If you work for a large medical institution in the United States, you will eventually be introduced to the notions of "culture" and "cultural differences" and there will be an expectation that you will become aware of these concepts and be sensitive to them. Yet I have found that most trainings in this area are overly generic and lack specific examples. So you end up listening to the Human Resources' cultural sensitivity presentation, but when you get back on the job, for the life of you, you cannot remember what to look out for or what you could do to rescue a situation where a cultural norm, yours or the patient's, was transgressed.
It is in this spirit that I have prepared a list of key cultural topics accompanied by real life scenarios that illustrate conflicts and their resolution. Specifically, I will address how any professional in the medical field, doctors, nurses, interpreters, social workers, or administrators, can develop a deeper undestanding of both Anglo and Latino cultures. When the information provided here is acted upon it will increase patient trust and understanding and lead to better health outcomes and patient satisfaction. For this discussion, "culture" refers to the beliefs, perspectives, ideology, superstitions, and expectations that are most prevalent within a particular group.
Author's qualifications: Daniel Catalaa has worked for 15 years with the San Francisco Bay Area Latino immigrant patient community as a Certified Spanish Medical Interpreter mainly at Sutter Health California Pacific Medical Center, and has lived abroad in Europe and South America for 20 years. He received health care as a patient in England, Italy, France, Argentina, and the USA, and completed a bachelors and masters degree in Cell and Molecular Biology.
Each of the articles below explores a specific aspect of culture that has a direct impact on patient-provider relations and the delivery of medical care:
Article |
Anglo Culture top values & factors |
Latino Culture top values & factors |
---|---|---|
Communication style |
➤ Assertive ➤ Direct ➤ Low context |
➤ Passive ➤ Indirect ➤ High context |
Decision Making |
➤ Personal autonomy ➤ Patient-driven ➤ Citizen socioeconomics |
➤ Family-integrated ➤ Doctor-driven ➤ Immigrant socioeconomics |
Health literacy |
➤ Informed patients ➤ Some awarenesss of healthcare system |
➤ Uninformed patients ➤ Low awareness of healthcare system |
Notions of time |
➤ Efficiency ➤ Precision ➤ Protection |
➤ Enjoyment ➤ Flexibility ➤ Improvisation |
Personal Interactions |
➤ Informality ➤ Equality ➤ Personal Boundaries |
➤ Formality ➤ Deference ➤ Connection |
Religion and philosophy |
➤ Free will ➤ Science-oriented |
➤ Fatalism/Determinism ➤ Christianity-oriented |
Self-identification |
➤ Personal Identity ➤ Job-defined identity ➤ Gender balanced |
➤ Family membership ➤ Nationality-defined identity ➤ Gender specialized |