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JAAD article focuses on cultural competence in dermatology

Multiple studies have suggested that cultural competence of the health care provider and staff leads to improved patient adherence, satisfaction, and ultimately, health outcome. Cultural competence in the workplace also leads to efficient and cost-effective health care and better community integration into health care systems. Member to Member recently interviewed Amit G. Pandya, MD, lead author of “Cultural competence for the 21st century dermatologist practicing in the United States,” a JAAD article designed to help dermatologists understand the benefits of culturally competent care for their patients and themselves and identify methods and resources to achieve this goal.

Member to Member: Why did you and the other authors decide to focus on cultural competence in dermatology?

Amit-G.-Pandya.jpgDr. Pandya: As our society changes and becomes more diverse, we’re seeing more cross-cultural interactions between doctors and patients. This is the first report that I know of that focuses on the issues of cultural competence in dermatology. Cultural competence has been written about in the mainstream medical literature, but it has not been a focus in dermatology. The other authors and I felt it was important to educate about this topic in JAAD.

Dermatologists come face to face with patients of different race, ethnicity, sexual orientation, language, religion, etc., on a daily basis. And all those factors can impact the way a patient utilizes health care. As a result, understanding those factors will impact the efficacy of diagnosis and treatment.

It also will impact a dermatologist’s ability to counsel a patient and their family. For example, a dermatologist may not realize that the decision maker for a patient’s health care is not the patient himself, but a family elder or a religious leader. A dermatologist might be completely surprised by that.

Some cultures have a stigma about skin disease. For example, vitiligo has a very strong stigma in certain Eastern cultures. The condition might cause the patient to be unusually anxious and stressed. By understanding the cultural issues underlying the condition, the dermatologist will be able to treat the patient more effectively.

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MTM: How can physicians improve their cultural competency?

Dr. Pandya: In the article, we suggest ways for dermatologists to improve their cultural competence. One way is to learn more about your patients and their community. Question patients about their background and belief systems.

The first thing dermatologists should do is assess their patient population. So, for example, if you live in a community with a lot of Vietnamese immigrants, you should research the Vietnamese culture. There could be certain food habits that would impact your patient’s health, and that could help you recommend what type of foods to eat or avoid. Another thing to consider is whether your patient’s culture relies on non-physician healers that use alternative medicine.