Cultural Issues in Clinical Care Culture, Integrative Medicine, and Holism “If a man be gracious to strangers, it shows that he is a citizen of the world, and his heart is no island, cut off from other islands, but a continent that joins them.” --Sir Francis Bacon "What lies behind us and what lies before us are tiny matters, compared to what lies within us." --Ralph Waldo Emerson

Faculty Contributors Susie Gerik, MD—Associate Professor of Pediatrics Kay Sandor, PhD RN, LPC, AHN-BC — Associate Professor, School of Nursing Victor Sierpina, MD—W.D. and Laura Nell Nicholson Professor of Integrative Medicine, Associate Professor of Family Medicine Harold Vanderpool, PhD—Professor, Institute of Medical Humanities.

What is Cultural Competency? Cultural Competency refers to the ability of people, organizations, and systems to function and perform effectively in cross-cultural situations.

Key Points Integrative medicine Holism Medical pluralism Cultural constructs about illness

Readings Kligler B, Maizes V, Schachter S, et al. Core competencies in integrative medicine for medical school curricula: a proposal. Academic Medicine. 2004;79(6): Engebretson J. Cultural contructions of health and illness. Journal of Holistic Nursing. 2003;21(3): Ernst E. Disentangling integrative medicine. Mayo Clinic Proceedings. 2004;79:

Definition of Integrative Medicine “Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches to achieve optimal health and healing.” ….. Consortium of Academic Health Centers for Integrative Medicine

INSTINCTUAL EGOCENTRIC CONFORMIST RATIONAL PLURALISTIC INTEGRAL TRANSPERSONAL

Some of the patient population groups that benefit from a culturally competent healthcare system include:  American Indian/Alaskan Native  Asian  African American  Hispanic/Latino  Native Hawaiian/Pacific Islander  Gay, Lesbian, Bisexual, Transgendered  Economically Disadvantaged  Illiterate/low literate  Religious diversities  Recent immigrants

Cultural Competency in health care consists of:  Awareness & acceptance of cultural differences  Awareness of one’s own cultural values  Recognition that cultural beliefs impact patients’ health beliefs, help- seeking activities & interactions with health-care outcomes, including adherence to prescribed regimens  Ability & willingness to adapt the way one works to fit the patient’s cultural or ethnic background in order to provide optimal care for the patient

Bridging the Gap  Learn about your patients’ cultures  Be NON-JUDGEMENTAL!  Use appropriate interpreter services  Practice culturally sensitive interpersonal dynamics  Accommodate your patients’ health beliefs  Practice the Platinum Rule: “Treat others the way they want to be treated.”