Featured case: With a Little Help from “Nuestros Amigos”:
Hispanics and Kidney Transplants

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The case

Who – the protagonist

Juan Caicedo, a surgeon and head of the Hispanic Transplant Programme at Northwestern Memorial Hospital, US.

What?

In 2005, over 28,000 people received organ transplants in the United States, nearly 60% being kidney transplants. Transplants are now considered a standard and successful treatment option for the end-stage of many diseases and conditions.

Why?

surgeons passing utensil

During his three years as a fellow, Juan was struck by the number of Hispanic patients on the kidney waiting list. Hispanic patients represented the highest growth group on the transplant waiting list. They also waited the longest for transplants and died while waiting at higher rates than non-Hispanic whites and African-Americans. Hispanic people were also underrepresented as live donor transplant patients and as donors.

When?

Juan first visited Northwestern Memorial Hospital during a sightseeing tour in 2000. His unplanned visit changed the course of his life. He asked to meet with the hospital’s leading transplant surgeons, despite having poor English at the time. The meeting led to the offer of a fellowship. By 2006, Juan was considering how the unique barriers to transplantation faced by Hispanic people could be overcome.

Where?

Northwestern Memorial Hospital is in Chicago, an American city with a high Hispanic population.

Key quote

‘Translators, in my view, are barriers and are obstacles in communication … Hispanics are nice people. They don’t complain too much. They always smile and nod their head … non-Hispanics think that means they understood, and they probably didn’t understand anything.’ – Juan Caicedo

What next?

The apparent ‘solution’ of providing an interpreter had proved almost wholly inadequate in the face of a complex range of issues from religious beliefs and cultural concerns, to who has power in the family. Hispanic transplant patients faced unique barriers. Could a comprehensive programme be put in place that would address these complexities?

 
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The author

Julie Hennessy

authorJulie explains how she met the protagonist and why businesses of all kinds need to know who the decision-makers are.

Success story

I met the protagonist Juan Caicedo through his colleague, the head of Northwestern Memorial Hospital’s organ donation programme, who was at a conference on managed care at Kaiser Permanente in Washington. The subject of their work with Hispanic patients came up and he told me the story of their success.

hospital corridor

Obvious ‘solutions’

This case exemplifies that what seem like obvious solutions don’t always work.  We have to try them out and see. In this case, the doctor’s instincts were that people almost never asked questions through the translator, and so they never got enough information to be comfortable enough to make decisions like agreeing to a transplantation. In the live donor situation, the patient may have to understand the details well enough to ask someone else to donate an organ. It’s a high bar!

surgeonVideo interviews

Students love the video interviews with Juan Caicedo that form part of the case.  I always use the first video to introduce him. We then talk about their impressions of him, and what he is likely to be very good at. He comes across as both impressive and very easy to relate to. This is not the typical ‘surgeon’ persona.

Potential market

The Hispanic population represents a massive opportunity for many different types of business. The lessons drawn from this case could help both established and new entrepreneurial companies of all kinds to understand this potential market, especially issues such as who makes the decisions.

In this case, uncovering that the elder female makes the decision for the whole group and has enormous power in ‘delivering’ donor options was crucial for Juan Caicedo.

About the author

Julie Hennessy is Clinical Professor of Marketing at Kellogg School of Management, Northwestern University.
e j-hennessy@kellogg.northwestern.edu

 

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