When patients arrive at your facility, do you treat them all the same? While the self-evident answer is, “yes” the reality is not that simple. To provide all patients with the same quality of care, you need to understand what makes each individual different. This is especially important for patients from minority communities, non-English speakers, and immigrants. Without adapting your approach to treatment, your patients’ experience is likely to fall short.
Cultural Competency 101
At its foundation, treating patients differently as a sensitive response to their particular identity position is a practice known as cultural competency and it’s an important part of medical care – from psychological counseling to nutritional advice. And on the medical side, many diagnoses cluster in specific social and cultural groups, so understanding patients’ background can help you arrive at the correct diagnosis.
Cultural competency is important across a range of interactions, inside and outside of the hospital, but in healthcare settings, culturally competent care involves everything from providing interpreter services to expanding your hours of operation and creating culturally-targeted health promotion tools. Too many healthcare practices consider these added services to be optional components of their work – in fact, cultural competency is the heart of all care.
The Role of Holistic Healthcare
One of the hallmarks of a cultural competent medical practice is the willingness of doctors to engage in holistic care, rather than a narrow understanding of Western medicine. This includes a willingness to include chiropractic and acupuncture in care plans, to provide safety guidelines to patients using herbal remedies, and to be open to practices like Ayurveda.
Holistic care is important for all patients; it addresses the psychological and social components of health as well as the physical ones, but doctors are typically more open to holistic care they understand. Administrators, then, should work with local experts to introduce doctors to different treatment modalities, so they are better able to address their use when meeting with individual patients.
Developing Dietary Guidelines
Another important way that doctors can improve their care of diverse patients is by developing culturally specific nutrition guidelines. With obesity and type-2 diabetes being such serious problems, especially among immigrant and low-income populations, offering diet plans that reflect familiar foods rather than an Americanized set of offerings can help patients experience greater success.
The first step to developing these guidelines is understanding international cuisine –
what exactly is in your patients’ cabinets? As this chart reveals, common foods in one country may be unfamiliar in another. For example, while corn is a common grain here in the United States, in Pakistan, Bangladesh, and many other countries, rice is more common. Japanese cuisine relies heavily on soy sauce, but Vietnamese food uses more fish sauce.
These fine distinctions will shape what your patients eat and what recommendations you should make. Asking patients to completely change their diet to reflect a foreign-to-them culture is unreasonable and psychologically damaging. It basically guarantees that your patients will fail to adhere to your recommendations.
Culturally Sensitive Psychology
Of all the different areas of healthcare, psychology and psychiatry may be the most culturally sensitive of them all – as stigmatized as mental illness is in the United States, the situation is much worse in many other countries. Additionally, psychological symptoms are largely shaped by cultures of origin. Overall, minorities are less likely to seek psychiatric treatment because they don’t expect to be understood and because they’ve received negative messaging about mental illness from their communities.
African American patients have played an important role in increasing awareness about cultural competency in mental health care, addressing subtle racism among therapists and the impact of racism on depression and anxiety. This has helped increase the number of therapists who are equipped to address intercultural mental health concerns, but there’s more work to be done.
The Humble Servant Model
Ultimately, culturally competent medical care demands that doctors act with humility when providing patient care. While your doctors may be more knowledgeable about biology or medications, they aren’t omniscient and they certainly can’t understand every patient’s individual circumstances and cultural background. When doctors are taught to reflect patient concerns, accept different perspectives, and engage with the patient on their terms, they’re more likely to reach an agreement about the course of care.
Patient care cannot be a one size fits all model, despite the presumed equality of that approach. This is what the cultural competency perspective reframes – it addresses the fact that white, American patients typically receive treatment that reflects their background and beliefs. From there, it says that all patients deserve that kind of treatment and offers a framework through which doctors can provide it.
