Physicians' Cultural Competency as Perceived by African American Patients by ProQuest


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Physicians’ Cultural Competency as Perceived
by African American Patients
Georgia Michalopoulou, PhD; Pamela Falzarano, MA; Cynthia Arfken, PhD; David Rosenberg, MD

  Funding/Support: This project was conducted with the sup-                  lower quality of health care than Caucasians even when
  port of the Michigan Department of Community Health and                    access-related factors, such as patients’ insurance status
  the State of Michigan Joe F. Young Sr Psychiatric Research                 and income, are controlled.1,6,12-14
  and Training Program.                                                          Cultural barriers and biases on the part of health
                                                                             care professionals may contribute to lower quality of
  The purpose of the study was to determine the association                  services.6 Specifically, studies have found that when
  between African American patients’ perceptions of physi-                   compared with Caucasian patients, African American
  cian cultural competency and patient satisfaction with                     patients report lower quality interaction with their physi-
  the visit, independent of other factors, including physician               cian.11,15 This lower-quality interaction may be due to
  and patient race concordance. African American partici-                    lack of cultural competency by the physicians.
  pants were surveyed at urban clinics. Cultural competency                      One approach to enhance cultural competency of
  (Perceived Cultural Competency scale) was based on the                     physicians is to have concordance between patients and
  3-factor model that includes patients’ perception of (1) phy-              physicians on race. The literature has shown African
  sicians’ cultural knowledge, (2) physicians’ cultural aware-               Americans tend to prefer African American physicians
  ness, and (3) physicians’ cultural skill. The results confirmed            and to rate those physicians as providing better inter-
  that patients’ perceptions of physician cultural competency                personal care than other physicians.11,16,17 However,
  are independently associated with satisfaction with the visit.             assuring African American physicians for African Amer-
  These results further validate use of the Perceived Cultural               ican patients is not always an option nor does it neces-
  Competency scale as a tool to measure patients’ percep-                    sarily guarantee quality care.
  tions of physicians’ cultural competency.                                      To improve the quality of care provided by all physi-
                                                                             cians, cultural competency curricula have been devel-
  Keywords: cultural competency n race/ethnicity n health
                                                                             oped. Medical educators across the United States are
  disparities n patient-physician relationship
                                                                             addressing the topics of culture, race, language, behav-
  J Natl Med Assoc. 2009;101:893-899                                         ior, and social status through the development of cross-
                                                                             cultural coursework.18 These include teaching the ratio-
Author Affiliations: Department of Psychiatry and Behavioral Neuroscienc-    nale for learning about culture in health care—“culture
es (Drs Michalopoulou, Arfken, and Rosenberg; Ms Falzarano), Division of     basics”—such as definitions, concepts, the basis of cul-
Child Psychiatry and Psychology (Drs Michalopoulou and Rosenberg; Ms
                                                                             ture in the social sciences, relationship of culture to
Falzarano), Wayne State University School of Medicine, Children’s Hospital
of Michigan, Detroit, Michigan.                                              health and health care, and health systems as cultural
corresponding Author: Georgia Michalopoulou, PhD, Wayne State Univer-        systems; data on and concepts of health status, including
sity School of Medicine, Children’s Hospital of Michigan, 3901 Beaubien,     demographics, epidemiology, health disparities, and the
4th Floor, Detroit, MI 48201 (                       historical context; tools and skills for productive cross-
                                                                             cultural clinical encounters, such as interviewing skills
IntroductIon                                                                 and the use of interpreters; characteristics and origins of

    t is well established that African Americans have                        attitudes and behaviors of providers; community partici-
    higher rates of death, disease, disability, psychologi-                  pation, including the use of expert teachers, community-
    cal distress, and lower levels of subjective well-being                  school partnerships, and the community as a learning
than Caucasians.1-8 These disparities are often ascribed                     enviro
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