Every person deserves to be treated with respect by their doctor. But what does that mean exactly? You can bet that it doesn’t mean the same thing to everyone. As a doctor, I understand that health care providers must be kind, polite and knowledgeable, but we must also deliver care in a way that our patients want and deserve. That means doctors can’t do things the way they’ve always been done, or in a way that makes them comfortable. We have finally arrived to the era of patient-centered care, which means it’s not about doctor-convenient treatment.
Per the U.S. Dept. of Health and Human Services Office of Minority Health, culturally and linguistically appropriate services (CLAS) are respectful of and responsive to the health beliefs, practices and needs of diverse patients. Delivering care in this way is not only a good idea, it promotes better health for more people. The CLAS standards recommend practices and policies geared towards culturally and linguistically appropriate health services. Many institutions, like our local hospitals and clinics, work towards achieving these standards in order to provide “effective, equitable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.”
Unfortunately, none of this happens overnight, and many doctors struggle with how to do things differently, even when they know it is the right thing to do. Just grasping the language can make your head spin. Should doctors have cultural sensitivity? Competence? Proficiency? Humility? Aren’t they all the same thing? For clarity:
- Cultural sensitivity is the most basic of all, realizing that we all have different backgrounds − whether it be race, ethnicity or religion − and our background influences how we seek care, and manage our health.
- Cultural competence and proficiency relate to learning some facts about those of different backgrounds.
- Cultural humility refers to one’s ability to understand that he/she will be continually learning about others’ cultures, and to accept the guidance of the individual you are working with to lead you to care that is appropriate for that individual.
The African American Health Coalition believes that the key to good, appropriate care is treating everyone as an individual. Providers need to get to know their patients by talking to them, and learning from them.
From a patient’s perspective, what should you do if faced with a provider who just doesn’t get it? Well, you can try to work with your provider and use “cultural activation,” a way to provide information about you and your cultural identity, and see how willing your provider is to learn and adapt. A few examples of prompts for cultural activation that patients can use are:
- Sharing your preferred name with the provider
- Disclosing your cultural identity, and what aspects are most important to you
- Discussing the different types of care and experiences that you had in the past that were helpful, or not helpful
Trust your health provider with the truth, including your opinion of how your care is going. If that doesn’t work, it’s time to find another doctor. Your health is more important than your doctor’s ego – take your purchasing power somewhere else!
Dr. Linda Clark is a practicing occupational medicine physician, and a member of the African American Health Coalition. She received her degree from the University of Virginia School of Medicine. Her private practice provides occupational medicine services, drug and alcohol testing, hearing conservation programs, and work-related injury or illness management.
Learn more at:
“Cultural & Spiritual Sensitivity ─ A Learning Module for Health Care Professionals, and Dictionary of Patients’ Spiritual & Cultural Values for Health Care Professionals were developed by the Pastoral Care Leadership and Practice Group of HealthCare Chaplaincy, New York, NY. (Revision and update of earlier work by the Rev. Susan Wintz, BCC and the Rev. Earl Cooper, BCC)
Office of Minority Health’s (U.S. Dept of Health and Human Services) website:
Cultural Activation Prompts tool, Center of Excellence in Culturally Competent Mental Health Nathan Kline Institute for Psychiatric Research NYS Office of Mental Health: http://www.carecoordination.org/documents/CAPSCardfinal.pdf .