SCU Cultural Competency in Healthcare Article Essay

Instructions

The purpose of this assignment is for you to practice reviewing and analyzing articles that contribute to the healthcare industry. Reviewing healthcare literature and trends provides you with the opportunity to read about what was successful in the industry and how it was accomplished. It also allows you to analyze what was unsuccessful, how you can improve it, or at least how you can avoid repeating the mistakes of others.

In order to foster positive organizational culture, mission, and philosophy, it is important for the healthcare professional learn to respect and embrace cultural differences rather than being afraid of them. For this assignment, you will utilize the CSU Online Library to locate and choose a peer-reviewed article about organizational cultural competence and cultural differences that you may encounter in the workplace. You will then analyze the role that cultural competency plays in effective healthcare administration based on the article.

The article you choose must meet the following requirements:

As you read the article you choose for this assignment, consider the questions below.

Your critique must meet the requirements below.

STRATEGY AND INNOVATION
ENVIRONMENTAL INFLUENCES
CULTURAL COMPETENCY
IN HEALTHCARE
n By Brittney C. Bauer, PhD, and Neil Baum, MD
In this article…
In our increasingly diverse world, clear communication is critical. The authors offer strategies for interacting effectively
with patients from dif­fer­ent cultural backgrounds.
THE UNITED STATES HAS BEEN CALLED THE
­great “melting pot” in reference to the arrival of vari­ous nationalities on its shores. This meta­phor assumes that immigrants from diverse backgrounds transform their identities and
assimilate to the norms, values, and beliefs of the dominant
racial and ethnic group.1
The immigration landscape changed over the past several
de­cades, however, and so has the way we view the country’s
interracial and multicultural composition. Whereas most immigrants in the early 20th ­century w
­ ere Caucasians of Eu­ro­pean
descent, the waves of immigrants since the 1970s have come
predominately from Latin Amer­i­ca and Asia and are more
widely multicultural and multiracial.2
This diversity has led to seismic shifts in the racial composition of the United States, with significant growth in major
minority groups such as African Americans (13.4%), Hispanics
and Latinos (18.5%), and Asians (5.9%).3
As such, the notion that the culturally diverse immigrants
“melt” and assimilate into the traditional American culture is
not entirely accurate. Many modern immigrant groups nurture
their specific racial, ethnic, and cultural identities and encourage their c­ hildren to carry on t­hese traditions in addition to
integrating with their a­ dopted country.
Thus, the “salad bowl” meta­phor is considered a more
precise conceptualization of American immigration since the
1970s: “…not only does the salad bowl meta­phor allow for the
individuality of ethnic identities it represents, but it also paves
the way for selective integration between ethnic groups based
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JANUARY/FEBRUARY n 2022 n physicianleaders.org
on their need to integrate in host socie­ties.”1,p114 This perspective suggests that the integration pro­cess is relational. The
culturally diverse immigrants select which values and norms
to adopt or adapt and, in turn, stimulate changes to the host
nation’s own culture.
Hence, healthcare must be adapted to be mindful and
capable of treating culturally diverse patients —­something the
medical industry has not accomplished, as evidenced by the
ethnic and racial disparities in healthcare during the COVID-19
pandemic.
While serving diverse patients’ health and wellness needs
can pre­sent challenges, it is critical to society. To be culturally
competent, physicians must increase their ability to communicate with and care for diverse patient populations.
THE IMPORTANCE OF CULTURAL COMPETENCY
Cultural competency is relevant in the United States, with
its workplaces’ and its schools’ increasingly broad array of
cultural, racial, and ethnic groups. Cultural diversity is linked
to several learning benefits, such as enhanced information,
knowledge, and creativity.4 However, before we can learn
from one another, we must have a level of understanding
about each other.
Cultural competency helps us recognize and re­spect “ways
of being” that are not necessarily our own so that we interact with o
­ thers in a manner that builds trust, re­spect, and
understanding across cultures. Cultural diversity also makes
our country a more in­ter­est­ing place to live as ­people from
diverse cultures contribute new languages, ways of thinking,
knowledge, and broadening experiences.
Nonetheless, b
­ ecause we live in an increasingly interconnected and multicultural world, this can generate prob­lems
or misunderstandings based on a lack of cultural sensitivity
and inadequate communication. Thus, gaining insights about
other cultures can help us understand dif­fer­ent perspectives
of the world we live in and dispel negative ste­reo­t ypes and
personal biases.
Through improved cultural intelligence and efforts to learn
more about ­others from diverse backgrounds, healthcare providers can understand the culturally driven ways that ­people
think, feel, and act. Demonstrating an understanding and
sensitivity to other cultures w
­ ill help us overcome and prevent racial and ethnic divisions and provide better care for all
patients. Given the racial and ethnic composition of the United
States, it is unlikely that a physician ­will have a homogenous
patient population; consequently, it behooves us to become
more culturally sensitive and knowledgeable about the differences among our patients.
CULTURAL INFLUENCES IN HEALTHCARE
Caring for diverse populations is a challenge for most providers
and healthcare organ­izations. It is often necessary to bridge
chasms related to language, religion, and traditions in caring
for patients from culturally diverse backgrounds. While it is not
pos­si­ble for us to review ­every culture in this article, we include
several selected examples in healthcare from geo­graph­i­cally
and culturally diverse areas.
Note that the examples discussed below are intended to
introduce the vari­ous aspects of ­these cultures but that they may
not be representative of specific individuals with that cultural
heritage. Healthcare providers should listen and learn from each
patient and not assume or act on a broad national ste­reo­type.
Therefore, we also provide resources for prac­ti­tion­ers interested
in learning how to better manage patient care for t­hose who
are culturally diverse from the providers and their staff.
Providing care for patients with Hispanic or Latino
heritage. Patients with Hispanic or Latino heritage may place
a premium on personal relationships. With this in mind, asking about the patient’s ­family and interests before focusing
on health issues generally promotes rapport and trust. T­ hese
patients may be reluctant to discuss emotional prob­lems with
their doctor; careful and sensitive probing over multiple visits
might be necessary before the patient shares their feelings
and emotions.
Large extended families are common in ­these communities, so several generations of the ­family may accompany the
patient for a medical appointment. The patient may even
request that multiple f­amily members be pre­sent during the
examination.
Modesty is impor­tant to Hispanics and Latinos, especially
among older ­women. Healthcare providers should try to keep
older ­women covered whenever pos­si­ble. Given that ­these
cultures tend to have a higher ac­cep­tance of hierarchical order

­ omen may
and established gender roles,5 more traditional w
defer to their husbands in decision-­making. Hence, it is impor­
tant to find out whom they may want to consult before making healthcare decisions.
Since it is common for f­amily members to request that a
fatal diagnosis not be shared with the patient, early in the
patient-­provider relationship, ask the patient and immediate
­family members how much information and with whom they
want it shared.
­Family members may resist hospice for fear it w
­ ill emphasize the fact that their loved one is ­dying and thus encourage
the individual to give up hope or w
­ ill to live. The f­amily of a
terminal patient may also be reluctant to remove life support
lest it is seen as encouraging death. Alternatively, if the patient
or f­ amily believes the illness is “punishment by God,” life support may be considered interfering with the opportunity for
patients to redeem their sins through suffering.
Hispanic and Latino patients tend to exhibit a present-­time
orientation or “live for the moment” mentality, which could
impede medical compliance and follow-up care. For example,
it may be necessary to explain the need for preventive medi­
cation (e.g., related to hypertension or high cholesterol levels)
or the importance of finishing antibiotics even a­ fter symptoms
have subsided.
Among Hispanic patients who follow traditional practices,
“fat” is considered a sign of being healthy. Many Mexican
foods are high in fat and very high in salt; thus, nutritional
counseling may be necessary for p
­ eople who have diabetes
and t­hose who have high blood pressure. It is often helpful
to connect compliance with medical treatments to something
they care about personally, such as dancing at a d
­ aughter’s
wedding or seeing a grand­child.
Traditionally, it is common for matriarchs in the community
to advise new ­mothers to avoid cold temperatures, bathing,
and exercise for six weeks postpartum. Similarly, they advise
that a baby with a fever be bundled up, countering the medical advice and cooling mea­sures the healthcare practitioner
suggests to the m
­ other.
Including the grand­mother in patient teaching is helpful, because she may have the most influence on day-­to-­day
healthcare issues, especially if she lives with the f­ amily.
A chubby baby boy is considered healthy in Hispanic and
Latino cultures; consequently, additional instruction regarding
diet and diabetes education is often warranted. “Belly button
­binders,” which some may use to prevent an “outie,” should
be part of a discussion. Rather than advising caregivers not to
use them, instruct them about making sure the area is clean
and that the b
­ inder is not too tight.
In ­these cultures, many diseases are thought to negatively
affect c­ hildren, including mal de ojo (“evil eye”), caída de la
mollera (fallen fontanelle, often caused by dehydration), and
empacho (stomach pain). The “evil eye” is generally believed
to be caused by envious compliments. Healthcare providers
should touch the child when giving a compliment, especially
if the child is wearing a red string with a large brown seed
(“deer’s eye”), denoting belief in the evil eye.
Ask Hispanic patients about their use of herbal remedies.
For example, manzanilla (chamomile tea) is used to treat colic,
American Association for Physician Leadership® n Physician Leadership Journal
53
and it is generally safe and sometimes helpful. However, greta
(a yellow to grayish-­yellow powder) and azarcón (a bright
reddish-­orange powder) are used to treat empacho (stomach
pain), and contain lead, so they can be dangerous.6
If providers discover patients are using ­either or both, it
is impor­tant not to embarrass patients or make them feel
that they made a ­mistake. Instead, ask what remedies, if
any, the patient has tried in a way that implies that all of
your patients attempt self-­treatment before seeing the doctor. Explain that you need to know what t­hose treatments
­were to avoid prescribing something that could result in a
harmful interaction.
Implying that patients are being criticized for trying home
remedies or seeing other healers may lessen their trust and
rapport with their doctor; proper cultural sensitivity and communication can circumvent adverse reactions
Providing care for patients with Southeast Asian heritage.
Patients of Southeast Asian heritage value hierarchical authority
and have g
­ reat re­spect for elders in their culture.5 When relatives
accompany a patient for a medical appointment, it is considered respectful to address the eldest person pre­sent first —­
especially if the elder is a male. Adult c­ hildren are expected to
care for their aging parents and ­will often accompany them
to the appointment.
Often, a first-­or second-­generation family member ­will be
fluent in En­glish and serve as the translator for the patient;
however, it is impor­tant to note that the translator may not
be the decision-­maker of the f­amily. Among older generations, men are traditionally the decision-­makers, and e­ ither
the husband or eldest son (e.g., if his f­ ather is deceased) may
take on the role.
It may be difficult to obtain an accurate health history
from older individuals, as many Southeast Asian patients ­were
rarely told the names of illnesses, medicines, or procedures
performed in their native countries. Both male and female
patients tend to be modest to the extent of avoiding some
medical screening procedures such as pap smears, PSA testing,
and colonoscopies. Thus, clinicians may need to take extra
time to explain the purpose of t­ hese screening tests and make
­every effort to protect the patient’s modesty.
If a patient is diagnosed as terminal, f­ amily members may
wish to shield them from that fact. Upon admission or when
the need arises, healthcare providers should ask patients to
identify how much information they want to be given regarding their condition and to whom the information should be
provided. In most of Southeast Asia, diagnoses are typically
given to the ­family first; they decide w
­ hether to tell the patient.
Southeast Asians practice many dif­fer­ent religions or belief
systems. For example, many who are Buddhists believe in
reincarnation; ­others practice Chris­tian­ity; some are traditional
animists who believe that spirits inhabit objects and places
and that ancestors must be worshipped so their spirits do not
harm their descendants. Each of t­ hese belief systems comes
with its own unique practices that can influence a patient’s
medical treatment plan and compliance.
Traditional patients may wish to consult a shaman or a non-­
medical healer about their diagnosis or treatment plan. It is not
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JANUARY/FEBRUARY n 2022 n physicianleaders.org
unusual for a patient to ask the doctor to share their findings
with the shaman and receive the shaman’s opinion. Alternative therapies like cupping and coining (“coin rubbing”) are
traditional remedies. Physicians should be careful not to confuse marks left on the body by ­these practices with forms of
abuse. C
­ hildren may wear “spirit-­strings” around their wrists
or necks, which should not be cut or removed ­because some
consider ­these to carry the c­ hildren’s life-­souls.
Fi­nally, some patients might have concerns about blood
being drawn. They may fear it w
­ ill sap their strength, cause
illness, force their souls to leave their bodies, or ­will not be
replenished.6 It requires tact and understanding to encourage
­these patients to accept this kind of medical testing.
Providing care for patients with Rus­s ian heritage.
Patients with Rus­sian heritage tend to value power distance
(e.g., be­hav­iors represent status roles) and avoid uncertainty
(e.g., needing detailed background and contextual information).5 Formality is of g
­ reat importance and is a sign of re­spect.
Providers can demonstrate their re­spect by referring to their
Rus­sian patients as “Mr.” or “Ms.” and never assuming that
using the first name is appropriate with t­ hese patients.
Further, individuals with Rus­sian heritage prefer direct eye
contact and communication with their healthcare providers; in
contrast, t­ hose from M
­ iddle Eastern or Southeast Asian cultures
avoid direct eye contact as a sign of deference and re­spect.
Most Rus­sians have a “prepare for the f­uture” mentality
and put a high value on punctuality. T­ hese patients may arrive
early to appointments to be seen first. As such, providers
might consider giving Rus­sian patients the first appointment
of the day to avoid making them wait. Unlike other cultures,
the sex of the provider is usually not an issue with Rus­sian
patients. Still, they may prefer to have a ­family member of the
same gender pre­sent when receiving personal care (e.g., with
male doctors and female patients).
In the past, it was common for physicians to withhold an
ominous diagnosis from their patients, but that is no longer considered ethical. Rus­sian patients, however, prefer this
approach and often want to withhold fatal diagnoses from
the patient. Suppose the physician believes that withholding
a medical diagnosis or information may be an issue in caring
for a Rus­sian patient. In that case, they might consider asking patients how much information they want to be given
regarding their condition or with whom they would like to
share the information.
Rus­sian patients, especially el­derly individuals, may not like
taking large numbers of pills. Providers may improve compliance
by spacing medi­cation dosage so that as few pills as pos­si­ble
are given at one time. Notably, patients who participated in the
Rus­sian healthcare system typically are uncomfortable choosing
among vari­ous treatment options ­because ­these patients may
have been treated ­under a system that offered no choices —­the
patient did what­ever the doctor recommended.7 For this reason,
the physician ­will be viewed as an authority figure, and patients
are likely to seek their direct recommendations or advice.
Providing care for patients with ­Middle Eastern heritage.
Patients with ­Middle Eastern heritage are relationship-­oriented
and value long-­term and trusted associations. Effective rela-
tionships with ­Middle Eastern patients often involve two-­way
communication. The provider may need to share personal
information for ­Middle Eastern patients to feel comfortable
sharing information about themselves. Consequently, healthcare providers may be expected to take a personal interest in
their patients and their lives.
As with all high-­context cultures that rely on implicit and
non-­verbal communication, it is particularly impor­tant to be
familiar with their hand gestures, volume or tone of voice,
and facial expressions. For example, for many Ira­ni­ans, the
“thumbs up” signal is a rude gesture. Understanding ­these
nuances in culture is crucial to fostering effective and meaningful interactions.
­Middle Easterners have a past and pre­sent time orientation,
meaning that they honor the past and live in the moment.
­Human interaction is given a higher priority than “clock time,” so
physicians must emphasize this expectation if being punctual for
appointments is impor­tant to the medical practice’s schedule.
­These patients are family-­oriented; the collective f­ amily is
seen as being more impor­tant than the individual. Providers
should expect many ­family members to participate in the care
of the patient.
This concern about the care of a ­family member should
guide physicians to include ­family members in patient education. The entire immediate f­amily may participate in
decision-­making, but traditionally the eldest male is the
final decision-­maker on behalf of the patient. ­Women typically
defer to husbands for decision-­making regarding their own
and their ­children’s health. In fact, the husband may answer
questions that are addressed to his wife.
Direct eye contact with members of the opposite sex may
be interpreted as a sign of sexual interest, particularly from
females to males, so female patients may avoid direct eye contact with male providers. ­Middle Eastern patients ­will often not
be comfortable with healthcare providers of the opposite gender, considering that sexual segregation is extremely impor­
tant. The medical practice should assign same-­sex caregivers
whenever pos­si­ble. Female patients should be ensured modesty with adequate coverings during exams and procedures.
Islam is a dominant force in the lives of many M
­ iddle Easterners, so patients of the Islamic faith must have the opportunity to pray facing east t­ oward Mecca several times a day.
Furthermore, Muslims may not take medi­cations, eat, or drink
from sunrise to sunset during Ramadan. This period of fasting,
self-­sacrifice, and introspection is based on the Islamic calendar and occurs at a dif­fer­ent time each year. Some Muslims
may be exempt from daytime fasting if they are ill or pregnant.
Providers should be aware that observant Muslims do not
eat pork, which is considered haram (impermissible or unlawful). Medi­cations delivered in pill or capsule form often contain
gelatin, which is typically derived from pork. They are also
expected to abstain from alcohol, which may be found in
cough medicine. For ­these reasons, M
­ iddle Eastern patients
may prefer injections that are halal (permissible or acceptable)
and which they believe are often more effective.
Many followers of this faith have a fatalistic attitude regarding health and believe that every­thing is in Allah’s hands (e.g.,
Inshallah, meaning “God willing”), making their health-­related

be­hav­ior of l­ittle consequence or importance. When a M
­ iddle
Eastern patient is diagnosed as terminal, ­family members may
wish to shield them from that fact. As previously mentioned,
it is impor­tant to ask patients to identify how much information they want to be given regarding their own condition or
to whom the information should be provided.
­These patients may not want to plan for death, since ­doing
so can be seen as challenging the ­will of Allah. Physicians
might approach them by demonstrating their understanding and respectfully asking, “Some [Muslim] families feel that
making such decisions is interfering with the ­will of Allah. Is
this a belief you share, or do you want to begin discussing the
decisions that need to be made?”
Notably, Muslims may not allow for organ donation since,
according to Islam, the body should be returned to Allah in the
condition in which it was given (­whole). For the same reason,
they may be reluctant to allow an autopsy, but they w
­ ill accept
a post-­mortem examination if required by law. In other cases,
­those who are in f­ avor of organ donation say that b
­ ecause it
can save a life, it falls ­under the Islamic doctrine that “necessity
allows the prohibited.” Physicians should approach t­ hese topics carefully to discover the wishes of the patient and family.
Damp, cold drafts, and strong emotions may be thought
to lead to illness. For example, the “evil eye” (envy) is believed
to cause illness or misfortune. Amulets worn to prevent misfortune include the hamsa (a hand with a blue stone in the
palm) or a round blue stone with a blue and white “eye” in
the center.6 Given the importance of cultural nuances to health
and wellness outcomes, providers and their staff need greater
understanding of the impact of cultural diversity in healthcare.
Improving Physician and Staff Cultural Competency
Physicians and staff must understand the impact of cultural
diversity in healthcare. Cultural differences can be a source
of frustration for both patients and healthcare professionals and may result in poor health outcomes. By practicing
cultural competency when caring for patients from diverse
backgrounds, healthcare providers can improve health outcomes, increase patient satisfaction, and reduce frustration.
Developing the cultural intelligence of healthcare
providers. Working with ­people from dif­fer­ent backgrounds
can be difficult due to cultural barriers that cause misunderstandings and detract from efficient and effective interactions.8
Earley and Ang9 proposed a multifactor concept of cultural
intelligence (CQ), defined as an individual’s capability to deal
effectively in situations characterized by cultural diversity. CQ
has four dimensions: meta-­cognition, cognition, motivation,
and be­hav­ior.
Meta- ­cognition refers to the control of cognition and is
comprised of the pro­cesses that individuals use to obtain
knowledge. Cognition refers to the a­ ctual knowledge of cultural differences that an individual acquires or learns through
international experience or education. Motivation is the desire
to initiate and direct energy ­toward learning how to function effectively in an unfamiliar context. Be­hav­ior is an individual’s capability to exhibit appropriate verbal and nonverbal
actions when interacting with ­people from diverse cultural
American Association for Physician Leadership® n Physician Leadership Journal
55
backgrounds.9 Past research on CQ has developed a cultural
intelligence scale to mea­sure the level of cultural competency
for individuals and employees.10
In hiring new employees, a medical practice might mea­sure
applicants’ existing levels of CQ in order to determine which individuals would be the best fit for an increasingly diverse patient
population. Beyond recruitment and se­lection of ideal personnel,
the medical practice can develop higher levels of CQ in their
existing staff. CQ can be learned, developed, and enhanced
through exposure to other cultures via educational opportunities
(e.g., cultural sensitivity training and workshops) and international travel (e.g., employee retreats and conferences abroad).11
­These training experiences result in better care for culturally
diverse patients and growth opportunities for the practice.
interpreter to follow up immediately with written information and instructions in the patient’s native language.
The following are suggestions for using an interpreter:
Bridging language barriers in healthcare. The most fundamental and essential tool to improving the healthcare of
culturally diverse patients is communication skills. Often patients from dif­fer­ent backgrounds and cultures do not speak
En­glish or have ­limited En­glish abilities. The patient may not
be able to rely on a ­family member or friend to serve as a
translator and interpret or convey medical jargon accurately.
The translator may not understand the need to interpret
every­thing the patient and/or doctor says and may summarize
the information instead. Medical interpreter ser­vices that the
practice can call on at short notice are readily available in most
medical communities. We recommend choosing a practical
and eco­nom­ical method for the medical practice.
When pos­si­ble, the translator should conduct face-­to-­
face translations instead of telephone or virtual visits with an
interpreter. This enables the interpreter to convey nuances
observed in non-­verbal communication and help build a
relationship between the patient and the care providers. If
a practice has large numbers of patients with ­limited En­glish
proficiency, healthcare providers might consider scheduling
all patients with a common language in blocks of time. An
interpreter could come in for that period and help with multiple patients. The cost for professional interpreters varies from
approximately $20 to $26 per hour, but that can fluctuate
based on the location and experience of the interpreter.12
Another interpreter option is to employ bilingual staff
members. If professional interpreters are not feasible for the
practice, hire trained and competent dual-­role bilingual staff
members for roles such as receptionist or medical assistant, or
train the existing employees in needed language skills. ­These
staff members can provide interpreter ser­vices and perform
their regular duties in the clinic, saving the cost of paying an
outside interpreter and making the ser­vice more accessible.
If neither of ­these options is ­viable, the practice could use a
remote interpreter ser­vice. Telephone interpreter ser­vices can
be a quick and con­ve­nient way to accommodate patients with
­limited En­glish proficiency when in-­person ser­vices are unavailable. This is also a g
­ reat option for infrequently encountered
languages or for practices that have only an occasional need
for such ser­vices.
Many telephone ser­vices offer instant access 24 hours a
day, seven days a week, and charge by the minute. A
­ fter
the encounter, the standard procedure should be for the
■ Use short sentences and speak slowly and clearly,
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JANUARY/FEBRUARY n 2022 n physicianleaders.org
■ Ask the patient for permission to use an interpreter.
■ Provide additional time for the visit.
■ Speak briefly with the interpreter outside the exam
room to explain the purpose and goals of the visit.
■ Sit facing the patient and speak directly to him or
her, not to the interpreter. If using an interpreter
over the telephone, conduct the visit in a private
room with a speakerphone or a second handset to
preserve confidentiality.
avoiding the use of medical jargon.
■ ­After speaking, pause to allow the interpreter to
translate for the patient.
■ Ask the patient to repeat key information back to
you to ensure understanding.
■ Rec­ord the name of the interpreter in the chart.
Understanding and Respecting Cultures
To provide culturally appropriate care, caregivers must learn
about the patient’s ethnic and religious background. Some
might believe that it is “po­liti­cally incorrect” to ask about
cultural or religious beliefs in a medical examination; however,
understanding t­ hese cultural aspects is vital to the success of
the interaction. The key to success is in the way it is done.
If healthcare providers ask patients about their culture with
respectful curiosity and genuine interest, most patients are
delighted to be the “chief explainer” about their culture.
Take advantage of this excellent opportunity to market
medical ser­vices to ethnic populations. For example, one of the
authors (NHB) has several referring physicians from Vietnam
who have many Viet­nam­ese patients. To build a relationship
with his Viet­nam­ese colleagues, he contributed articles for
their Viet­nam­ese dental and medical journals.
To demonstrate cultural inclusivity, NHB and his staff learned
a few words of Viet­nam­ese to use with their patients. Being
able to say “hello,” “thank you,” and “good-­bye” in another
language is not a difficult task, and it goes a long way in helping the doctor and staff to connect on a ­human level with the
local ethnic community. If some words and terms are difficult
to pronounce, asking the Viet­nam­ese doctors and patients
for some verbal coaching is also a g
­ reat way to build rapport.
By understanding and respecting the unique healthcare
needs of ­those with cultural differences, the doctor and the
practice w
­ ill find that they can bridge the cultural divide.
THE BOTTOM LINE
Focusing on cultural diversity in patient populations may pre­
sent the potential for stereotyping, which must be avoided. It
is impor­tant to understand the ecological fallacy, which argues
that inferences cannot be made about an individual based
on the group’s aggregated, national-­level cultural be­hav­iors.
Gaining cultural competency allows healthcare providers to
treat individuals of diverse backgrounds in an inclusive rather
than exclusive manner.
It is never appropriate to make sweeping statements and
refer to every­one in a certain culture as “being aggressive”
or “always avoiding eye contact.” For instance, although he
or she knows that certain cultures generally prefer to keep
social distance, the culturally competent practitioner does not
assume that every­one from that cultural background wants
to socially distance. Culturally­competent prac­ti­tion­ers use
the cultural knowledge they already have, then modify their
perspective and be­hav­iors based on their interactions with
the specific patient being treated.
Using ­these guidelines gives healthcare providers a “best
first introduction,” but if they are not entirely correct, the
provider ­will have the cultural intelligence to change their
approach. We hope t­ hese insights w
­ ill allow you to know your
culturally diverse patients in light of the broad generalizations
that we have provided. Vive la difference!
Brittney Bauer, PhD, is an assistant professor
of marketing and holder of the Chase
Minority Entrepreneurship Distinguished
Professorship in the College of Business at
Loyola University, New Orleans. Her primary
research interests focus on social judgments,
psychological attachment, and marketing
communications.
bcbauer@loyno​.­edu
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Neil Baum, MD, is a professor of clinical
urology at Tulane Medical School in New
Orleans, Louisiana, and author of The Three
Stages of a Physician’s Career-­Navigating
From Training to Beyond Retirement
(American Association for Physician
Leadership, 2017).
doctorwhiz@gmail​.­com.

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