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Are You Culturally Competent?

Dr. Fernandez agrees. “Practicing medicine in a patient-centered way is ultimately a more rewarding way to work and live,” she says. “There also needs to be reform at a national level that allows physicians and hospitalists to be appropriately compensated for much of the conversation and bedside work that we do.” TH

Writer Gretchen Henkel lives in California and writes regularly about healthcare.

References

  1. Unequal Treatment: Understanding Racial and Ethnic Disparities in Health Care. Institute of Medicine, National Academy of Sciences. 2002. Available from the National Academy Press Available at http://books.nap.edu/catalog/11036.html. Last accessed July 27, 2005; and Unequal Treatment: What Healthcare Providers Need to Know about Racial and Ethnic Disparities in Healthcare. Institute of Medicine, National Academy of Sciences. Available at www.nap.edu/catalog/10260.html. Last accessed July 27, 2005.
  2. Shin HB, Bruno R. Language use and English-speaking ability: a Census 2000 brief. U.S. Census Bureau, 2003. Available online at www.census.gov/population/www/cen2000/briefs.html. Last accessed July 27, 2005.
  3. John-Baptiste A, Naglie G, Tomlinson G, et al. The effect of English language proficiency on length of stay and in-hospital mortality. J Gen Intern Med. March 2004;19(3):221-228.

Resource List

Tools to help improve your cultural competency skills

  • “Worlds Apart,” a 47-minute video produced by Maren Grainger-Monsen, MD, director of the Bioethics and Film Program at the Stanford Center for Biomedical Ethics. It follows four patients (an Afghani Muslim man with stomach cancer, a young African-American man on dialysis for renal disease, a Laotian girl who needs an open-chest procedure to repair a hole in her heart muscle, and a Puerto-Rican-American woman with depression and diabetes) as they navigate their way through the healthcare system.

    The stories are told from each patient’s perspective and include filming of physician-patient encounters, as well as scenes at patients’ homes and places of worship. A study guide designed by Harvard University cross-cultural medicine educators accompanies the film, and is downloadable free (the video must be bought) from the distributor, Fanlight Productions (www.fanlight.com) or (800) 937-4113.

  • Ethnic-specific curriculum modules created by the Collaborative on Ethnogeriatric Education and edited by Gwen Yeo, PhD, can be downloaded in Adobe Acrobat from the Web site of Stanford University Medical Center’s Geriatric Education Center. Health beliefs and cultural traditions from 12 ethnic groups (including African-American, Korean, Filipino, and Pakistani) are explained, and tied to geriatric and end-of-life issues (www.stanford.edu/group/ethnoger/efiles.html).
  • Age through Ethnic Lenses: Caring for the Elderly in a Multicultural Society, a book edited by Laura Katz Olson, professor of political science at Lehigh University, features chapters on a variety of socioreligious groups, populations from European origins, as well as rural elderly (2001, Rowman & Littlefield Publishers, Lanham, Maryland: www.rowmanlittlefield.com. Also available through www.amazon.com and www.bn.com).
  • The U.S. Department of Health and Human Services’ Office of Minority Health offers a wealth of links to agencies and reports regarding minority health access and health disparities: www.omhrc.gov.
  • The National Center for Cultural Competence at Georgetown University, Washington, D.C., offers guiding principles, systems of care, and training modules for developing and improving cultural and linguistic competence: http://gucchd.georgetown.edu.
  • The Center for Cross-Cultural Health (www.crosshealth.com), at the International Institute of Minnesota, offers information, training, research and consulting to develop culturally competent individuals, organizations and systems.—GH
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