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Different cultures want better communication, Summa survey finds; pros say they already have skills
By Tracy Wheeler
Beacon Journal medical writer
Published on Sunday, Sep 16, 2007
Whether Muslim or Amish, Eastern European or African-American, patients want doctors who can communicate clearly, without rushing and without medical jargon.
Yet more than 90 percent of doctors and nurses believe they already have the necessary skills and training to interact with patients from different cultures, as well as those who have little understanding of medical information.
Whether both groups can be right will be an ongoing discussion of Summa Health System's Diversity Advisory Council. From fall 2006 through spring 2007, the council surveyed about 60 patients and 190 staffers to determine how well the health system is handling the cultural, language and spiritual needs of its diverse patient population.
Some of the needs and concerns were common across all groups, such as the communication issue.
In focus groups, Asians said the want doctors and nurses to speak more slowly and clearly, and to ''explain things until I understand.'' Eastern Europeans saw a need for interpreters. Muslims said they felt rushed at doctors' appointments. African-Americans wanted more easy-to-understand medical information. Only Hispanics said that doctors routinely go out of their way to communicate with patients, despite language barriers.
The cost of medical care, confusion in navigating the insurance and health care system, and transportation were also concerns cited by many of those interviewed. The focus groups also found:
African-Americans' view of health varies by age. Older generations don't view health as something that can be controlled and have little interest in healthy lifestyle changes, while younger generations are more interested in following healthy habits. They were also bothered by long waits, but preferred to avoid medical interns for care.
Muslims need doctors of the same gender. Doctors of any faith are fine, as long as they treat the patient with respect.
Asians prefer a holistic approach to health care, even if it requires care by someone other than a doctor. The report says they are skeptical of prescriptions, preferring natural remedies.
Hispanics want Hispanic doctors who will spend quality time with them. They also want family to be involved in their care to lessen fear and frustration.
Findings like these ''give me the heebie-jeebies,'' said Dr. Joseph Zarconi, Summa's vice president of medical education and research. While the quest to serve a diverse population is ''very right-minded,'' the effort often leads to ''misguided strategies.''
Zarconi worries that such efforts can lead to stereotyping, or a belief that all members of a certain race or religion are the same. He said that could contribute to poor health care as much as cultural insensitivity.
It's not about race and ethnicity, he said. It's about a person's life experience.
Just because two patients happen to be 52-year-old black men doesn't mean they have similar lives. Just as two heart-attack patients aren't necessarily the same.
''It's up to us to ask, 'What's going on in your life?' '' he said.
It's a matter of treating the patient and not just the disease.
The issue is an important one, as disparities in health care contribute to a shorter lifespan for most minorities.
The survey of doctors and nurses presented a short list of possible solutions, including spending more time with patients; creating the position of a patient advocate; specialized training for doctors and nurses; and helping patients be better prepared before appointments.
Zarconi said the main barrier will be convincing doctors and nurses that it's necessary to do a better job of caring for the cultural and spiritual needs of patients. Most doctors were schooled on the idea of ''detached concern,'' which builds a wall between doctor and patient.
As the diversity council builds programs and solutions, it hopes to share what it learns through journal articles, medical seminars and classes at the Northeast Ohio Universities College of Medicine, said Tracy Carter, Summa's director of advocacy and health policy.
''This is an area where we can't be selfish,'' she said.
Tracy Wheeler can be reached at 330-996-3721 or tawheeler@thebeaconjournal.com.
Whether Muslim or Amish, Eastern European or African-American, patients want doctors who can communicate clearly, without rushing and without medical jargon.
Get the full article here.
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