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INTRODUCTION

KEY POINTS

  • Limitations on treatment time and lack of cultural understanding often cause culturally competent care to be sidelined.

  • To empathize with a patient’s cultural issues, the physician should explore his or her own background, using the tools provided in this chapter.

  • Intake procedures should incorporate a cultural assessment, and provisions should be made for non–English-speaking patients.

  • Multiculturally competent care can improve patient outcomes.

In the current healthcare community, the skills associated with providing culturally competent healthcare are more greatly appreciated than ever before. Unfortunately, many healthcare professionals still fail to provide health services that respect the health beliefs, practices, and cultural and linguistic needs of their patients. For a variety of reasons, including limited treatment time and ignorance, providing culturally competent healthcare may be sidelined in the service of expediting patient visits. A common physician complaint is that there is not enough time to focus on anything beyond the patient’s presenting illness. The approach described in this chapter attempts to help practitioners identify the value of putting healthcare in a multicultural context and how this can actually help physicians to provide better medical care to their patients. A very important step toward this is to build a connection with patients by learning to value one’s own cultural identity. To this end, this chapter begins with exercises for clinicians aimed at improving their personal understanding of the potential importance of a patient’s individual cultural identity.

A LOOK WITHIN

Some might question the necessity of physicians investigating their own cultural identity in order to provide culturally competent care for their patients. However, this process is very significant because a fundamental component of the physician–patient relationship is empathy, which requires the capacity to vicariously identify with the feelings or experiences of others. With respect to identity, we are unfortunately well aware that empowered groups can lose touch with—or perhaps never understand to begin with—the difficulties that are faced by those who are less privileged. Psychologically, it takes more effort to empathize with others than to ignore them; this may be due to a variety of reasons, most pertinently an instinct for self-protection. Hence, it may be easier and less time consuming for physicians to ignore the cultural identities of their patients; however, this does a great disservice to the patient and undermines the doctor–patient relationship.

The current demographics of the United States are changing rapidly, and it is estimated that the majority of American citizens by 2050 will be individuals with skin of color. The Hispanic population, already the nation’s largest minority group, will triple in size and will account for most of the nation’s population growth through 2050. Additionally, Hispanic Americans will compose 29% of the population of the United States by this time, compared with 14% in 2005. Similarly, the Asian American population is expected to grow to almost 10% of the population. In contrast, the Caucausian American population ...

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