Knowing how to properly treat patients from various cultures, religions, and ethnicities can mean the difference between life and death. Misdiagnoses and other medical errors make up between $17 billion to $29 billion of healthcare costs annually, according to the Office of Management and Budget. The OMB is the White House office responsible for devising and submitting the president’s annual budget proposal to Congress.

According to the OMB, providing cultural competency training to physicians would decrease medical costs, increase patient satisfaction, and create a true “informed consent” and understanding of other legal issues. Language barriers, coupled with not fully understanding a patient’s ethnic background, religion, and mores, appear to be the main cause of medical errors in this group.

Cultural competency
Cultural competency refers to the level of knowledge-based skills required to provide effective clinical care to patients from a particular ethnic or racial group.

This case may be a familiar one for your practice:
Mr Lopez has diabetes and has been unable to keep his blood sugar under control. When his insurance changed, his daughter was pessimistic that the next physician she took him to could help, but she knew he needed to see a physician to get better. Mr Lopez speaks only Spanish and his daughter serves as his interpreter. He has difficulty reading patient education materials because of his poor vision. He has seen a Spanish-speaking dietitian, but went to the appointments by himself because he did not need his daughter to translate.

How can the new physician prepare for a situation like this one to ensure that Mr Lopez gets optimal care based on his culture and environment? How can the physician show Mr Lopez that he is both sensitive to and respectful of his needs?

Many physicians lack the skills to communicate effectively with their patients because English often is their patients’ second language. This is where linguistic competence comes into play.

Linguistic competence is the capacity of an organization and its personnel to communicate effectively and convey information in a manner that is easily understood by diverse audiences, including people with limited English proficiency, low literacy skills, and disabilities.

But it takes more than learning a second or third language or hiring an interpreter for your practice to be culturally competent. Both the American Medical Association and Institute of Medicine have encouraged physicians to build their cultural proficiency. This involves training in applying effective communication techniques and gaining knowledge about their patient’s background.

Cultural competency training
During the last three years, the US Department of Health and Human Services’ Office of Minority Health developed a nine-module physician educational training course on cultural competency. The Cultural Competency Curriculum Modules were developed to equip primary care physicians and their staffs with awareness, knowledge, and skills in cultural competency to better treat the increasingly diverse US population. The modules can be taken online or by obtaining a DVD. Physicians who complete the course can receive up to 9 Category 1 Continuing Medical Education credits.

The Cultural Competency Curriculum Modules address the following themes:

• Patient-centered care
• Effective physician-patient communication
• Legal requirements and obligations for healthcare providers in ensuring Language Access Services
• Business and practice issues in providing LAS
• Working effectively with an interpreter
• The importance of environment/climate
• The importance of data collection and analysis, data collection resources, and using and managing data
• Forming partnerships in the community to assist in developing cultural competency

TMF Health Quality Institute offers cultural diversity training
TMF (Texas Medical Foundation) Health Quality Institute, a nonprofit healthcare consulting company that serves as the Medicare quality improvement organization for Texas, has launched an intensive training initiative to increase physicians’ understanding of how ethnic background affects healthcare quality. The free course is offered to physicians, nurse practitioners, and other healthcare officials who provide care to diverse patient populations.

For more information about the course, go to www.tmf.org/9CME or call Madeline Gill or Brenda Ortiz, beneficiary relations consultants, at 1-800-725-9216.