Despite guidelines and training for doctors regarding patients who come from cultures and ethnic backgrounds different to their own many health professionals still have profound difficulties when caring for such groups.
That is the verdict of research published in PLoS Medicine which also suggests more still needs to be done to improve the confidence of clinicians in this area.
Professor Joe Kai from the University of Nottingham interviewed more than 100 doctors, nurses and other health professionals in focus groups across the Midlands.
The professor and his team asked them to describe their experiences of caring for people from ethnic minority backgrounds. They were encouraged to recall actual cases and to identify what they saw as problems and strengths in their interaction with these patients.
The researchers found that health professionals wrestled with many challenges such as problems with language and communication. But an equally powerful challenge was health professionals feeling uncertain about what to do (for example, deciding when it was acceptable to touch a patient to show empathy).
This was because they felt they did not know enough about different cultures and wanted to avoid causing affront or appearing racist. This uncertainty, the researchers report, disempowered health professionals, sometimes making them hesitate or fail to do what may be best for their patient.
The researchers suggested several things that might be done to help. For example, health professionals should be encouraged to recognise their uncertainty and the inertia it may cause in them when dealing with patients from ethnic minorities.
In addition, there should be a shift in emphasis away from health professionals relying solely on knowledge-based cultural information towards taking an “ethnographic” approach.
In other words, health professionals should be helped to respond to patients as individuals. Rather than make assumptions, this may help them feel able to ask each patient about what matters most to them about their illness and treatment.
