Avoiding a Suit – The Cultural Communication Challenges

By Matt Gracey
July 2009

Much has been written on communication issues leading to malpractice lawsuits in health care because communication is the vital link not only between the patient and the doctors, but at every step of care, among each and every cast member involved in the patient’s care.

Studies have been done on many of these miscommunications issues, including about just how little a patient understands and retains from even a simple office visit, and how much worse it gets when any bad news is delivered. Multiply these potential communication issues in a primary care visit by the possible miscommunications between each and every person involved in compounded care, and it becomes a bit staggering. Should we be surprised that nearly 75% of malpractice cases originate from some sort of miscommunication?

Add a Dose of Laguage Problems

So let’s take this even further and add a thick overlay of cultural miscommunications, starting with the basic cultural differences of language. Given that miscommunication is a huge issue for patients who speak fluently in the same language as their doctor, how can we even begin to expect anything other than near chaos in states like Florida, New York, Texas and California where there are large percentages of immigrants who speak English as a second or third language?

Let’s assume we get over the language differences by having interpreters at every health-care encounter of every non-English speaking patient, what are we to do about all of those other possible language issues with the multiple layers of other people involved in a patient’s care? Should we expect or require them to all use interpreters, too, if their English skills are not proficient?

Add More Doses of Cultural Missteps

So now to all of these possible miscommunication links, let’s add another heavy overlay of cultural barriers going way beyond language problems. Issues involving very serious religious, cultural and gender taboos or customs are ones that health-care providers are facing everyday, or will soon as our country’s diversity deepens. Maybe we need to consider cultural diversity summer camp programs for healthcare providers?

Only in America

What I know about America, though, is that we have been a melting pot from the Indians’ first encounter with the pilgrims, and somehow with all of the challenges that have been continually created by our diversity we have created the best health-care system in the world.

What we probably need to worry as much about is what we are going to do when all of the different, non-standardized EMR systems miscommunicate with each other! I hope the computer folks are writing good cultural competency programs so we can keep down the medical computer malpractice lawsuits.