There are a lot of challenges in the doctor-patient relationship. One that’s becoming increasingly noticeable as society gets more global is cultural differences.
Here are just a few ways a patient’s culture affects their health, as well as their relationship with healthcare providers:
– Lifestyle. Certain health issues are more common among particular populations, often due to cultural norms. For example, soft drinks, fast food, and relying mostly on cars for transportation are aspects of mainstream American culture, contributing to why the leading cause of death in the US is heart disease. Regardless of sobering statistics, it may be hard or even impossible for a doctor to tell a patient to do something that would completely change the lifestyle and standards they’re familiar with.
-Beliefs. A patient’s beliefs can affect their understanding of diagnosis and treatment – and they may also have a major psychological influence on their recovery. Most Western, European-based cultures see illness as biological phenomena that can be treated with medications and other man-made techniques. But as this site points out, in other cultures, people believe health problems have supernatural or spiritual causes, making medication useless.
– Individual or interdependent. Western cultures tend to be individualistic: each person is responsible for their well-being. Many East Asian cultures, on the other hand, focus on the collective and are very family-oriented. East Asian patients might follow advice and decisions taken by a senior family member, and can have a harder time accepting mental health-related diagnoses because these could bring difficulty or shame on their family. This article notes, for example, that certain Indian and Pakistani patients often refuse to believe diagnoses like mental illness or retardation, since it would limit or even eliminate any marriage proposals their family members might receive.
Luckily, just as there’s a lot of research on conflicts between culture and health(care), there are also a lot of suggestions on how to improve the situation.
It’s always a good idea for healthcare providers to learn about the culture of their patients. But some other possible solutions are less obvious. For example, it’s a well-known fact that emotional support can have positive effects on a patient, but this seems to work best when it’s culturally appropriate. Studies have shown that while patients from European-based cultures tend to openly seek support, those from Asian cultures tend to prefer doing this more subtly, say by spending time with family and not thinking about their health issue. So a health worker should consider how to approach a suggestion about, say, their patient joining a support group.
Another interesting idea comes from this Georgetown study: Since many minority groups report feeling condescended to or discriminated against during medical visits, healthcare providers should consider hiring minorities in offices where there’s a high percentage of minority patients.
When it comes to making sure patients follow through with treatment, knowing that individualistic cultures tend to respond to the idea of a reward, while collectivity-focused cultures try to avoid problems, could be important.
Here are some other strategies to help breach cultural barriers, from lists you’ll find here and here:
– Put your judgment aside, no matter how much you disagree with a patient’s cultural beliefs. – When it comes to communicating with families, follow patients’ cues and advice. – Provide cultural and language training to all staff and medical professionals in your organization (we can help with that!).