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Culturally insensitive health care systems and providers are thought to be one source of poorer quality of care among racial and ethnic minorities. These patients often feel discriminated against, misunderstood, and uncomfortable in doctors' offices. Training physicians in skills related to cultural competence may improve health care delivery to these patients, suggests Carolyn M. Tucker, Ph.D., of the University of Florida.
A study led by Dr. Tucker and supported in part by the Agency for Healthcare Research and Quality (HS13151) discusses what cultural competence means from the standpoint of mostly low-income whites, Latinos, and blacks. Based on 20 focus group interviews with 135 of these patients (52 blacks, 38 whites, and 45 Latinos), all groups agreed on four indicators of culturally sensitive health care by their primary care physician.
The four indicators were:
- Physician people skills (empathy, acceptance, respectfulness, concern, good listening, friendliness, and patience).
- Individualized treatment (personal knowledge of the patient and his or her situation, especially financial concerns).
- Effective communication (thorough explanation of procedures in easily understood language).
- Technical competence (thorough physical examinations, knowledge, and confidence).
For Latinos, sharing a common language with their doctor influenced levels of trust and comfort. Latinos were also more vocal than either blacks or whites about culturally insensitive doctors and their front desk clinic staff, possibly as a result of language barriers.
White patients emphasized the importance of a collaborative relationship with the doctor, whereas blacks and Latinos focused more on wanting
individualized care and attention. Latino and black patients also said they felt more comfortable in primary care offices that included respectful office staff, as well as culturally sensitive art, pictures, music, and reading materials, including those that addressed health problems specific to them.
See "Cultural sensitivity in physician-patient relationships: Perspectives of an ethnically diverse sample of low-income primary care patients," by Dr. Tucker, Keith C. Herman, Ph.D., Tyler R. Pedersen, Ph.D., and others, in the July 2003 Medical Care 41(7), pp. 859-870.
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