Friday, April 29, 2011

Cultural Competency

What is cultural competency? Well I could google it or look it up in wikipedia but its too early in the morning (and I am slightly distracted because I really want to see Kate's wedding dress). Therefore I will define it as I understand it.

In my opinion, cultural competency is being informed on other the socio-economic and culture issues of cultures other than the one in which you grew up. For example, is a big city person familiar with life on a farm? Or someone from suburban American familiar with life in a third world country? And its not just being comfortable with the other lives but aware of the differences in life style, social constraints, religious pressures, economic quality of life, etc. And to understand that these differences are theirs and you cannot force them on you.

There are thousands of examples of this but a few are - here in the US almost everyone has access to clean water and we dont necessarily understand that others do not and its implications.

Being culturally competent is also important to doctors and US medical schools are finally becoming aware of this and will begin requiring it of medical students. They want fewer science nerds and more of the fluffy stuff.

I think this is a wonderful idea. I don't want a geek to take care of me, I want someone who has a clue of how life really is. They can be a geek too if they want. Just because you went to medical school, doesn't mean you are any better than me, or your way of life is the same as mine.

I mean how often have you run into an older doctor who is 'old school' in their practice and thinks that they are a god and you are supposed to kiss their feet and do what they want. Or a doctor who doesn't understand that your lifestyle is not the same as theirs and you can't quit your job and stay home simply because you are sick or had surgery. Or a doctor who is dictatorial and tells you its 'their way or the highway' essentially. Or a doctor who doesn't understand a welfare mother can't afford fresh fruit and vegetables all the time.

I know there are different personalities and cultures out there and the differences between all of us are what makes the world interesting instead of boring. However a doctor who makes lifestyle suggestions and doesn't understand when a patient cannot comply, not that they don't want to comply but that they are not able.

I have one doctor who is from a different culture where I think opinions are not suggested but are demanded from elders or superiors. I feel she makes demands of me and not suggestions. I don't think she understands how she comes across to her patients. I also don't think she understands that here patients have brains and occasionally use them.

I think if she took a few lessons in cultural competency to realize that I will question her decisions because I do research and think for myself she might be better off. I am ready to vote with my feet and find a different doctor. I want a doctor to accept me for who I am and let me think and question. Maybe she grew up where doctors were gods and now she subconsciously thinks she should be thought of as one?

Cultural competency should be a required accomplishment in medical school (and probably in other areas as well but that's another story). Maybe we would all be a little bit more accepting of each other with more cultural competency.

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