As medical professionals treat an increasingly diverse patient population, they need to understand how a patient’s beliefs, values, and behaviors might affect their health. Combined with challenges around health literacy, it is thought by many that communication has become the keystone of all effective care.
In 2004, Georgetown University’s Health Policy Institute defined cultural competence as “the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. This extends much further than medical interpretation in different languages. It includes learning about the family values, societal norms, and healthcare beliefs of minority groups, and gaining an understanding of how they affect a patient’s attitudes toward healthcare, illness, and treatment.”
Social factors can impact one’s ability to obtain wellness, including education, living environment, socioeconomic status, access to transportation.
Why is cultural competence important? A 2017 Medscape survey showed more than 50% of responding doctors had been sued for malpractice. The number one reason? Failure to diagnose a medical condition, given by 31% of respondents. At the root of many of these malpractice claims is a breakdown in the relationship between the physician and the patient, due to problems with communication. Patients complained that doctors failed to listen to them, were not clear or open in their discussions, were dismissive of the patient’s or family’s perspective, and showed a lack of understanding for their concerns.
“The unifying theme that emerges from these dissatisfied patients is communication—the most crucial aspect of the interaction and relationship between doctor and patient. The researchers emphasized that if a relationship characterized by both trust and respect was initially established between patient and doctor, that patient was far less likely to sue—despite a doctor’s error in treating that patient,” noted the study.
A culturally competent physician has the ability to work effectively within the particular context of a patient’s cultural practices, beliefs, and needs and is less likely to experience the kinds of miscommunication that result from cultural ignorance.
Research shows that training and education in cultural competence increase the quality of care provided to all populations.
An easy first step is to know who your patients are, and have translated forms available, or a translating service.
Think about your own culture and the way it determines what you say and do, and how it influences what you assume about others. Practice being aware of the expectations you have that are based on background and culture.
Model listening closely to patients. “Active listening” is achieved by being fully engaged in the present conversation, and by the use of eye contact, questioning, clarifying your understanding, summarizing, and defining next steps together.
Developing cultural competence is a step toward better communication and delivery of health care services, and it can also help prevent malpractice claims and health care disparities. Training and education in cultural competence are well worth the investment.