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1. Try to Learn How Your Patients Want to be Treated!
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What is viewed as polite, caring, quality health care in one culture may not be considered the same in another culture.
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2. Address All Adult Patients By Their Surnames
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The Hispanic culture is more formal than the general U.S. culture. It is considered by many born out of the U.S. as a lack of respect to be addressed by their first names. This is especially true when there is a difference in age among caregiver, staff member, and patient.
HINT: Respect and use the two surnames used by Hispanics. The first is her father’s last name, the second her mother’s. If you need to call her, ask for Ms. and use first surname.
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3. Don’t Raise Your Voice
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When speaking to a patient who seems to have a limited knowledge of English, remember, the patient is hard of understanding, not hearing.
HINT: You can improve the patient’s understanding of what you are saying by repeating it several times in different ways, integrating Spanish phrases, using gestures, pictures, and other non-verbal forms of communication.
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4. Every Culture Has It’s Own Rules for Touch and Distance
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- Hispanic patients expect the physician to shake hands with them at the beginning of the interview.
- Respectfully, many Hispanics will not look you in the eyes.
- They value medical assistance, which includes physically checking an ailment (i.e. rashes, wounds, sore areas, painful area, etc.…)
HINT: Observe the patients closely and try to “negotiate” distance so that it is acceptable to both of you.
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5. Don’t Ask a Limited English Speaking Patient “Do You Understand?”
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Begin questions with “when,” “where,” “what,” “why,” and “how”. Courteously ask clients to repeat back to you the treatment steps that you have explained. Ask them, “How will this fit into your day?”
HINT: Encourage your clients to ask questions! You can say, “Please feel free to ask me anything you’d like. I am here to assist you.“
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6. Patient Compliance with Treatment is Dependent Upon the “FIT” of the Treatment Plan with the Patient’s Lifestyle and Eating Habits.
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Lifestyle and eating habits are heavily influenced by the patient’s degree of assimilation, the region of the country from which the patient is from, work schedule, and his/her social class, economic circumstances, and education.
HINT: Ask the patient questions to help you to know if your treatment plan is going to ?Fit? their reality. Don’t assume.
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7. When Possible, Use the Patient’s Preferred Form of Medication (pill, injection, tonic, etc.) when giving or prescribing drugs.
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Simply, ask your patient their preference. If you can’t provide their preferred form of medication, explain why you are not able to offer it to them and how the other option will serve them well.
HINT: Patients from some cultures may equate the quality of care with the giving of prescriptions. When medication is not required, a minor suggestion regarding change in diet or lifestyle may satisfy the patient’s desire because their complaint has been validated by some form of treatment.
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8. Always Offer an Explanation Before a Test or Procedure is Performed
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Most people are not familiar with medical protocols and that the nurses or others, rather than a doctor, may be responsible for doing the testing. Invasive testing by any staff member needs to be explained beforehand, especially if there is use of syringes or blood samples are taken.
HINT: A brief explanation of why a procedure is recommended and who will be doing the testing will reduce misunderstandings. A brief but detailed explanation about invasive testing is a must, along with assurances that blood taken will not cause weakness, anemia or other illnesses.
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9. Making a Telephone Call Maybe a Difficult Task for Limited English Speakers.
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When possible, don’t require that clients call in for appointments or test results. Ask the client for a good time to contact them and call them to give results or check in with them by phone. If this is not possible, set up appointments for clients prior to their departure. Many clients will prefer to miss follow up appointments if they need to call in, rather than deal with the intimidation of making a phone call in English.
HINT: When speaking to anyone over then phone who has limited English, speak simply, slowly and clearly. Don’t show impatience, and give that person all your attention. The person may not be able to explain what they mean, try to listen to what is said “between the lines” as well as what is said directly!
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10. Don’t Underestimate the Intelligence of Patients who are Unable to Describe or Trace the Course of a Complaint!
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English-speaking cultures, as reflected in our language, tend to be precise and ruled by dates and the clock. Many other cultures pay less attention to a particular hour or day, than to events or seasons.
HINT: If a patient seems to be having difficulty telling when, what day, or what hour a particular symptom appeared, help him/her to first connect this occurrence to another event (work, meal time, sunshine, moonlight, etc.) and then go on from there.
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11. Studies Have Shown That Patient Satisfaction with Treatment is Heavily Influenced by Their “Comfort Level” with the Physician, Office Staff and the Quality or Successful Outcome of Treatment.
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It is best to never assume that the patient wants what you want or expects the same type of care and service that you do.
HINT: Take time to learn about your patient’s culture, traditional health/illness beliefs and practices, and to demonstrate your knowledge and interest by customizing your rules of courtesy, your procedures, and your treatment plans to suit your patient’s needs and expectations.
Remember you can ask what are they expecting and what their concerns are. They may not be very good at speaking English, but they do know what they need. Just ask!
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Adapted in 2004 by the RWHP, with permission from the Suwannee River AHEC. Materials included with permission from Suzanne Salimbene, Ph.D.,
Inter-Face International, and Diversity Resources. Reference: http://www.diversityresources.com/health2k/ss-tips.html
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