At some point during medical school, residency or fellowship, you will encounter a patient, colleague, nurse or other health professional who belongs to a different race, ethnicity or faith. According to the U.S. Census Bureau, the 15 most populated metropolitan areas in the U.S. include inhabitants who speak more than 100 languages at home. In 2014, 39.9 percent of the country’s population was classified as minority, defined as any race other than white.
Minority populations have greater health disparities when compared with the white population. Native Americans are 2.5 times more likely to be diagnosed with diabetes , for example, while Hispanic and Latina women are 30 percent more likely to have a stroke. African-Americans have the highest mortality rates from cancer of all races and ethnicities. Even when statistics are controlled for income, minorities still experience inferior health outcomes compared with white patients.
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Cultural competency is a method of improving the accessibility and effectiveness of health care services for people from ethnic or minority backgrounds. This skill is needed for a better understanding of the cultural context from which patients arrive in exam rooms and hospital beds.
Patients interact with the health care system from a variety of viewpoints and backgrounds. Preconceived thoughts originate from previous experiences. Perhaps a patient did not receive the highest quality of care, or was treated with disregard because of a language barrier or due to a cultural history of unfair treatment. Consequently, patients may not trust or may be skeptical of the health care professional in the exam room, and this directly affects care.
Patients may delay seeking care or may not adhere to medical treatment because they do not trust the medical community. Physicians, residents, fellows and students are sometimes all too quick to label a patient as being noncompliant when that patient does not do what health care professionals recommend.
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Cultural competency allows the clinician to design a treatment plan in the context of the patient’s life by engaging the patient to be a partner in the treatment plan.
The aim is to improve communication between patients and physicians, resulting in increased patient adherence to recommendations and satisfaction, as well as the elimination of health care disparities between minority groups and the white population.
Undergraduates can increase cultural competency through their experiences both inside and outside the classroom. A broad undergraduate curriculum includes classes in literature, communication and the arts. If you are not a liberal arts major, consider classes that increase your exposure to a variety of backgrounds and perspectives.
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While volunteering, pay attention to patients and fellow volunteers who may come from various backgrounds, and take advantage of the opportunity to learn through observation and engagement. If you speak a language other than English, investigate becoming a medical interpreter to experience the health care system from the perspective of a non-English speaker. If you seek complete immersion in a foreign culture, study abroad.
College classes and activities can form the foundation of cultural competency that will set the stage for more formal training in medical school. Cultural competency pays dividends not only to the individual and field of medicine but to society at large.
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