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An essay on doctor patient relationship
Importance of understanding culture
Importance of understanding culture
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“Confronting ‘culture’ in in medicine’s culture of no culture”, by Taylor, J, 2003
Theme:
Medicine as discipline is assumed to have a culture of ‘no culture,’ why is this? This is because right from training, through residency and even when one becomes a doctor, physicians are trained to think of themselves, their practices and ideas as being completely devoid of culture, but rather, as timeless truths that need not be questioned. This is why medicine is assumed to have a culture of no culture; but is this entirely true?
As articulated in the article, physicians endure medical school as well as their residency for one sole purpose, that is, to acquire medical knowledge that their patients do not have, so that they may be able to assist them when need arises, now, after spending all this time trying to achieve this one goal, would it then be fair of us to require of them to accept the conception that, their view of reality is simply just a view,-among the many other views-, and not reality itself?
Over the years, the need for cultural competence has grown in the field of medicine, with the increase of different types and races of people in the U.S. As a result of this, courses and practices meant to create and nurture cultural competence among medical students have been introduced in their school curricula, but as stated in the above article, medicine students seldom take them as seriously as they do those other courses, that are supposed to give them “real” knowledge. Why is this? Well, according to the article, this is because “cultural” knowledge and “real” knowledge are two very different things, which obviously begs the question, is one more important than the other?
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...sicians as well.
However, these meanings, of what it once meant to be a physician as was established by the white coat, are currently being eroded by the recent changes in the way scientific medicine is now being seen. This may be as a result of the emergence of a capitalistic or rather profit driven medical system, or due to a number of many other factors. Whatever the case, one thing remains for sure, the subsequent tension between the profession and the society is affecting the interaction between the individual patients –and the physicians, gradually creating irreparable rift of distrust, and rendering null and void what the ‘white coats’ were created to stand for.
Reference
“The doctor’s white coat. The image of the physician in modern America..”NCBI.U.S. National Library of Medicine, n.d. Web. 8 Apr. 2014. http://www.ncbi.nml.nih.gov/m/pubmed/8897//
pp. 41-84. Pine Forge Press, Thousand Oaks, Calif. Pigg, Stacy Leigh. (1997) "Found in Most Traditional Societies: Traditional Medical Practitioners between Culture and Development.”
So, how do we who are aspire to be Hippocratic physicians achieve this goal? First we must look at the foundations for our personal ethical frameworks through meta-ethics. Meta-ethics refers to the systems by which we establish morals and ethical principles. Today there are many philosophies of meta-ethics, divided into two basic categories, moral absolutivism and moral relativism (Lawhead, 2000). The difference between these is in the nature of ethical principles, whether subjective or objective. Say something exists objectively, like a vase on a table. The subject’s perception of the vase must conform to the true vase. If, however, the subject is simply thinking about a vase, that vase exists subjectively, and its properties are contingent to the subject’s contemplations. So, how do these differing systems affect the physician in attaining the Hippocratic ideal? Let us first consider relativism.
This internal conflict is a result of the mistakes a physician makes, and the ability to move on from it is regarded as almost unreachable. For example, in the essay, “When Doctors Make Mistakes”, Gawande is standing over his patient Louise Williams, viewing her “lips blue, her throat swollen, bloody, and suddenly closed passage” (73). The imagery of the patient’s lifeless body gives a larger meaning to the doctor’s daily preoccupations. Gawande’s use of morbid language helps the reader identify that death is, unfortunately, a facet of a physician’s career. However, Gawande does not leave the reader to ponder of what emotions went through him after witnessing the loss of his patient. He writes, “Perhaps a backup suction device should always be at hand, and better light more easily available. Perhaps the institutions could have trained me better for such crises” (“When Doctors Make Mistakes” 73). The repetition of “perhaps” only epitomizes the inability to move on from making a mistake. However, this repetitive language also demonstrates the ends a doctor will meet to save a patient’s life (73). Therefore, it is not the doctor, but medicine itself that can be seen as the gateway from life to death or vice versa. Although the limitations of medicine can allow for the death of a patient to occur, a doctor will still experience emotional turmoil after losing someone he was trying to
For countless years there has always been an urgent need for doctors. Different methods would be used to cure people from their sicknesses. However, life is given by God and it is he who can take it away. Doctors play the role of saving lives, but in the end, they are powerless because nature has to take its course leaving humanity at its limits. In Vincent Lams novel “Bloodletting and Miraculous Cures”, Lam challenges the myth that doctors are omnipotent by contending that “medicine is a science of uncertainty and an art of probability”. Using Fitzgerald as a focal point, Lam debunks the myth that doctors are omnipotent through situations of medical failure, having a loss of power and control and by inhabiting deadly diseases. By showings his mistakes, Lam proves that Fitz is not perfect and God like.
Cultural competency is a very significant necessity in health care today and the lack of it in leadership and in the health workforce, is quite pressing. The lack of cultural competency can bring about dire consequences such as racial and ethnic disparities in health care. It may not be the sole reason for these disparities, but it certainly places a significant role. A patient and health care provider relationship is very significant and can make or break the quality of care that is given. The lack of cultural competency leads to poor communication which then leads to those of diverse backgrounds to feel either unheard or just plain misunderstood. As an East African
When working in a medical/health related field one would be able to see countless people and odd things. Some medical procedures that might seem small to one person may be complicated or even taboo to another person’s beliefs. That is why as nurses, one should be culturally competent. (Newman Giger & Davidhizar, 2008) says, “to be culturally competent one must be able to deliver meaningful care to a patient
Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved , 117-123.
In all professions there are timeless issues. In the field of medical field one such issue about the symbol of the doctors white coats. But Throughout this article title “The Doctor's White Coat. The image of the physician in modern America.” Give a sense of humors about physicians toward their white coats which represent a symbol for what it means to be a healer. It is very clear that the most well recognized of these symbols is the doctor`s white coat. In the article, Blumhagen mentions that “The purpose of the coats in this setting appears to be twofold: to protect the patient from being contaminated by the physician, and to protect the physician from contamination by the patient during the procedure being performed.” I totally, agree with this because
The number of doctors that present in the United States of America directly affects the communities that these doctors serve and plays a large role in how the country and its citizens approach health care. The United States experienced a physician surplus in the 1980s, and was affected in several ways after this. However, many experts today have said that there is currently a shortage of physicians in the United States, or, at the very least, that there will be a shortage in the near future. The nation-wide statuses of a physician surplus or shortage have many implications, some of which are quite detrimental to society. However, there are certain remedies that can be implemented in order to attempt to rectify the problems, or alleviate some of their symptoms.
Cultural competence has to do with one’s culture. Culture affects among other factors, how children are raised, how families communicate, what is considered normal or abnormal, ways of coping with issues, the way we dress, when and where we seek medical treatment, and so forth. I should know because I come from a very cultural home where it is considered bad to talk to a male doctor about anything gynecological.
..., p.261) With this knowledge of the culture that one works in, the health care worker can better see the differences with the cultures of the patients that they are taking care of. Hopefully this understanding will lead to less conflict and better healing.
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures shares the journey of cultural illiteracy from the Hmong and American side. Fadiman states, “In 1995, for the first time, the national guidelines for training psychiatry residents stipulated that they learn to assess cultural influences on their patients’ problems,” (Fadiman 270). Though the unfortunate events that occurred were definitely able to avoid now, at the time, there was no standard set of actions and procedures to take in order to provide the best health care to different cultures. Fadiman truly succeeded in showing the reader that good intentions and compassion must be weighed more heavily when analyzing events and the consequences must be met with an objective eye.
Cultural competence like so many other social constructs has been defined in various ways. One particular definition as determined by the Office of Minority Health states cultural competence is a set of behaviors, attitudes, and policies that are systematically exercised by health care professionals which enables the ability to effectively work among and within cross-cultural situations (Harris, 2010). Betancourt (2005) implied cultural competence is starting to be seen as a real strategy to help with improving healthcare quality and eliminating the injustices pertaining to healthcare delivery and healthcare access. This appeal is gaining favor from healthcare policy makers, providers, insurers and
Kodjo, C. (2009, February,2009). Cultural competence in clinician communication [Pediatr Rev]. Pub Med Central, 30(2), 57-64. doi:10.1542/pir.30-2-57
Medicine as a Form of Social Control This critique will examine the view that medicine is a form of social control. There are many theorists that have different opinions on this view. This critique will discuss each one and their different views. We live in a society where there is a complex division of labour and where enormous varieties of specialist healing roles are recognised.