The purpose of the study was to determine the association between African American patients' perceptions of physician cultural competency and patient satisfaction with the visit, independent of other factors, including physician and patient race concordance. African American participants were surveyed at urban clinics. Cultural competency (Perceived Cultural Competency scale) was based on the 3-factor model that includes patients' perception of (1) physicians' cultural knowledge, (2) physicians' cultural awareness, and (3) physicians' cultural skill. The results confirmed that patients' perceptions of physician cultural competency are independently associated with satisfaction with the visit. These results further validate use of the Perceived Cultural Competency scale as a tool to measure patients' perceptions of physicians' cultural competency.
o r i g i n a l c o m m u n i c a t i o n 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 (email@example.com). 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 I 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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