Multicultural Medicine and the Year 3/ 4 Student
"It is much more important to know what sort of patient has a disease than what sort of disease a patient has." (Sir William Osler)
The U.S. is Becoming More Culturally Diverse
Our health care systems must adapt in order to provide care that is culturally appropriate. When physicians and patients interact, their respective cultural domains influence their assumptions and perceptions. The quality of this cross-cultural interaction affects clinical decision-making and outcomes (Flores, 1998). Health care providers must, therefore, strive to view each patient as a unique individual, gathering culturally relevant information in a trust-promoting manner in order to provide culturally sensitive care.
Cultural knowledge for physicians includes an understanding of:
- The culture, traditions, values, and family systems.
- The impact of ethnicity on patient's health status, values & health-seeking behavior patterns.
- The roles of language, speech patterns, and communications styles.
- Health care resources available for patients.
- How professional values may conflict with needs of patients of diverse backgrounds.
Cultural competencies for physicians include being able to:
- Discuss cultural issues openly and respond to culturally based cues.
- Interpret the implications of symptoms as they are expressed by patients from different cultures.
- Work effectively with interpreters.
- Consider learning new phrases and strategies to bridge communication gaps.
- Develop the trust necessary for adherence to prescribed treatments and recommendations.
A multicultural approach to healthcare delivery requires that the patient-physician interaction go beyond focusing merely upon the chief complaint to look at lifestyle, risk behaviors, stressors, and personal circumstances, as well as the more visible cultural aspects of age, gender, race, and language. This whole-patient perspective promotes more holistically focused care-- consistent with osteopathic philosophy.
Many medical schools are integrating knowledge of cultural diversity into their curricula. Cases and readings assigned to students in both the CPC and the PCC curricula are designed to help our students develop the knowledge, skills, and attitudes to effectively meet the health care needs of an increasingly diverse society. Efforts to promote and reinforce this perspective in the clinical setting will enhance students' abilities to develop a culturally sensitive approach to providing medical care.
- role model for the student those aspects of physician behavior consistent with cultural knowledge and sensitivity.
- Discuss openly with the student issues of diversity that present a challenge to you.
- Learn from students by giving them assignments (e.g. literature search, web search) that will increase their knowledge of multicultural medicine and then have them share the information with you.
- Observe the student with patients of different cultures and provide specific feedback.
- Have the student spend some time just getting to know some of your patients who come from different cultures.
References and URLs:
Cross Cultural Health Care Program
http://www.diversityrx.org/ Resources for Health Care Providers and Consumers
http://healthlinks.washington.edu/clinical/ethnomed/ Ethnic Medicine Guide
Google: Flores, G.R. Cultural Competency in Medical Practice
Flores G, Gee D, and Kastner B. The Teaching of Cultural Issues in U.S. and
Canadian Medical Schools. Academic Medicine, 2000, May;75(5):45-5
Lum CK and Korenman SG. Cultural-Sensitivity Training in U.S. Medical Schools. Academic Medicine, 1994, March;69(3):239-41