How much have you explored your own cultural heritage and the potential effects your background may have on your patients? How culturally competent are you to be fully present with your patients and families?
As practitioners, increased self-awareness and openness yields better understanding and acceptance of your patient population. It also helps you become an effective, culturally competent practitioner. Physicians need to examine, on a deeper level, the process of how they care for their patients by being curious, present, accepting, reflective and empathetic. Being mindful of yourself is critical before you develop the ability to serve others.
With changing demographics in our population, we are becoming more culturally and ethnically diverse than ever. As health professionals, we have an ethical and professional obligation to maintain cultural competence and recognize and respect diversity. Developing multicultural competencies includes increased understanding, awareness, acceptance and knowledge of the skills of different cultural, racial and linguistic groups. This is required to care for others in a way that truly meets their needs and respects them as individuals.
Additionally, reaching the Delivery System Reform Incentive Payment (DSRIP) goal of reducing avoidable hospital use by 25 percent will be achieved by collective means. DSRIP programs are charged with demonstrating cultural competence and the engagement of Medicaid members in the development of programs to address healthcare disparities. The development of a culturally competent organization and programs will also address the health disparities within given communities
In our practice as health professionals, we have to attend to individual differences and cannot ignore the role of culture and ethnicity. Our patients bring with them unique histories and experiences that influence the way they think, view the world and care for themselves. We need to assume responsibility in maintaining competency in treatment and service, understanding cultural differences, environmental influences and norms. One’s ethnicity and culture impact one’s behavior and understanding of the world.
While this is a big task, it does require intentionality and commitment on your part. It is also our ethical obligation. Maintaining multicultural competency is ongoing and may be achieved in a host of collective ways by:
- Training and participating in conferences and professional development programs
- Keeping abreast of literature and publications about multiculturalism and diversity
- Being open to learning, which is a lifelong commitment
- Listening to your patients’ stories. They are the experts and the best teachers about their lives and the community in which they reside.
- Interacting with an ethnically diverse team of healthcare providers and sharing in intercultural dialogue
- Being attentive and developing empathic relationships
- Engaging in examination and critical reflection of yourself as a cultural being with feelings and biases
- Maintaining sensitivity and openness regarding other cultures, races, genders, religions, ages, disabilities, socioeconomic statuses and sexual orientations
- Looking at and leveling the power imbalances in the physician/patient relationship
- Developing partnership and a mutually agreed upon plan that is nonpaternalistic
- Being an advocate for those unable to speak for themselves
With the challenges we face discharging patients who require increasingly complex care, our obligation as health professionals is to provide the best possible care for all with sensitivity, compassion, understanding and acceptance. Increasing cultural competence and practicing cultural humility also contributes to a positive increase in patient satisfaction and adherence. This impacts and influences reductions in length of stay and readmissions, and it supports appropriate use of healthcare resources post-discharge.
Healthcare providers should model for their colleagues. This can result in positive organizational influence, as well as ensure that the understanding and acceptance of diversity and the development of a culturally competent organization is present. This will help you and your organization meet the requirements for DSRIP. Most importantly, the end result is the provision of high-quality patient care.
Paula A. Roberts, LCSW, works as a Health Care Consultant at Miller & Milone, PC, a law firm that focuses its practice on healthcare law, elder law and estate planning. Roberts is the former Director of Social Work and Case Management at NewYork-Presbyterian Hospital, Columbia. She received her master’s degree in social work from New York University. She is a member of the National Association of Social Workers and the American Case Management Association. She is also an adjunct professor at The City University of New York.