While the wide variety of cultures present in New Zealand makes us richer as a nation, some cultural beliefs and practices can present challenges to doctors.
The way you discuss health, or even who you talk to about health, can upset a patient, making it difficult to establish trust. People want to feel safe in your care, and it’s difficult to feel that if you are (even accidentally) breaching their cultural norms and expectations.
There are ways to work with them and come to a culturally-sensitive, mutual understanding. This quick guide will help you get started.
Working within cultural boundaries
As mentioned, there are an enormous number of different ethnicities, religions and other cultural groups present in New Zealand. Almost 40 per cent of Auckland’s population, for example, is made up of people born overseas. That makes it more diverse than Sydney, Los Angeles, and even New York, which is often heralded as the “melting pot” of the world.
With this in mind, the prospect of learning each and every single cultural norm of each and every ethnic group may seem like an impossible task. Are you expected to know all of them?
Thankfully, the answer is a resounding no—but doctors are expected to be aware of their own beliefs, cultures and ideas, and how that affects their work and how they interact with patients.
Doctors must be willing to be introspective, as well as learn how the patient views their illness and how to deal with it within culturally acceptable parameters. Asking questions like “What do you think is wrong?” and “How have you been treating this illness?” is an excellent start to a medical-cultural conversation that is respectful and productive.
Common cultural faux pas to avoid
While it would be difficult to learn every intricacy of every culture present in New Zealand, there are a few regularly-recurring challenges that doctors should be ready for.
Among traditional groups, particularly those of the Islamic faith, there can be strict rules around gender interaction. A woman, for example, is often not allowed to be touched for any reason by any man who isn’t a member of her family.
You may also notice that major decisions in some groups—including those around healthcare—are made not by the patient, but rather by the males of the family. While in New Zealand we aim for egalitarianism in these circumstances, not adhering to this decision (or trying to bypass it) can cause more consternation than good.
Modesty tends to be another recurring issue, for example, where traditional garb may be required for everyday dress and must not be removed. This can cause obvious issues during examinations. This is often a gender-related issue, so be ready with a nurse, doctor or other healthcare practitioner of the appropriate gender to assist in these cases.
While most issues can be dealt with by having a frank discussion with the patient, there is one arena that doctors must be proactive with information: diet.
Many medicines and/or treatments are made with animal products (including insulin) which are prohibited by various cultural groups. The easiest way to avoid issues caused by prescribing such medicines is to simply inform all of your patients if there are animal-based products in the treatment.
Even something small like maintaining or avoiding eye contact can mean different things in different cultural groups. In New Zealand, avoiding eye contact might seem like the person is being suspicious or dishonest. In other cultures, it can be a sign of respect.
If in doubt about cultural norms and expectations, there is no harm in simply asking your patient or their family about previous experiences, taboos and what they expect from you as a doctor.
While you may not agree with all cultural practices, it is integral to your responsibility of care that you ensure your patient feels comfortable in your practise—regardless of what cultural beliefs they may have, and how much they may differ from yours.
Over time, you’ll become more familiar with the variety of cultural behaviours and beliefs among your patients, and be better ready to work with them to ensure they have an excellent healthcare experience.
Remember, if in doubt, just ask.
For more tips and techniques for training doctors stepping onto the wards for the first time, download our free ebook below!