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Knowledge of non-Western health practices may help doctors avoid misdiagnoses and other problems in Asian-American patients

Low-income Chinese- and Vietnamese-Americans, who speak very little English, often practice non-Western ways of healing such as coining (rubbing the spine and sternum with oil and a coin to release the "wind" or "cold") or cupping (heating air in a cup with a flame and placing the cup onto the skin to "pull out the cold air") for symptoms of respiratory infections and other minor illnesses. They would like to talk to their American doctors about these practices but often find that their doctors disapprove of the practices and/or know little about them, according to a study supported by the Agency for Healthcare Research and Quality (HS10316).

Without knowledge of coining or cupping, an American doctor viewing a bruise on an Asian American may see it as a sign of a hematological disease or abuse. Also, if a doctor dismisses discussions of Asian medicine, he or she may not be told that a patient is taking an herb to supplement the doctor's treatment, perhaps leading to problems for the patient. To avoid potential medical complications and misdiagnoses, doctors should ask patients directly about their health beliefs and their use of non-Western therapies, suggest the authors of the study. The study was conducted by researchers at Harvard Medical School, the University of Massachusetts, and the University of Rhode Island.

The researchers conducted 12 focus groups (6 for men and 6 for women) with a total of 122 predominantly poor, Chinese and Vietnamese patients who were recent arrivals in the United States and had limited English proficiency. The videotaped discussions revealed three areas of concern about quality of care that differed from those of other minority groups. Participants believed that providers' knowledge of, inquiry about, and nonjudgmental acceptance of traditional Asian medical beliefs and practices were essential to their quality of care. They wanted same-sex professional interpreters instead of children and other family members to communicate with the doctor. Finally, they wanted help navigating the health care system and obtaining support for social services.

See "Linguistic and cultural barriers to care: Perspectives of Chinese and Vietnamese immigrants," by Quyen Ngo-Metzger, M.D., M.P.H., Michael P. Massagli, Ph.D., Brian R. Clarridge, Ph.D., and others, in the January 2003 Journal of General Internal Medicine 18, pp. 44-52.

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