Cultural Barriers Evident Between Patients and Doctors

(Ivanhoe Newswire) -- Most physicians acknowledge how important it is to provide care that accommodates the needs of diverse populations, but many don't feel they're prepared to face cross-cultural issues they encounter in their practices.

A research team from the Massachusetts General Hospital (MGH) Institute for Health Policy in Boston mailed surveys to about 3,500 residents in the final years of their training programs. Residents from seven specialties at 149 academic health centers across the United States were targeted. More than 2,000 residents responded and many agreed culturally based difficulties could cause problems, such as longer office visits and patients not understanding or complying with instructions.

Lately, attention has been given to how socio-cultural differences between patients and providers can complicate health care. Poor communication, patient dissatisfaction, and reduced quality of care are often the result.

Joel Weissman, Ph.D., from the MGH Institute for Health Policy, led the study. "Residents are getting mixed messages during their training. On one hand, they recognize that these issues are important," says Weissman. "But on the other hand, they have little clinical time to address cultural issues, they receive limited instruction and little or no evaluation, and there are too few good role models and mentors."

When residents were questioned about their experiences, up to half said they received little or no training in handling situations like addressing patients from other cultures, understanding different family decision-making structures, or working with interpreters. A lack of good role models or mentors for cross-cultural care was reported by 30 percent of respondents, and more than 60 percent reported not being evaluated on cross-cultural skills.

With regards to specific situations such as caring for patients who mistrust the United States health system or caring for patients who have health beliefs that contrast Western medicine, between 20 percent and 25 percent of the residents who responded to the survey said they felt unprepared. A similar percentage did not feel they would be able to recognize mistrust in patients or identify cultural or religious customs that might have an impact on care.

Weissman says, "We know communication is a critical part of good patient care, and our study indicates there is lots of room for improvement in our training programs."

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SOURCE: The Journal of the American Medical Association; 2005;294:1058-1067