Cross-cultural health care

health — By Bob Riel on March 14, 2007 at 8:10 am

A simple conversation between a doctor and a patient can often cause problems when the two individuals are from different cultures. Due to a growing awareness of such challenges, some efforts are now underway to improve the cultural competence of health care providers. One such program has been launched in Maryland and was recently profiled in this article, which provides a few examples of how cultural confusion can occur.

For instance, the preference of some cultures to deal with individuals in positions of authority:

Marcos Pesquera of North Potomac left his native Puerto Rico behind nearly 30 years ago to study at the Massachusetts College of Pharmacy. As he moved from behind a People’s drug store counter into retail pharmacy and managed care administration, he sometimes found himself in a totally unexpected role as a translator for Spanish-speaking patients.

He quickly realized that clear communication depends on more than just words. Asked to translate between a young female doctor and an elderly Hispanic woman with congestive heart failure, he was baffled by the patient’s refusal to listen to the doctor’s advice.

“[The patient] said, ‘She has no white on the top of her head, she looks like a kid,’ ” Pesquera said.

With the aid of an organizational chart showing that the doctor headed the department, he won the patient over.

Or, the way in which gender roles can influence decisions:

… while some doctors may be uneasy with the preference by some Middle Eastern women to have their husbands accompany them during consultations, to the patient it’s all about the husband showing a proper level of love and care.

“There’s a clash of cultures at times, but it’s not about wrong or right. It just is,” Pesquera said.