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Cross-Cultural Primary Care
- Alexander R. Green, MD;
- Joseph R. Betancourt, MD, MPH; and
- J. Emilio Carrillo, MD, MPH
- New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021 (Green) New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021 (Betancourt) New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021 (Carrillo)
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IN RESPONSE:
We appreciate and welcome these insightful comments. Cross-cultural medical education is attracting great interest while rapidly evolving. It is crucial to have open and ongoing dialogue on the content and approach to curricula that attempt to improve care to socioculturally diverse populations. We agree with Drs. Perkins and Hazuda on the importance of looking “beyond patients to health professionals.” The brief description of our “basic concepts” module mentions that “ … participants reflect on their own cultures and how these influence their personal perspectives on illness and health care.” Although this is simply stated, we pay great attention to this issue through various exercises, including participant testimonials, case discussions, and the exploration of “biomedicine” as culture. Furthermore, our “core cultural issues” module emphasizes the importance of understanding both the patient's and provider's perspective on issues such as patient autonomy and the perceived role of the physician.
Drs. Plotnikoff and Barnes are correct to state that the patient's spiritual and religious perspective is a critical dimension of culture and an important component of cross-cultural care. We integrate this perspective into our entire curriculum, especially in our “meaning of the illness” module. Several of our case discussions deal with different religious perspectives, and the concept of illness as “God's will” frequently arises when participants present their own cases. In addition, the patient's religious and spiritual views are explored as part of their “social context,” and we did not intend to minimize the importance of this facet of a patient's life and culture.
Alexander R. Green, MD
New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021
Joseph R. Betancourt, MD, MPH
New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021
J. Emilio Carrillo, MD, MPH
New York Presbyterian Hospital-Weill Medical College of Cornell University; New York, NY 10021
- Copyright ©2004 by the American College of Physicians
