The rise of non-communicable disease. The opioid epidemic. Widening health disparities. These complex health issues are also complex communication issues. As physicians, providers, public health professionals, medical educators, and patient advocates, you are communicating with people every day about difficult, emotionally-charged, and ‘taboo’ topics.
And you are sometimes talking with people from different social and cultural backgrounds than yours.
It’s no wonder cross-cultural communication is such a vital concern.
In this episode, you’l learn about 6 mistakes it’s easy to make when you’re talking across social and cultural differences – and what you can do to avoid them.
Hi. This is Ten Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel.
Cross-cultural communication is one of the more critical communication issues in healthcare today. And for good reason. Cross-cultural communication training is helpful to numerous outcomes. And when it’s missing, outcomes suffer.
In this episode, I’ll talk about some common pitfalls when it comes to communicating across difference. We’ll look at how they show up, why they matter – and what you can do to avoid them.
Mistake #1: Forgetting yourself. Also known as forgetting that your own position is culturally mediated and created. We’re all reading situations from a certain perspective, but our perspectives can become invisible to us. This is an important starting point, and that’s why I’m sharing it with you first.
We all can fall into the trap of thinking that our ways of seeing things are normal, or natural, or common sense. It’s easy to forget they are culturally influenced and socially situated. For instance, your ideas about how the human body works are built on millennia of research, supported by your education, enriched by your years of experience, and reinforced by your social groups.
What you can do instead: Remember where you stand, how you’re seeing, and how you got there. Acknowledge your own position and what you take for granted. Then you can spend some energy on your patient’s position.
Mistake #2: Gazing at the gap. Otherwise known as emphasizing differences between your patients and you. Or focusing on disadvantages, and gaps. You’re in trouble if you assume your patients can meet you where you are, in your ‘culture.’ Or even in the middle. You will do more of building of the bridge and the crossing between cultures when it comes to cross cultural communication.
For example, I’ve written before about an OB-GYN who regularly encounters patients who believe they urinate and menstruate from the same place. Is this frustrating to her? Sure. But she doesn’t let that get in the way of her patient relationships.
What you can do instead: Don’t fall into the abyss. Yes, there are differences between you and your patients. And sometimes these differences can feel troublesome. Go ahead and be frustrated, or exasperated. Then get to work talking across difference. Remember, cross cultural communication is crossing work.
Mistake #3: Essentializing. Also known as generalizing, stereotyping, lumping folks together. You know in-group variation is a thing. Still, it might be easier to recognize essentializing when it happens to you. For instance, it’s been suggested that medicine is a kind of a “culture.” If it is, you know it’s not a monolithic culture. For example, use of the hashtag #whatadrlookslike could be seen as drawing awareness to assumptions of a universal norm of male whiteness in medicine.
It’s not always fun when someone makes assumptions about you or about the social or cultural groups you belong to. However well-intentioned they might be.
What you can do instead: One-size-fits-all solutions are seductive but misleading when it comes to human communication. Don’t put pressure on yourself to have it all figured out about a group. Ask some good questions. It’s a good idea not to assume that your guesses about the patient’s life and values are correct.
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Mistake #4: Feeling pressured to get it right. Otherwise known as: feeling you need to be extremely clever; ignoring your audience; designing at the white board. Don’t put pressure on yourself to hypothesize or guess about your patient’s viewpoint, priorities, and thoughts so you can ‘say it right.’
What you can do instead: Stay curious. When it comes to communicating across cultures, we don’t get it right, or arrive, or know it all. It’s a process. Involve patients and patient representatives in developing communication guidelines for you, your practice, your organization. I have links to an example in the show notes of one study team who did just that.
If you’re on a large scale project, reach out to your patient advisory board. In your own practice, ask patients about their viewpoint, their priorities, and even their language use. Don’t guess at patients’ viewpoint, priorities, and thoughts. Just involve them!
Mistake #5 Closing the door. Otherwise known as: leaving out your colleagues. Sure, your patient communication usually happens when you’re the only one in the room with the patient. So in a very real sense cross cultural communication is often hidden from view. One sure-fire way to lose your groove is to talk to exactly no one about how difficult this work can be.
What you can do instead: Reach out to some colleagues who are also interested in cross-cultural communication. Even just one. I have links to an example of a team who did this (the team in this “Ethics Rounds.”) Consider joining (or starting) a community of practice with some like-minded colleagues, maybe even some smart people across campus, or outside your institution.
Mistake #6: Being a lone ranger. Also known as doing this solo. Being the only group or department involved. Cross-cultural communication is no joke, and it merits support. If you’re an educator, you’re preparing and supporting others to do some delicate and difficult bridge-building. This means you have to do everything I’ve already been talking about…and then teach others to do it. Yikes!
What you can do instead: Get some institutional support. I have links to a study that does this, you could use to make an argument at your institution (this study here). Take advantage of the resources on this site. And contact me. I’d love to help.