Culture Competency For Doctors: Does it Matter?

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 Margaret Waage
CTLatinoNews.com

 As the state’s population continues to become increasingly diverse, area hospitals and health centers find themselves offering additional training to be able to more effectively provide medical services.  Doctors at many facilities are now required to undergo cultural competency training so that they may be better able to treat their patients.
At the UConn Health Center, Dr. Anton Alerte, assistant professor of pediatrics describes its program as focusing on the unique differences of  patients because he says, “…it’s paramount to providing good care.”  At the medical center, the care for patients with language and perhaps cultural barriers  is addressed through UConn’s ongoing training program called  the Principles of Clinical Medicine (PCM).
“In addition to familiarizing differences in language variations, PCM teaches factors that contribute to the patient’s unique cultural qualities according to their locations,” said Dr. Alerte, adding that, “Patients come from a number of cities that include a low social-economic status. Just as the city of Hartford has differences between the North, South, West and East areas, inner city populations have their own challenges.”
And, since the Hispanic and Latino communities refer to people with backgrounds in Latin America and contain various sub communities, the need for a background in cultural competency is necessary to distinguish differences in languages and account for Latinos born within the United States.  Additionally, the UConn Health Center serves not only patients of various ethnic backgrounds, which also include Chinese, Haitian, Ghanaian, and Middle Easterners, but  Dr. Alerte adds, “We serve all racial groups and social classes including gay, lesbian, bisexual and transgender populations.”
The UConn PCM program offers its residency interns a one-year curriculum that is made up of a three parts. Interns are required to complete all three components that include: an online component covering health care disparity, stereotyping bias, communication training skills on how to talk and listen, and how to show respect. The second component is a 4-hour session in groups of 20. This section aims to cover the diverse population of Greater Hartford and covers several foreign languages. A third component is an evaluation that is done in a study lab with live socio-economic population that tests language skills through practice.
UConn Health Center uses Language Line, a translation service provider.
“We have bilingual staff, but it’s imperative to have a service on hand for all languages such as Mandarin.” UConn staff also serves in the community doing educational outreach.
The second semester of PCM focuses on physical examination, health literacy and community influences on health and wellness, and includes on-site visits. Because diet plays an integral part of health, seeing first-hand what resources are available to patient populations aids in behavioral counseling.
Medical students and faculty volunteer through on-site visits to communities in under-served areas. UConn’s outreach includes serving in Hartford’s South Park Inn Medical Clinic, services founded by UConn students, a migrant farm workers clinic, and hands-on care of medical and dental screenings at homeless shelters .
“These visits and volunteer work in the community is a big part of learning cultural competencies,” said Dr. Alerte, who  also serves as a faculty member of PCM, says doctors, medical students and interns participate in the program in addition to fulfilling Connecticut’s mandated National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care requirements. While the National CLAS Standards are intended to advance health equity, improve quality and help eliminate health care disparities, UConn’s PCM program provides a hands-on resource for staff.
“It’s important that any provider treat all cultures with dignity and respect,” said Jose Ortiz, President and Chief Executive Officer of the Hispanic Health Council, who described mandated CLAS training as a general practice that should transcend the health community. The Hispanic language varies among Columbians, Cubans, Puerto Ricans, and many subcultures. Common values among Latinos are family, religion and building interpersonal relationships, and that includes caregivers.
Ortiz said the more cultural knowledge health practitioners acquire the better their communications proficiency and their ability to do their jobs with patients.
“Cultural competency is an on-going process that can always be expanded. State required training is just a starting point because there’s always more to know about people and their sensitivities.
“All cultures and people are deserving of being treated in an appropriate way, and that requires knowing the small, little things that define who the patient is,” said Ortiz.
 
For information on the UConn Health Center and their comprehensive PCM program visit: http://medicine.uchc.edu/prospective/curriculum/phase1/pcm.html
For information on National CLAS Standards visit:
https://www.thinkculturalhealth.hhs.gov/pdfs/NationalCLASStandardsFactSheet
http://www.hdassoc.org/wp-content/uploads/2013/03/CLAS_handout-pdf_april-24.pdf
https://www.thinkculturalhealth.hhs.gov/Content/clas.asp
For information on Connecticut’s health law regarding cultural competencies:
http://www.healthlaw.org/images/stories/issues/Connecticut.pdf
 
Photo: Americanprogress.org
 
 
 

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