. As a parenting expert and speaker, she helps parents use everyday opportunities to create respectful, responsible, and resilient children (See her “3 R’s of Parenting” book series). She is also the author of Get the Behavior You Want...Without Being the Parent You Hate! (Demos Health, 2014).
However, those who are familiar with her work as a physician and parenting expert or her accomplishments as a prolific author may not be as familiar with her dedication to the deaf community. Deborah is fluent in American Sign Language and has lectured nationally on improving health care for deaf and hearing impaired patients. She worked to extend health care education and access to Pittsburgh’s deaf community. Her work with the deaf community has received national recognition and was the focus of her service as an Albert Schweitzer Fellow.
She lives with her husband and four boys in Pittsburgh, PA.
Myrna Beth Haskell, managing editor, had previously sought Deborah's expertise for several parenting features, but only recently learned of her phenomenal work with the deaf community. She spoke with Deborah about her service to the deaf community throughout her career and the continued challenges deaf and hearing-impaired patients face when seeking medical care.
Tell me a little bit about the inspiration behind your decision to focus your research and service on the deaf community as an Albert Schweitzer Fellow.
Before I was a medical student, I was involved in theater. I was part of a production of One Flew Over the Cuckoo’s Nest with the Deaf West Theater Company. The director decided to give the original story a twist - all the patients were deaf. I was immersed in rehearsals with deaf actors. I spent a lot of time learning about their personal experiences. Those in the deaf community did not have a lot of confidence when trying to have meaningful communication with doctors and their staff.
Deborah’s interest in the deaf community and learning ASL (American Sign Language) continued for the next several years. By the time she entered medical school, she was already a trained, fluent ASL interpreter. During her fellowship, she focused her service on providing public health information to the deaf community in the Pittsburgh area.
I found that basic public health messages were not getting to the deaf community, so that’s the area I decided to focus on. Deaf agencies would choose from a list of health topics (e.g. STIs, smoking, alcohol and drug use, etc.). I would talk to the agency to find out which health class to teach. I would then give the workshop in ASL – their “native” language.
Could you describe some obstacles deaf and hearing-impaired patients face concerning doctor-patient communication, acquiring quality medical advice or overall medical care?
I received all kinds of feedback from the deaf community concerning their frustration. They experience problems with making appointments and hang-ups. Doctors would ignore them and speak directly to family members instead. Doctors might ask them to write back and forth in English, but many ASL patients are not “fluent” in English. They are only fluent in ASL because this is the language they have known all of their life. Lip reading doesn’t work well either. Only 40% of what is said accurately shows up on the lips. For instance, “olive juice” looks like “I love you.” Many doctors don’t provide interpreters. Doctors can’t bill insurance companies for interpreters, so there is a major financial obstacle since interpreters cost more than double what doctors make for an appointment. Also, there is rarely any formal education concerning the ADA (Americans with Disabilities Act) for doctors.
Note: The obligation for health care providers to offer auxiliary aids and services to deaf or hearing-impaired patients is a requirement by the ADA. Auxiliary aids and services include equipment or services a person needs to access and understand aural information and to engage in effective communication. However, this requirement is flexible and a health care provider can choose aids and services. (See: The National Association of the Deaf for more information).
Deborah clarifies…
Interpreters are the responsibility of the health care provider. The ADA says you have to provide information that the patient says he needs, and deaf patients definitely don’t want to be perceived as incapable. It’s also important to understand that it’s necessary for interpreters be certified ASL interpreters.
Note: The current certification given by the Registry of Interpreters for the Deaf and the National Association of the Deaf is the National Interpreter Certification or NIC.
You are a physician who is fluent in ASL. How common is this, and can you explain a bit more about the use of interpreters to communicate with deaf patients?
ASL is a distinct language with expressions. It's not a code for English. I am the only primary doctor within a 200 mile radius of Pittsburgh who is fluent in ASL, and there is a large school for the deaf nearby.
Most deaf people are fluent in ASL. Some are also fluent in English. You can have pre-lingual deafness (born deaf or became deaf before age 1) or post-lingual deafness (became deaf after language acquisition).
However, this doesn’t make a difference to someone who has been using ASL for most of their life. Deborah continues with an analogy that language usage is the same for ASL as it is for all languages.
If you were deafened at age four, you would forget English if you only used ASL for the rest of your life, just as a child would lose his native language if he only used English after age four.
It’s important to understand that there is a unique situation with deaf children. Ninety percent of deaf kids are born into families with hearing parents. Most hearing parents don’t use ASL fluently. Yet, these parents want to be interpreters for their kids. A hearing parent will come in with a deaf child and the doctor will talk to the hearing parent. Parents interpret with bias for obvious reasons. That’s why a certified ASL interpreter is always the better choice for the patient.
How has the initial research and service you provided during your fellowship translated over to your current practice and work with the deaf community?
My choice for fellowship gave me the confidence to go directly to the community to ask them what they need. You don’t go to a community of people and tell them what they need. When I take on new patients who are deaf, my practice bears the cost and burden. When my deaf patients get sick and I am not present, other medical staff must see them.
There is more to it as well. We don’t just treat our patients medically. We also teach them to advocate for themselves when they see other medical doctors. We teach them how to prepare for appointments.
Is there a resource that deaf and hearing-impaired patient s can go to in order to find out more information about local medical groups that provide good service for deaf patients as well as other health services geared for the deaf community?
There is, but it is not a complete source. DeafHealth.org (previously DeafMD.org) has a partial registry and other health care information.
Editor’s Note: This organization provides health education in American Sign Language (via video). It contains information about understanding tests, medications and illnesses. It also provides a list of deaf-friendly doctors that can be searched for geographically.
You continue to be passionate about helping out in areas where you feel your expertise can make a difference. You are on the advisory boards of several non-profits. Can you tell me a bit about that?
Yes. I am on the national advisory board of the Foundation for Advancing Alcohol Responsibility. (This is a non-profit with a focus on the prevention of drunk driving and underage drinking). I am the president of the board for the Cybersmile Foundation. (This non-profit promotes education and awareness about cyberbullying). I am also the parenting expert for Classroom Champions. (This non-profit organization connects Olympic and para-Olympic athletes with classroom teachers to help students develop skills such as leadership, goal setting, fair play and respect).
Each of these organizations that I support have something in common. All three work to put tools in the hands of parents and their kids.
Deborah Gilboa, M.D. (a.k.a. Dr. G) is a respected parenting expert, author, speaker and founder of AskDrG.com. Deborah is a board certified, attending family physician at Pittsburgh’s Squirrel Hill Health Center. She has received multiple awards for clinical excellence in teaching, including the Alpha Omega Alpha Volunteer Clinical Faculty Award as a clinical associate professor for the University of Pittsburgh School of Medicine. As a parenting expert and speaker, she helps parents use everyday opportunities to create respectful, responsible, and resilient children (See her “3 R’s of Parenting” book series). She is also the author of Get the Behavior You Want...Without Being the Parent You Hate! (Demos Health, 2014).
However, those who are familiar with her work as a physician and parenting expert or her accomplishments as a prolific author may not be as familiar with her dedication to the deaf community. Deborah is fluent in American Sign Language and has lectured nationally on improving health care for deaf and hearing impaired patients. She worked to extend health care education and access to Pittsburgh’s deaf community. Her work with the deaf community has received national recognition and was the focus of her service as an Albert Schweitzer Fellow.
She lives with her husband and four boys in Pittsburgh, PA.
Myrna Beth Haskell, managing editor, had previously sought Deborah's expertise for several parenting features, but only recently learned of her phenomenal work with the deaf community. She spoke with Deborah about her service to the deaf community throughout her career and the continued challenges deaf and hearing-impaired patients face when seeking medical care.
Tell me a little bit about the inspiration behind your decision to focus your research and service on the deaf community as an Albert Schweitzer Fellow.
Before I was a medical student, I was involved in theater. I was part of a production of One Flew Over the Cuckoo’s Nest with the Deaf West Theater Company. The director decided to give the original story a twist - all the patients were deaf. I was immersed in rehearsals with deaf actors. I spent a lot of time learning about their personal experiences. Those in the deaf community did not have a lot of confidence when trying to have meaningful communication with doctors and their staff.
Deborah’s interest in the deaf community and learning ASL (American Sign Language) continued for the next several years. By the time she entered medical school, she was already a trained, fluent ASL interpreter. During her fellowship, she focused her service on providing public health information to the deaf community in the Pittsburgh area.
I found that basic public health messages were not getting to the deaf community, so that’s the area I decided to focus on. Deaf agencies would choose from a list of health topics (e.g. STIs, smoking, alcohol and drug use, etc.). I would talk to the agency to find out which health class to teach. I would then give the workshop in ASL – their “native” language.
Could you describe some obstacles deaf and hearing-impaired patients face concerning doctor-patient communication, acquiring quality medical advice or overall medical care?
I received all kinds of feedback from the deaf community concerning their frustration. They experience problems with making appointments and hang-ups. Doctors would ignore them and speak directly to family members instead. Doctors might ask them to write back and forth in English, but many ASL patients are not “fluent” in English. They are only fluent in ASL because this is the language they have known all of their life. Lip reading doesn’t work well either. Only 40% of what is said accurately shows up on the lips. For instance, “olive juice” looks like “I love you.” Many doctors don’t provide interpreters. Doctors can’t bill insurance companies for interpreters, so there is a major financial obstacle since interpreters cost more than double what doctors make for an appointment. Also, there is rarely any formal education concerning the ADA (Americans with Disabilities Act) for doctors.
Note: The obligation for health care providers to offer auxiliary aids and services to deaf or hearing-impaired patients is a requirement by the ADA. Auxiliary aids and services include equipment or services a person needs to access and understand aural information and to engage in effective communication. However, this requirement is flexible and a health care provider can choose aids and services. (See: The National Association of the Deaf for more information).
Deborah clarifies…
Interpreters are the responsibility of the health care provider. The ADA says you have to provide information that the patient says he needs, and deaf patients definitely don’t want to be perceived as incapable. It’s also important to understand that it’s necessary for interpreters be certified ASL interpreters.
Note: The current certification given by the Registry of Interpreters for the Deaf and the National Association of the Deaf is the National Interpreter Certification or NIC.
You are a physician who is fluent in ASL. How common is this, and can you explain a bit more about the use of interpreters to communicate with deaf patients?
ASL is a distinct language with expressions. It's not a code for English. I am the only primary doctor within a 200 mile radius of Pittsburgh who is fluent in ASL, and there is a large school for the deaf nearby.
Most deaf people are fluent in ASL. Some are also fluent in English. You can have pre-lingual deafness (born deaf or became deaf before age 1) or post-lingual deafness (became deaf after language acquisition).
However, this doesn’t make a difference to someone who has been using ASL for most of their life. Deborah continues with an analogy that language usage is the same for ASL as it is for all languages.
If you were deafened at age four, you would forget English if you only used ASL for the rest of your life, just as a child would lose his native language if he only used English after age four.
It’s important to understand that there is a unique situation with deaf children. Ninety percent of deaf kids are born into families with hearing parents. Most hearing parents don’t use ASL fluently. Yet, these parents want to be interpreters for their kids. A hearing parent will come in with a deaf child and the doctor will talk to the hearing parent. Parents interpret with bias for obvious reasons. That’s why a certified ASL interpreter is always the better choice for the patient.
How has the initial research and service you provided during your fellowship translated over to your current practice and work with the deaf community?
My choice for fellowship gave me the confidence to go directly to the community to ask them what they need. You don’t go to a community of people and tell them what they need. When I take on new patients who are deaf, my practice bears the cost and burden. When my deaf patients get sick and I am not present, other medical staff must see them.
There is more to it as well. We don’t just treat our patients medically. We also teach them to advocate for themselves when they see other medical doctors. We teach them how to prepare for appointments.
Is there a resource that deaf and hearing-impaired patient s can go to in order to find out more information about local medical groups that provide good service for deaf patients as well as other health services geared for the deaf community?
There is, but it is not a complete source. DeafHealth.org (previously DeafMD.org) has a partial registry and other health care information.
Editor’s Note: This organization provides health education in American Sign Language (via video). It contains information about understanding tests, medications and illnesses. It also provides a list of deaf-friendly doctors that can be searched for geographically.
You continue to be passionate about helping out in areas where you feel your expertise can make a difference. You are on the advisory boards of several non-profits. Can you tell me a bit about that?
Yes. I am on the national advisory board of the Foundation for Advancing Alcohol Responsibility. (This is a non-profit with a focus on the prevention of drunk driving and underage drinking). I am the president of the board for the Cybersmile Foundation. (This non-profit promotes education and awareness about cyberbullying). I am also the parenting expert for Classroom Champions. (This non-profit organization connects Olympic and para-Olympic athletes with classroom teachers to help students develop skills such as leadership, goal setting, fair play and respect).
Each of these organizations that I support have something in common. All three work to put tools in the hands of parents and their kids.
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