Underserved Populations and Cultural Disparities

[WRL]

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Hello,
Im interested in people's opinion on the role of health care personnel in treating patients across contrasting cultural experiences. Specifically, who should be treating at-risk groups when there aren't enough doctors coming from those at-risk groups?

As a concerned pre-med individual and a reasonably-conversant Spanish speaker, I have been drawn to working on Hispanic-American healthcare, a group that has been shown to receive less care(http://elatinavoices.org/health-disparities-in-the-latino-community/ ). But I recognize that doctors and other healthcare personnel who have grown up in the Hispanic community have a stronger cultural sensitivity to Hispanic patients and their needs.

I am currently of the opinion that conversation on topics of mutual interest, such as a communication between a doctor and her patient of a different culture, can be just as productive as that between more culturally similar people as long as agreement is reached on the proper course of action. I worry though that patients may feel uncomfortable bringing up their concerns if they find cultural insensitivity in the doctor.

 

[Lya]

That's a good question. It addresses several things, among many others:

-the maldistribution of healthcare providers
-lack of minority medical students
-lack of funding and supports for young doctors who want to serve the rural
-lack of exposures to minority professionals for rural communities, leading to less interests in medicine among students
-concern of raising a family and their quality of life in rural communities for the doctors who came from different backgrounds
-concern that good communication does not necessarily lead to good compliance

In other words, I think your question requires several different issues to discuss prior to answering it fully.

Yes, ideally, you want to have a local doctor who understands everything that the locals go through. I also agree with your statement about the communication with a patient from different culture should be just as productive. However, in a limited amount of time available for consulting each patient, you might not even be able to execute all the "proper course of action" necessary. Your efficiency in treating patients might not be on a par with a local, ideal doctor, even if you are a "doctor."


It's simply my opinion, but I think that the answer to your question might not be "doctors" all the time, depending on environments and other conditions. Whether it be nurse practitioners or other providers, perhaps they have to do all the physicals, ask all the necessary questions, and treat however they can while staying in touch with the closest doctors through telecommunication to ensure they are doing things correctly.

The question should be rather about how can healthcare providers, whoever is available in rural areas, become culturally sensitive for future patients if they weren't sensitive to the current patients. I would say, stay open-minded, learn their language, and find time to talk to the locals about their lifestyles and values. At least this is how cultural anthropologists, as far as I know, become sensitive to unknown cultures from the scratch.