Communicating in the clinic, across cultures

Language and culture can come between patients and caregivers, sometimes with disastrous clinical consequences, said Glenn Flores, M.D., co-director of the Pediatric Latino Clinic at Boston Medical Center. “Culture affects clinical care,” Flores said during his talk in March, “Culture and Patient-Physician Relationships: Achieving Cultural Competency in Health Care,” sponsored by Y-NHH Ambulatory Services. “It affects outcomes and it affects quality of care.” He cited the example of a physician who failed to grasp the severity of a Mexican girl’s abdominal pain because her parents spoke no English. After two return visits to the emergency room she was diagnosed with peritonitis. In another case, a mistranslation led to suspicions of abuse and a mother’s uninformed consent to turn her daughter over to child welfare officials. Caregivers, he said, must be familiar with the language and culture of their patients. “What is not going to work,” he said, “is to say, ‘Let’s all be sincere, let’s hold hands and sing ‘We Are the World.’ We need to have a more diverse work force.”