ACP Recommends Changes to Accommodate Multicultural Patients

Janice Simmons, for HealthLeaders Media , July 28, 2010

As the nation's population continues to grow and diversify, the healthcare system still needs to change and adjust to meet the needs of an increasingly multicultural patient base, according to the American College of Physicians (ACP) in an updated paper released Monday.

Racial and Ethnic Disparities in Health Care, a revision to a policy paper that was originally released in 2003, looks at what further steps are needed to close the gap between racial and ethnic minority patients and their white counterparts.

"Closing the healthcare disparities gap will be a difficult, multifaceted, and important task," said J. Fred Ralston, Jr, MD, president of ACP, in a statement. "Overwhelming evidence shows that racial and ethnic minorities continue to be prone to poorer quality health care than white Americans, even when factors such as insurance status are controlled."

As the nation's population diversifies, one area of concern is cultural competency, which will become more important as clinicians are confronted with different belief systems that "influence their ability or patient receptivity to provider recommendations," the report states.

While only half of all patients generally adhere to medical or prescription instructions offered by clinicians, rates of adherence are significantly lower for racial and ethnic minorities, according to the report. Cultural competency is a key part of delivering patient-centered care that stresses "respect for the patient, clear communication, shared decision making, and building of the doctor-patient relationship."

Communication barriers—particularly language barriers—are a significant problem for many physicians, especially those who provide care frequently to Medicaid and other public insurance program beneficiaries. In one survey, 63% of hospitals and 54% of internal medicine physicians reported treating "limited English proficiency" patients at least weekly, and 84% of federally qualified health centers cared for these patients daily.

According to one ACP survey, internists reported seeing limited English proficiency patients speaking nearly 80 dialects and languages. Even after the influential 2002 IOM report "Unequal Treatment" highlighted the difficulties of communication between physicians and other health providers and patients with limited English proficiency, the problem has worsened among some groups.

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