Values and the patient-physician relationship

Abstract

on Latinos, soon to be the largest minority group in the United States, the concepts that emerge apply to any cultural group. The following components of culture's effect on clinical care are examined: (1) normative cultural values , (2) language, (3) folk illnesses, (4) parent/patient beliefs, and (5) provider practices. The specific clinical impact of each of these components is examined, together with practical solutions to ensure that culturally sensitive care is provided. Finally, a model for cultural competency in health care is proposed, which can be used to guide clinicians in interactions with any cultural group. DEFINITIONS Latinos The term Latino denotes all persons living in the United States whose origins can be traced to the Spanish-The world's current population of almost 6 billion people inhabits 191 countries and speaks more than 6000 languages, 1 but little is known about the importance of culture in health care. Anthropologi-cal and cross-cultural studies have yielded key contributions about clinical aspects of selected cultural differences, such as patient belief systems and eth-nomedical practices. 2-4 The actual clinical ramifications of culture, however, have rarely been examined. C Culture and the patient-physician relationship: Achieving cultural competency in health care The purpose of this article is to describe how culture affects clinical care. Studies are presented that detail the impact of culture on health care processes, outcomes, quality, and satisfaction in order to provide a general framework for understanding the clinical consequences of culture. This is achieved through an in-depth focus on the culture of a single group, rather than a cursory survey of the cultures of multiple groups. Although the focus is From the Division