The vital signs of culture

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As our nation continues to debate how the healthcare system should be fixed, little attention has been paid to the need to better incorporate multiculturalism in the provision of medical care. The US is undergoing one of the most profound shifts in national demographics in decades, and the 2010 census will prove that America is becoming more diverse. But the medical community, and the brands that market to them, have not kept apace.  
While language obstacles can lead to faulty diagnoses, medical providers who service minority and immigrant communities often lack a fundamental cultural understanding that can impede proper communication overall. Patients need to trust their doctors to share personal stories or circumstances without fear of judgment. This trust is imperative if care is to be administered properly.
 The best way to address this in healthcare is by embracing multiculturalism as an evolutionary mindset and asset instead of a politically correct requirement. When done correctly, it represents a transition from what until now has been termed “cultural competence”—simple translating and interpreting services—to what I call “cultural fluency,” whereby culture is at the core of creating a better healthcare experience.
 This approach is a positive shift because it acknowledges the inherent power of culture in human behavior and puts the multicultural consumer at the heart of healthcare planning, not just an afterthought that requires translation. Cultural fluency improves the system by presenting doctors with new perspectives on identity; culturally relevant forms of treatment and healing; storytelling; and extended support systems.
 Cultural fluency is closely related to a greater trend among patients and doctors toward more inclusive wellness practices such as yoga, acupuncture and meditation, among others. These and other culturally progressive techniques are already being explored by leading healthcare providers such as Kaiser Permanente, which has gone beyond basic translation services to design treatment and patient experience modules that are multiculturally friendly.
 While becoming culturally fluent might seem daunting at first, its premise is relatively simple. Like a good doctor, the process begins by observing and listening to the varying cultural needs of the communities being served. Look at qualitative factors to understand variances from mainstream needs. Visit the places where these communities come to life, like shopping centers, community centers and places of worship. Also, make sure to spend some time with community leaders.
 But most importantly, don't lose sight of the transformative power of different cultures overall. Thinking about multiculturalism should not be a silo. Ask how different cultures can inform key questions, such as what role do cultural networks play in healing? Are there any steeped traditions that can generate the next treatment breakthrough? You'll be surprised how the creativity unleashed can give rise to innovation and new ideas.
 Cultural fluency is an innovative business and patient-centric mindset to inform the evolution of healthcare. As the US passes the symbolic threshold where multicultural groups will soon represent more than half of the population, it should be the new benchmark for healthcare service providers: mere “competence” will no longer cut it.
Roberto Ramos is president & CEO of the Vox Collective
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