This weekend I attended a dynamite conference about improving the treatment of diabetes in the Latino population. The presenters, from the University of Texas Southwestern Medical Center, discussed tailoring medical care to a population that is steadily growing. Even as the conference focused on the Latino populations, there is much that can be applied to the general population.
We as physicians can, and must take the first steps to improve the quality of health care services to diverse populations. We need to recognize and respect gender preferences within certain religious groups and we need to respect our patients’ efforts to communicate in a second language. We also need to understand the strong influence of recommendations from family and friends.
No matter the language, common terms may be different enough to engender misunderstanding. If a physician asks a patient to take insulin with “dinner,” does that mean the main meal at midday or the evening meal? The course director, Jaime Davidson, MD, tells the story of prescribing a medication once daily. Dr. Davidson wanted the patient to take the medication one time per day; however, once is ‘eleven’ in Spanish. After three days, the patient had used all his medication for the month. This is a dramatic example, but miscommunications can happen at any time.
Our perception of a ‘healthy meal’ is heavily influenced by our preferences and cultural background. If our grandparents never ate broccoli, and our parents never ate broccoli, how likely is it that we will be serving broccoli to our children? This may sound silly, but we once had a babysitter who was speechless when served eggplant – her parents had always threatened the kids with eggplant for dinner if they were bad!
One of the thrills of primary care medicine is that we never know who will next come through the door with what problem – sensitivity to cultural differences can help improve care to all our patients.
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