Dose of cultural sensitivity helpful in health care setting - Austin American-Statesman |
| Dose of cultural sensitivity helpful in health care setting - Austin American-Statesman Posted: 01 Nov 2010 02:34 AM PDT By Beth Bond Marketing Publications Staff After suffering a massive heart attack while out of the country, an Austin businessman opened his eyes to find himself in a hospital in China. Dr. David Kessler, who treated him, recalls how relieved the man was to return home and receive follow-up care in Texas. "He didn't speak the language and had no idea what was being done to him," said Kessler, who specializes in electrophysiology and cardiac pacing at the Heart Hospital of Austin. "It dawned on me how scary that can be. You could translate that to the average person who lives in Austin and doesn't speak English." For Kessler, that incident several years ago illustrates the need for wide access to translation services for patients and broad cultural knowledge among doctors. While written prescriptions and verbal instructions from a doctor might feel like obstacles to patients who don't speak English, the idea of cultural competence covers more than language barriers. "It involves sensitivity to and respect for differences in language, religion, customs, values and traditions — all these values around health care that shape the approaches that we take to health and illness," said Nydia Gonzalez, associate vice chancellor for institutional diversity at Tarrant County College District. As an example, Kessler, who is Jewish, points to an instance in which his own background enabled him to lift some stress from a patient of the same faith. The doctor said he sensed that scheduling heart surgery during Passover would be unnecessarily hard on the patient and his family. "I told my colleagues, 'This is not an emergency. Surgery is imminent but it's not urgent,'" he said. "I had the personal insight to the holiday and knew this could wait until the next week. If you had a patient who was Muslim and Ramadan was coming up, would you really want to schedule a surgery that month if it's elective?" Kessler's approach squares with Gonzalez's advice for a field that reaches people of all stripes: "The best way to respond is with understanding and innovation, and health care is all about these." Gonzalez's professional work deals with promoting cultural sensitivity in health care and education, the areas she said are the first affected by the United States' rapidly shifting ethnic and racial demographics. To that end, she previously held diversity-related positions at Yale University and the M.D. Anderson Cancer Center in Houston. Growing up with insight into two cultures provides the backdrop for Gonzalez's interest in cultural competence among health care providers. She said that when she had a fever as a child, a curandera, or faith healer, was called to the family's house to rub an egg from the crown of the girl's head down to her feet. Once the egg was cracked and left in a saucer under her bed overnight, the state of the egg indicated whether her illness was caused by mal de ojo, the evil eye — a concept that exists in cultures around the world. If that wasn't the case, her family figured she likely had an infection easily treated by driving to a pediatrician's office in Weslaco for a shot of antibiotics. In the time and place where Gonzalez grew up — in the 1950s in South Texas — it was common for Hispanic families to seek health care from a curandera as well as a medical doctor, she said. Now that she is an expert in organizational diversity, she has a name for the treatment she was given. "I didn't know it then, but what I was really experiencing was integrative medicine," Gonzalez said. She's since done research on cultural competence in health care that highlights its significance for both patients and doctors and found that it will grow only more important as the face of the nation changes. "There's a compelling need for cultural competence just by responding to projected demographic changes to eliminate long-standing disparities in people of diverse cultural backgrounds," she said. "Really, nowhere are the divisions of race, ethnicity and culture more sharply drawn than in the issue of health care in the United States." In response, health care organizations have been issued 14 national standards known as Culturally and Linguistically Appropriate Services (CLAS) by the Office of Minority Health, a division of the U.S. Department of Health & Human Services. CLAS mandates on providing translation services at no cost to patients are required of health care organizations that receive federal funds. Overall, the list of guidelines calls for care that's respectful of a patient's "cultural health beliefs and practices and preferred language." The standards also suggest that a health care organization's staff should reflect the demographics of the surrounding community and should receive training in cultural sensitivity. Kessler believes such training is essential, whether it's required or not. "Whether it's a class or reading the newspaper every day, it's incumbent upon you to get that training," he said. "That's what it means to be an informed citizen in this country." This entry passed through the Full-Text RSS service — if this is your content and you're reading it on someone else's site, please read our FAQ page at fivefilters.org/content-only/faq.php |
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