Patient Care

Cultural Sensitivity Is a Required Ingredient for Health Care Providers

There are approximately 320 million U.S. citizens; of these, 62 percent are non-Hispanic Caucasians, and the remaining 38 percent are racial minorities. Adding to this melting pot, a recent Gallup poll revealed that 3.4 percent of U.S. adults identify as LGBT.

Individual minority groups are collectively on track to become the majority, further beautifying the American landscape. Yet racism is still evident, whether in the streets, workplaces, or popular culture. And with regard to health care, the perception of sexual and cultural sensitivity among care providers has been shown to influence -- and largely dictate -- health care satisfaction.

It's All About Perception

A landmark study published in the Journal of General Internal Medicine interviewed more than 6,000 individuals across the U.S. regarding cultural competency in health care. Their findings demonstrate how perceptions of doctor bias and cultural competency are largely explained by demographics, sources of care, and doctor-patient communication. Moreover, African-Americans, Hispanics, and Asians have been found more likely to perceive that they would get better care if they belonged to different racial or ethnic groups, relative to non-Hispanic Caucasians. They also perceive that medical staffs treat them disrespectfully because of their race and/or level of English fluency.

A related study published in Ethnicity & Disease expounded upon these findings, reporting that African-Americans, Hispanics, and Asians were significantly more likely to perceive provider discrimination and poorer health, again relative to non-Hispanic Caucasians. Even more alarming, poor health was found to be mediated by perception of provider discrimination, while perceiving discrimination and having an unsatisfying experience with a doctor were shown to result in unmet needs for health care utilization. Effectively, the more a patient perceives discrimination and/or is unsatisfied with their doctor, the less likely they are to use health services -- even when they need to.

Focusing on the LGBT Community

Making matters worse, this evident bias doesn't simply follow the shades of our skin color, but rather extends outside those boundaries into the LGBT community. In fact, according to a study published in Psychiatric Services, even doctors recognize an anti-LGBT bias in health care. Per the study, "Providers commonly reported the presence of both individual and institutional forms of anti-LGBT bias in outpatient mental health clinics, residential treatment centers, and inpatient hospitals serving rural LGBT people." So for the skeptics who question patients' perception of bias, how can it be denied if the doctors themselves agree to its presence?

In recognition of that bias, researchers conducted a qualitative assessment of the perception of LGBT health care. In response to their findings, they put forth eight recommendations in order to level the playing field. These include educating doctors on cultural-competency issues, facilitating discussions with health care professionals regarding LGBT needs, and developing educational materials for patients who need to come out to their doctors.

It's clearer than crystal that there is insufficient sexual and cultural sensitivity in health care. Further research needs to be conducted in order to determine the specific causes of bias and -- to be fair to many well-meaning doctors -- whether this is but perception and not a reality.

Perception or not, a soon-to-be majority of U.S. citizens feel that they are being discriminated against, and many would rather suffer in sickness than expose themselves to such biases and disrespect. Thus, as U.S. citizens -- regardless of whether or not we are in the medical field -- we must first open our eyes to the problem and then open our hearts to a solution. That's the only way we can build a better community and serve our loved ones with the passion, respect, and care they so rightfully deserve.

Posted in Patient Care

Dr. Rami Hashish achieved his doctorate of physical therapy from the University of Washington School of Medicine and holds a doctorate in biokinesiology from the University of Southern California. Following his Ph.D. work, Dr. Hashish cofounded a footwear technology startup, JavanScience, which develops customizable footwear to help relieve and prevent foot and leg problems. Dr. Hashish is also active in the clinic, serving as the director of physical therapy for Regenerative Medicine - Pacific Pain & Wellness Group, at Urban Med in downtown Los Angeles.

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*This information is for educational purposes only and does not constitute health care advice. You should always seek the advice of your doctor or physician before making health care decisions.