The following readers have added their perspectives on cultural competence
Dr. James Wolff, M.D., M.P.H. (1)
Dr. James Wolff, M.D., M.P.H. (2)
Dr. James Wolff, M.D., M.P.H. (1)
There are so many ways for patients to misunderstand how to take or administer medications. In my practice situation, the emergency department, we seldom get follow-up information about our patients compliance for medications prescribed in the ED. However, we can extrapolate from many studies that show that patient compliance is often sub-optimal and can be greatly improved by strategies that improve communication between providers and patients. Our department has instituted several interventions to address this issue. For instance, we use an ATT interpreter to explain discharge and medication instructions to patients. Second, we have developed simple written instructions written at a 6th grade level that we provide to patients. In addition, we have discharge instructions in several of the most common languages of our ED patients.
Back to the top
Dr. James Wolff, M.D., M.P.H. (2)
We all have experiences where cultural differences or language and communication difficulties have caused problems. I can think of several recent incidents where my inability to communicate effectively with my patient has led to misunderstanding. In one incident I missed the important clinical history of bloody diarrhea because my Spanish was inadequate to elicit a complete history. Using an interpreter would have been extremely useful. As it turned out, the mother of the patient brought her son to another ED where a diagnosis of salmonella was made. She called to "inform me" of her subsequent visit and diagnosis. I think she felt that I had not taken adequate measures to communicate correctly with her.
Back to the top