Culturally Competent Care

By Nancy Giguere, Star Tribune Sales and Marketing

Last update: May 4, 2003 - 11:00 PM

Twenty-first century Minnesotans are diverse. A recent McKnight Foundation report noted Minnesota's school children speak 71 different languages. In this multicultural environment, healthcare providers are learning to treat patients from varied backgrounds.

Patient-Centered Care

To be effective, health care must be 'culturally competent.' For Dr. Patricia Walker, medical director of HealthPartners Center for International Health at Regions Hospital in St. Paul, that means "having the ability to provide patient-centered care to everyone we care for. As physicians, we cross many cultures every day: male physician and female patient, younger physician and older patient, sexual preference differences, and racial and ethnic differences."

Walker remembers a conversation she had with an African American colleague: "She said, 'When you look at me as a patient you see that I'm black. I presume that you're comfortable with our differences. But I also want to know if you know anything about high blood pressure in the African American community.'"

Beliefs and Practices

When treating patients from other cultures, it's helpful to know something about their beliefs and practices and how they might impact the patients' experience of western medicine. For instance, says Walker, a Southeast Asian woman suffering from low back pain might attribute it to a failure to regain her hot and cold balance after childbirth. The doctor, however, might diagnose osteoarthritis of the lumbar spine and prescribe physical therapy.

"What she wants from me is symptom relief because she doesn't believe the problem is curable," Walker says. "What I'm thinking as a physician is: what's her diagnosis and how can I cure the problem?"

Walker doesn't try to convince patients that hers is the only explanation. Instead she uses an approach of "and also." The problem can then be understood as both arthritis and hot and cold imbalance – an approach that is "mutually inclusive" rather than "mutually exclusive."

Respect and Humility

Of course, it's impossible for physicians and other providers to understand every culture. But they can consult providers' guides and Web sites on cross-cultural issues in healthcare. And increasingly, many medical and nursing students are taking courses in cross-cultural medicine.

Walker urges physicians and other healthcare professionals to approach all patients with respect and humility. "Ask them what they believe about their illness and what they want from you," she says.

Helpful Tips

Telephone triage nurse Angela Kuria talks with patients who call the Center for International Health for help and information. Kuria, who came to the United States from Kenya, understands the difficulties faced by many patients. She offers the following tips for healthcare providers:

Put yourself in the patient's shoes. It's not easy to navigate in an unfamiliar culture.
Really listen to what a person is saying.
Ask questions to find out what the person really wants or needs.
Try not to rush or hurry. Be patient.

Learn More

Center for Cross-Cultural Health: www.crosshealth.com

Diversity Rx: www.diversityrx.org

Office of Minority Health: www.omhrc.gov

Nancy Giguere is owner of Wordsmith, and is a freelance writer from St. Paul, MN.

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