Russian Cardiovascular Clinic: Good Medicine for Russian Immigrants
By Michael Lasalandra
Beth Israel Deaconess Medical Center Correspondent
When Joseph Serebrennikov suffered a major heart attack, about six months after having emigrated from Russia to the United States, he was taken to the Emergency Department at Beth Israel Deaconess Medical Center. After being admitted, he asked if there might be a doctor available who speaks Russian.
It turned out that
Dr. Eli Gelfand, a Russian-born, U.S.-educated cardiologist is not only on staff at BIDMC, but for the past three years has headed up a special cardiovascular clinic for Russian immigrants and their families.
"We were very happy to be in his capable hands," says Tamara Fuks, a 67-year-old retired physicist from Moscow and wife of the 78-year-old Serebrennikov. "It relieved our fears. Dr. Gelfand was very good for us because he is a Russian speaker and we can discuss everything with him in our language. That's very important to us. Plus, he is a first-class doctor who is very attentive and patient. He carefully listens to us."
Dr. Gelfand heads up the BIDMC Russian Cardiovascular Clinic, a comprehensive consultative practice located in the Shapiro Building on the hospital's East Campus. Dr. Gelfand was born and raised in Moscow, and came to the U.S. as a teenager with his scientist parents. He attended the University of Wisconsin-Madison and obtained his Medical Doctor degree with Honors from the University of Illinois. He then completed a residency in Internal Medicine at Brigham and Women's Hospital and did his cardiology training at BIDMC. He is a Board-certified cardiologist, with additional training in cardiovascular MRI and echocardiography.
"My medical experience with the immigrant community dates back to residency," says Dr. Gelfand. "A recent immigrant cannot possibly be expected to immediately grasp the idiosyncratic complexities of the American medical system. They inevitably gravitate towards focusing on its inefficiencies and begin to 'self-manage' their health, frequently in a counterproductive way. This often results in extremely fragmented and ultimately inferior care."
"The problem is not unique to the Russian immigrants, but is uniquely and paradoxically exaggerated in this community, because of the combination of high average educational level and simultaneous high expectations from their physician."
A large part of the problem is the language barrier, even though Dr. Gelfand says that the hospital has a large staff of capable Russian interpreters. "As good as the interpreters are, there is inevitably some loss of detail in translation," he notes.
Beyond that, Gelfand says the Russian patients often miss the personal touch and ready accessibility to their physician, which they were used to in the former USSR. Dr. Gelfand says he also listens to patients when they ask about traditional home remedies, which are popular in Russia. He says that he made a point to learn about most of them and to examine the scientific evidence behind them, so that he can discuss them with the patients, which they appreciate.
"I don't dismiss the remedies outright - an approach which is often counterproductive," he says. "Overall, I wanted to take some of the positive elements of the medical system to which they were accustomed and place that on a background of modern American evidence-based medicine."
To that end, the Clinic has a Russian-speaking manager who personally handles patient calls and sets up appointments -- in two days or less for routine visits, and on the same day if it is an emergency. If a patient calls with a question, it is passed along quickly to Dr. Gelfand who responds just as quickly in most cases.
"We have a tremendous number of calls from our patients," says Alla Shamkhalova,
Clinic manager. "They have absolute trust in Dr. Gelfand and often consider him to be their family doctor. They know he is very knowledgeable and cares about them."
Another reason Dr. Gelfand wanted to start the clinic is the fact that heart disease is a substantial problem in Russian immigrants, in part due to a high prevalence of past and current smoking and a traditional Russian diet high in starch, animal fats and sodium and relatively low in fruits and vegetables.
When he started the clinic, Dr. Gelfand says he expected to care mostly for elderly patients, whom he did not expect to assimilate well into American medical culture. What he has found, however, is that many younger Russians, those in their 30s, 40s and 50s, still prefer a Russian-speaking doctor.
"Even though they have assimilated well, they seem to want a US-educated physician who still shares their background and life experiences," he says.
Kiril Balanov, a 43-year old electrician, came to the U.S. eight years ago and ended up seeing Dr. Gelfand two years ago after suffering from chest pains. While he speaks excellent English, he prefers to speak to Dr. Gelfand in Russian. "He can relate to me. I can explain all of my problems in Russian," he says. "It's important to me, since I don't have to remember all of the medical words in English."
Besides taking care of Russian patients, Dr. Gelfand also serves as Director of Ambulatory Cardiology for BIDMC's
Cardiovascular Institute. So, overall, only about 40 percent of his patients are Russian.
"My Russian clinic is the highlight of the working week," he says. "I feel honored and proud to provide this kind of service."
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted December 2009