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ACADEMIA AND CLINIC

Cross-Cultural Primary Care: A Patient-Based Approach

right arrow J. Emilio Carrillo, MD, MPH; Alexander R. Green, MD; and Joseph R. Betancourt, MD, MPH

18 May 1999 | Volume 130 Issue 10 | Pages 829-834

In today's multicultural society, assuring quality health care for all persons requires that physicians understand how each patient's sociocultural background affects his or her health beliefs and behaviors. Cross-cultural curricula have been developed to address these issues but are not widely used in medical education. Many curricula take a categorical and potentially stereotypic approach to "cultural competence" that weds patients of certain cultures to a set of specific, unifying characteristics. In addition, curricula frequently overlook the importance of social factors on the cross-cultural encounter. This paper discusses a patient-based cross-cultural curriculum for residents and medical students that teaches a framework for analysis of the individual patient's social context and cultural health beliefs and behaviors. The curriculum consists of five thematic units taught in four 2-hour sessions. The goal is to help physicians avoid cultural generalizations while improving their ability to understand, communicate with, and care for patients from diverse backgrounds.

Author and Article Information
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From New York Presbyterian Hospital-New York Weill Cornell Medical Center, New York, New York.

Acknowledgments: The authors thank Drs. Leon Eisenberg and Arthur Kleinman for their seminal work in this field and the comments and support they have provided; Dr. Richard Levins and the late Dr. Norman Zinnberg for their teachings on the social environment and the importance of the social construct in patient care; Dr. B. Robert Meyer for providing time and support for the implementation of the curriculum at Cornell Internal Medicine Associates; and Professional Actors Training and Helping (PATH) for their important role in our curriculum.

Requests for Reprints: J. Emilio Carrillo, MD, MPH, New York Presbyterian Hospital-Cornell Internal Medicine Associates, 505 East 70th Street, HT4, New York, NY 10021.

Current Author Addresses: Drs. Carrillo, Green, and Betancourt: New York Presbyterian Hospital-Cornell Internal Medicine Associates, 505 East 70th Street, HT4, New York, NY 10021.


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