Some Docs to Be Schooled in Cultural Differences

AP, August 8, 2008

When a doctor doesn’t look an Asian-American patient in the eye, that might be seen as a sign of respect. But making eye contact is encouraged with black patients, according to the American Academy of Orthopaedic Surgeons, which has published a guidebook for culturally competent care.

As the country’s ethnic profile diversifies, some states are trying to assure that health care providers are trained in “cultural competency.”

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Dr. Elizabeth Szalay, an associate professor of pediatric orthopedics and pediatrics at the University of New Mexico’s Carrie Tingley Hospital, said that it’s important for doctors to understand how patients may be different, but patients also need to be open about themselves, by asking questions and revealing their beliefs, concerns or fears.

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Cynthia Lin, 55, of Taiwan, says she never has experienced a cultural barrier between herself and doctors, which she attributed to her open attitude.

She felt the need to tell a pediatrician once about something that’s common among Asian babies—that they are born with a sort of bruised look near the buttocks.

“Some doctors may think, ‘Oh my goodness, what happened to the baby’s butt?’” said Lin, who lives in Albuquerque. “(But) the doctor understood that’s just how Asians are. If the physician already knows about it, if they are aware that certain races have certain characteristics, then they don’t have any doubts.”

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New Jersey’s law is similar to New Mexico’s, requiring that the state’s medical schools provide instruction to their students as a condition of receiving a degree. But the schools also must provide cultural competency training to licensed physicians who did not receive the training while they were in school—something Flores said the New Mexico Legislature might tackle down the road.

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California had a voluntary program in place since 2003 but later made it mandatory for the state’s 400 continuing medical education providers.

Under the law, every CME course has to have an element of cultural and linguistic competency, which are accredited by the Institute for Medical Quality.

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