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New JAMA Study on Cultural Competency

Sept. 6, 2005

Many U.S. physicians are not being trained adequately about how to deal with cultural differences among immigrants and others that may affect the way medicine is practiced, a study said on Tuesday.

"These findings have implications for how residency training programs prepare physicians to provide high-quality care to an increasingly diverse nation," said the report from Massachusetts General Hospital published in this week's Journal of the American Medical Association.

"While attitudes regarding the importance of cross-cultural care seem to be positive, there appear to be relatively few opportunities for meaningful education and mentoring, and little evaluation," the report said.

The findings were based on a survey of 2,047 resident physicians undergoing their final year of training at major U.S. hospitals.

While 96 percent of those questioned said they knew it was important to address cross-cultural issues in providing care, many thought they were not prepared to do so in certain areas.

One in four said they were not prepared to deal with patients who had health beliefs at odds with Western medicine or those who were newly arrived immigrants. Twenty percent said they were ill-equipped to address cases where religious beliefs affected care.

In addition, 24 percent cited a lack of skills to identify relevant cultural customs impacting care, the report said.

"These findings highlight a need for significant improvement in cross-cultural education to help eliminate racial and ethnic disparities in health care," said the report.

The study was paid for by grants from The California Endowment and The Commonwealth Fund.

"Although physicians recognize that cultural competency is a necessary component of high-quality health care, they are not being given the tools they need to provide this care," said Stephen Schoenbaum, a physician who is executive vice president of the latter group.

"We are shortchanging physicians and patients by not preparing doctors with the interpersonal and communication skills they will need to provide the best care to all their patients," he added.


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