Bridging the Cultural Divide

Are you doing all you can to acknowledge and be sensitive to the cultural diversity of those seeking your care? You need to if the healthcare racial and ethnic disparity gap is to ever be closed, according to the American College of Physicians.

The organization recently updated a 2003 policy paper outlining recommendations on how to close the gap between ethnic minorities and white Americans, including several steps for physicians to take immediately if they are not already in place.

Among the ACP’s recommendations are that physicians, and other healthcare professionals, acknowledge the “cultural, informational and linguistic needs of their patients” as the U.S. “becomes more racially and ethnically diverse.”

One part of this, according to the ACP, is that language barriers are breached between limited English proficiency (LEP) patients through the use of an interpreter, covered by numerous federal and state laws. The organization notes that such laws however, are “insufficiently enforced” and gaps in services do persist. Noting the cost for physicians to provide an interpreter, the ACP recommends Medicare reimburse clinicians for language services and it also seeks a national clearinghouse to provide translated documents and patient education materials.

Another recommendation by the ACP is for physicians and others to be sensitive to cultural diversity among patients and “recognize that preconceived perceptions of minority patients may play a role in their treatment and contribute to disparities in health care among racial and ethnic minorities.”

The ACP notes, “Minority patients are more likely than their white counterparts to perceive racism in the health care system and are more prone to delay care because of distrust.” It recommends cultural competency training for physicians and staff to improve cultural awareness and competency to better treat patients.

The organization also promotes diversity in the workplace, more representative of the patients it serves as “crucial” to promote understanding among physicians and those seeking care.

The ACP acknowledges, through its president, J. Fred Ralston, that closing the healthcare disparity gap “will be a difficult, multifaceted, and important task,” but also that physicians “have a moral imperative that appropriate resources are devoted to responding to the challenge.”

This is not a new challenge by any means, but one that will get more attention given the millions of Americans that will access health insurance post-reform. But the ACP acknowledges that while steps have been made since its 2003 recommendations, “the issue of racial and ethnic disparities remains a difficult and complex problem to address.”

I agree with Dr. Ralston that the answer lies with you – physicians. You can and are taking the forefront in closing the gap through your work every day. So my question to you is simple: What are you doing in your office?

What training, programs, or other endeavors have worked? What has failed? What would you like to do?

There are more questions than answers, but perhaps by sharing ideas, the gap that the ACP aims to close will get a little tighter and perhaps in another seven years, with its next policy paper, there will fewer recommendations and more solutions.