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Does Your Practice Provide Culturally Competent Care?


If like many communities, yours has significant numbers of non-English speaking people with whom neither you nor your staff are able to converse, your practice is at a serious disadvantage.

"Culturally competent care requires a commitment from doctors and other caregivers to understand and be responsive to the different attitudes, values, verbal cues, and body language that people look for in a doctor's office by virtue of their heritage," says Oliver Goldsmith, MD, who championed this issue throughout his career at Kaiser Permanente before he retired as the medical director of the Southern California Permanente Medical Group.

If like many communities in North America, yours has significant numbers of non-English or limited English-speaking people with whom neither you nor your staff are able to converse, your practice is at a serious disadvantage - especially if other practices have multi-lingual personnel.

Here are some of the ways to address this communication gap:

• Hire associates and/or staff members fluent in the language of the target populations you would like to attract to your office. The staff of Dr. Neil J. Gajjar's office in Mississauga, Ontario, Canada, speak five different languages. "Speaking the same language as patients," he says, "automatically makes them feel more at home."

• If you are near a college or university, hire an exchange student for part-time work in your office as an interpreter.

• Offer to pay the tuition for a staff member willing to take an adult education course in the language needed for your practice - offer 125 percent of the cost for an "A" in the course - and upon completion of it, give the person a raise.

• Contact the language or other appropriate department of a local community college or university to find someone who is familiar with the culture, behavior, and beliefs of the ethnic groups for whom you provide care. Invite this person to present an educational seminar for everyone in your practice.

• Try learning a little of the language(s) spoken by the target populations you'd like to see as patients. "Ten years ago, I began practicing in Newport News, Va.," says internist Brooks A. Mick, "amid the largest concentration of military posts in the world. Because of service personnel who married overseas and former military people who've tended to settle in this area, there are many folks here whose primary language is Korean, Vietnamese, Japanese, Spanish, or Tagalog (Filipino). I try to greet each patient in his or her own language and it has become something of a ritual to ask every patient who speaks a new language to teach me a few words. It's remarkable how much goodwill a single phrase can promote."

• The federal government’s Office of Minority Health offers a CME program:"A Physician’s Practical Guide to Culturally Competent Care." According to the website, "this free, accredited online cultural competency curriculum offers CME/CE credit and equips physicians with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve."

• Reach out to newly settled ethnic groups, especially through health fairs, screenings, and sports connections. It can pay huge dividends but only if your office and staff are prepared to meet the often differing needs of new patients when they first visit your office.

Reality check: A recent U.S. Census Bureau report indicates that America's population is becoming increasingly diverse. Get ahead of the curve by making your practice culturally competent.

Bob Levoy is the author of seven books and hundreds of articles on human resource and practice management topics. His newest book is "222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices" published by Jones & Bartlett. He can be reached at blevoy@verizon.net.

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