American healthcare is full of challenges for patients and medical professionals alike. With affordability concerns, interference from insurance companies, and healthcare staffing shortages, it can be hard to access treatment. An often neglected concern, however, is when doctors and patients have a communication breakdown, failing to realize that they’re on the same team.
With health and lives at stake, communication and cultural competence is essential in healthcare. Cultural competence increases empathy and the necessary trust between medical professionals and the patients that rely on them.
Ageism and Medical Care
Doctors often ignore our experiences because of our age. Some patients present with chronic health symptoms at a young age, but don’t receive diagnoses until later in life. “You’re too young to have joint problems,” most of the doctors will say. “Lose weight,” they might advise, refusing to look deeper into the issue. Practitioners may also discriminate against the old, dismissing serious medical concerns as a natural part of aging.
When added in with a lack of knowledge regarding generational differences concerning diet and exercise habits, many doctors have failed at some point when it comes to cultural competency in regards to age.
Se Habla Español? The Importance of Language
When your medical staff doesn’t speak the same language as the populations you serve, you’re bound to experience communication issues. An example: a Spanish-speaking grandmother has difficulty communicating with doctors because of the language barrier and the provider’s lack of patience. Like many aging Americans, our hypothetical grandma has Alzheimer’s and often repeats herself.
While the grandmother could take measures to bridge this gap, this presents an unreasonable barrier to healthcare access. If the grandmother brings along a younger relative as a translator, it requires extra time, travel and expense on the family’s part. They shouldn’t have to do that.
By the year 2050, the United States will have 132.8 million Spanish speakers, making it the largest Spanish speaking country in the world. Unless you get medical care in a Spanish-speaking neighborhood (and our insurance rarely lets us choose providers freely), it can be challenging to find bilingual doctors, even through insurance referral services.
This results in misunderstandings and lack of care. This situation is very dangerous, and it may cause health complications for the patient and legal complications for the doctor.
Recognizing cultural differences is a key ethical concern in healthcare administration. In some cultures, such as those from East Asia, the family comes together to make a healthcare decision for one family member. In other cultures, individual autonomy is paramount. As a healthcare professional, are you ready to take input and discussion from an entire family?
The Root Cause of Health Concerns in Cultures
Racism is pervasive and dangerous when it comes to interactions with healthcare professionals. For example, many white doctors are unconsciously, culturally conditioned to falsely think of black Americans as lazy. At first glance, they might imagine that the obesity rate of 56.1% in African American women might confirm their unexamined, racist notions; however, there are a host of other reasons black Americans experience disproportionately high incidences of health issues, including:
- Cultural trauma: Exposure to trauma affect our descendents on an epigenetic level. Doctors need to empathize with patients whose ancestors have battled oppressive conditions, including slavery.
- Racism leads to stress: Even if black Americans did receive equal treatment (or equal opportunities to access quality healthcare), they’d still be at a major disadvantage. Racism is pervasive, and it causes stress, which harms people on a physiological level.
- Systemic racism: Systems that continually place minorities at an economic disadvantage hinder access to quality healthcare.
Misunderstanding any or all of these points leads to a breakdown in communication and an inability for a doctor to understand, diagnose, and treat a patient realistically.
Healthcare for Immigrants
Have you ever seen how much health insurance policies on the marketplace vary in price and coverage based on state of residence? That’s nothing compared to the varying levels of healthcare access throughout the world.
Immigrants from countries with socialized and semi-socialized medicine may be accustomed to paying little for their healthcare, but in the United States, the price of healthcare is exorbitant, even with coverage. This can be difficult to communicate to patients.
Similarly, some countries don’t provide economic potential for citizens to afford or access doctors. Other immigrants may come from remote places or severely traumatic situations. Almost 30% of uninsured people in the United States are immigrants. How do they receive affordable care?
Cultural Competence: Solutions in Healthcare
Diversity training is a huge benefit to hospital systems that require it. Currently, 64.5% of hospitals mandate diversity training, which helps impart cultural knowledge, teaches healthcare staff to recognize linguistic and body language cues, and assists in building empathy between doctors and patients from different cultures.
Providers must understand that individuals from different cultures may be more inclined to rely on natural remedies rather than prescriptions. When possible, providers must find ways to embrace a holistic approach to healthcare, incorporating both holistic and conventional approaches. For instance, home remedies can be effective for treating STDs when used in conjunction with medicine. Providers must earn the trust needed from patients to follow medical guidelines and achieve optimal healthcare outcomes.
Hopefully, hospitals and medical offices realize how important it is to ensure the medical staff can communicate with patients. Having a third party translate via phone or family member can cause communication problems. As we’ve seen before, inadequate communication and training can be deadly.
With education, training, and patience, medical personnel can become more sensitive to cultural needs. How are you stacking up?