Primaris Press Release
Originally Published in |
Contact: Matt Heger Primaris Communications Department (800) 735-6776, Ext. 136 |
Eleven spelled "o-n-c-e"
Culture, communications and compliance
Non-verbal debacles Be perceptive of eye contact. Patients may find it rude to meet and hold eye contact with an elder or authority figures especially for many Latino, Asian, American Indian and Arab cultures. It can also be viewed as aggressive, especially when a male insists on maintaining eye contact with a female. Avoid hand gestures. Varying radically across cultures, these can easily be offensive without you even realizing it. Be conservative. Be aware of touch and perceived invasion of space. Obvious, but extremely important. When unsure, limit touch as much as possible. Explain any physical contact before moving into patients' personal space, even for something as simple as taking blood pressure. And remember that your patient's idea of personal space may be larger (or much smaller) than your own.Know your role. Physicians are often considered authority figures. And while the respect is gratifying, it can prevent the patient from speaking up when they have questions or don't understand care instructions. If in doubt, it may be appropriate to have them repeat the instructions. |
“Take once daily,” the bottle reads. So why would an otherwise compliant Hispanic patient consume half of the pills in one sitting? Didn't she realize the dangers? Was she trying to hurt herself?
The answer may actually be simple enough; in Spanish, O-N-C-E spells “11.”
Sometimes the mystery in medical care is not the disease; it's the patient. After all, are your patients just like you? Do you watch the same movies, enjoy the same music, eat in the same restaurants… speak the same language?
When patients originate from different cultures, extra effort is needed to ensure they completely understand physician instructions. While this is not just a concern with minority patients – members of the G.I. and Silent Generations, for example, are more likely to downplay the importance of pain – the consequences strike minority populations particularly hard.
Disparities in minority health care have been consistently and frequently demonstrated in scores of studies. One of the most recent was a 2006 study that found African-American patients with lung cancer, despite equal access to care, were still nearly 50 percent less likely than Caucasians to receive potentially lifesaving surgery. Christopher Lathan, MD, lead author of that report, largely attributed this discrepancy to communications issues.
When recognized, the “once/eleven” issue is easy enough to address, but some issues are harder. Assisting patients with strong beliefs that an illness is in God's hands, for instance, can present a significant challenge. To help physicians address these and other cultural communications issues, Primaris is offering an online program providing CME credit to primary care physicians at www.primaris.org .
While such programs can assist physicians to better serve patients, it can also help avoid litigation. A 2004 study of 26,126 malpractice claims found that nine percent of those judged “negligent” were caused by poor communication. Simply knowing how to communicate well could reduce litigation risks.
The impact of minorities on the healthcare industry is poised to become much more significant. By the year 2050, Census Bureau projections estimate that nearly half of U.S. citizens will be minorities. Hispanic, Asian and black populations will soon make up considerably larger portions of the population. The change is happening now. Prepare your practice.
To enroll in the Primaris cultural proficiency project or for more information, visit www.primaris.org or e-mail culturalpro@primaris.org .
MO-06-03-CP
This material was prepared by Primaris, the Medicare Quality Improvement Organization for Missouri , under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy.