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Amira Faroud was a three-year-old Middle Eastern patient, newly diagnosed with type 1 diabetes. Understanding the importance of involving the entire family in the patient’s care, Lisa tried to get the patient’s father, Mr. Faroud, to participate. She had seen other fathers being the “heads” of families and believed involving him was the best thing to do because Lisa the doctor in this case believes that all Middle-Eastern Culture people defer to male authority for ALL desicions. But in this case Mr. Faroud would not even consider her suggestions. 

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Amira Faroud was a three-year-old Middle Eastern patient, newly diagnosed with type 1 diabetes. Understanding the importance of involving the entire family in the patient’s care, Lisa tried to get the patient’s father, Mr. Faroud, to participate. She had seen other fathers being the “heads” of families and believed involving him was the best thing to do because Lisa the doctor in this case believes that all Middle-Eastern Culture people defer to male authority for ALL desicions. But in this case Mr. Faroud would not even consider her suggestions. 

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Dr Jones is part of a healthcare team helping a newly diagnosed Chinese diabetic patient to understand & manage his diet and insulin levels. He has just explained to the patient how to take his medication. Dr: “Have you understood how & when to take your insulin Mr Chang? Do you have any questions ?”Patient: “I understand Doctor, thank you for your time” (Patient leaves in a hurry)Some weeks later Mr Chang returns & is very unwell, his insulin levels are elevated & when interviewed by the Medical team it is clear that he had not clearly understood how & when to take his Insulin 

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Dr Jones is part of a healthcare team helping a newly diagnosed Chinese diabetic patient to understand & manage his diet and insulin levels. He has just explained to the patient how to take his medication. Dr: “Have you understood how & when to take your insulin Mr Chang? Do you have any questions ?”Patient: “I understand Doctor, thank you for your time” (Patient leaves in a hurry)Some weeks later Mr Chang returns & is very unwell, his insulin levels are elevated & when interviewed by the Medical team it is clear that he had not clearly understood how & when to take his Insulin 

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An American doctor enquires about the type of medication a Latin American patient (P) took against his hypertension symptoms: D: In order to help you with your current complaint as well as possible, we would like to know what kind of medication you take on a regular basis or that you have taken recently.P:  I do not take any medication on a regular basis but  The doctor I went to a week ago suggested I take something. But I didn’t do it. I do not think it is good for me.D: Can you tell me more about this, what do you feel you should do or take ? P: Yes, look, the doctor I went to wanted to give me something. But I do not think this medicine is good for me. I am not sure this is the right one. We say that when one feels like I do one should take something which contrasts the symptoms.D: “one should take something which contrasts the symptoms’? What do you mean exactly? Do you mean that in your country patients are given other remedies against the symptoms?you should do? P: Yes, exactly, , they give some teas and I believe they are very good.D: We will see what we can do. If you would you like to continue to drink these teas adding to another form of medication which we would suggest & I will explain to you now, I think you will benefit from both.P : Oh that would be great doctor! Thank you very much. 

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An American doctor enquires about the type of medication a Latin American patient (P) took against his hypertension symptoms: D: In order to help you with your current complaint as well as possible, we would like to know what kind of medication you take on a regular basis or that you have taken recently.P:  I do not take any medication on a regular basis but  The doctor I went to a week ago suggested I take something. But I didn’t do it. I do not think it is good for me.D: Can you tell me more about this, what do you feel you should do or take ? P: Yes, look, the doctor I went to wanted to give me something. But I do not think this medicine is good for me. I am not sure this is the right one. We say that when one feels like I do one should take something which contrasts the symptoms.D: “one should take something which contrasts the symptoms’? What do you mean exactly? Do you mean that in your country patients are given other remedies against the symptoms?you should do? P: Yes, exactly, , they give some teas and I believe they are very good.D: We will see what we can do. If you would you like to continue to drink these teas adding to another form of medication which we would suggest & I will explain to you now, I think you will benefit from both.P : Oh that would be great doctor! Thank you very much. 

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Patient Autonomy and Confidentiality isn't being upheld. Additionally, the doctor is making assumptions about the patient's culture and whether or not she agrees with it [Stereotyping]

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Patient Autonomy and Confidentiality isn't being upheld. Additionally, the doctor is making assumptions about the patient's culture and whether or not she agrees with it [Stereotyping]

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I would possibly try talking to the mother or the nearest guardian, sibling 

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I would possibly try talking to the mother or the nearest guardian, sibling 

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patient autonomy and confidentiality, in addition to stereotyping  

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patient autonomy and confidentiality, in addition to stereotyping  

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Hard to convince any information further due to the nature of the father. Also, high context culture is a significant aspect of consideration where information is given indirectly. So effort should be made from the side of the HCP in dealing with such a situation 

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Hard to convince any information further due to the nature of the father. Also, high context culture is a significant aspect of consideration where information is given indirectly. So effort should be made from the side of the HCP in dealing with such a situation 

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At micro-level, I would try to convince the patient and maybe enable more understanding so that the attitude of the father can be changed.

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At micro-level, I would try to convince the patient and maybe enable more understanding so that the attitude of the father can be changed.

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understand were the father's behaviour are coming from (hidden culture?) and convey my understanding to him. 

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understand were the father's behaviour are coming from (hidden culture?) and convey my understanding to him. 

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the doctor was trying to be professional in her own way but she could have described more of the importance of her medical care to the entire family rather than asking the dad to make the desicion.

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probably talk to the mother since she is the caregiver and mostly with the child.

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Communicating with the patient about their wishes and how they would like to proceed when it comes to the their personal medical information is important. In addition to not making assumption about a patient based on their ethnicity/culture.

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Communicating with the patient about their wishes and how they would like to proceed when it comes to the their personal medical information is important. In addition to not making assumption about a patient based on their ethnicity/culture.

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a group decision would be the best outcome in the patients best interest.

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the patient did not understand how to take the medication, and the doctor failed to ensure that the patient has the adequate knowledge 

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the patient did not understand how to take the medication, and the doctor failed to ensure that the patient has the adequate knowledge 

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either convincing the the father take the suggestion or make her mother responsible for her management 

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either convincing the the father take the suggestion or make her mother responsible for her management 

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The patient likely thought he understood how to take the medication, or had something in mind already on how to take it 

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The patient likely thought he understood how to take the medication, or had something in mind already on how to take it 

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It is the doctor's job to ensure that the information is clearly understood

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It is the doctor's job to ensure that the information is clearly understood

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The patient does not want to be let down by telling the doctor that he does not understand the information. On the other hand, the doctor as well does not want to show that the patient did'nt understand the information even though he might vaguely know that the patient did not understand. 

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The patient does not want to be let down by telling the doctor that he does not understand the information. On the other hand, the doctor as well does not want to show that the patient did'nt understand the information even though he might vaguely know that the patient did not understand. 

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asking the patient to repeat everything they understood, and making sure it is correct 

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asking the patient to repeat everything they understood, and making sure it is correct 

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communication is a key aspect in the management of patient  

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communication is a key aspect in the management of patient  

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at micro level i would try to reach the patient so the patient can maybe convince the father.
at meso level, probably get the whole family in an informed consent.
at macro level, it would be an cultural training for doctors in the sense where to draw the line between professionalism and cultural sensitivity.

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Patient has a fast lifestyle most likely, and probably had other important matter on his mind at the time.

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Patient has a fast lifestyle most likely, and probably had other important matter on his mind at the time.

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It is the doctor's responsibility to make sure that the patient understands all instructions they are given 

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It is the doctor's responsibility to make sure that the patient understands all instructions they are given 

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communication is the key to managing a patient and their care should be in their best interest.

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micro: try to understand why her father didn't take the suggestion and try to change his view.  meso: make sure to contact other family members (mom), macro: make sure that doctors are culturally sensitive                    

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micro: try to understand why her father didn't take the suggestion and try to change his view.  meso: make sure to contact other family members (mom), macro: make sure that doctors are culturally sensitive                    

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I would ask the patient to rehearse the information i provided during the consultation. I would bring in to light the primacy-recency effect so that the patient has not missed anything and retained the significant aspects in memory.

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I would ask the patient to rehearse the information i provided during the consultation. I would bring in to light the primacy-recency effect so that the patient has not missed anything and retained the significant aspects in memory.

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Sit the patient down and double check that he understood. Make him repeat back what I said and maybe even provide some online resources to learn more.

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Sit the patient down and double check that he understood. Make him repeat back what I said and maybe even provide some online resources to learn more.

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i would use the Teach-back method, i will explain the concept again and ask the patient to explain it back and correct any error if present 

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i would use the Teach-back method, i will explain the concept again and ask the patient to explain it back and correct any error if present 

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Probably because the information wasn't delivered to the patient in an effective manner

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Probably because the information wasn't delivered to the patient in an effective manner

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the patient wants to handle the situation well without making sure that he knows the information 100%

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the patient wants to handle the situation well without making sure that he knows the information 100%

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the patient felt forced to say he understood what the doctor had said, in some cultures its rude to question authority figures. and the doctor also didnt wanna come out as rude to keep repeating if the patient could grasp everyghing.

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maybe the patient thought it was rude to question authority. it was the doctors job to make sure the patient understood.

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He thinks that the teas that are widely used in his culture are the medications he needs, and which will fix his issues. 

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He thinks that the teas that are widely used in his culture are the medications he needs, and which will fix his issues. 

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the patient is preoccupied, and maybe thought he can know it more later, on his own, maybe he did not want to bother the doctor, it is both the doctor and the patient, since he is an adult, to make sure that everything is understandable

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the patient is preoccupied, and maybe thought he can know it more later, on his own, maybe he did not want to bother the doctor, it is both the doctor and the patient, since he is an adult, to make sure that everything is understandable

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This might be because of the wrong information he is being surrounded with, he wants to stick to it and does not want to follow the doctor's advise.

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This might be because of the wrong information he is being surrounded with, he wants to stick to it and does not want to follow the doctor's advise.

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start with apologising at start and then ask them to explain to you what you had grasped and probably ask them to demonstrate on how to inject insulin.

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this is probably the reason why this patient thinks the medication he received from another doctor would not good for him 

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this is probably the reason why this patient thinks the medication he received from another doctor would not good for him 

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Probably because of his culture that he has been exposed to since childhood

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Probably because of his culture that he has been exposed to since childhood

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one should account for the cultural influence on how patient's behaviour. 

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one should account for the cultural influence on how patient's behaviour. 

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he doesn't have enough knowledge about how medications works 

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he doesn't have enough knowledge about how medications works 

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probably ask the patient to repeat and give him a translator so it can be properly understood

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showing the patient a simple drawings, illustration, video, sending him a link to see the steps, giving him a cd or tape for reference, asking him to do it in front of you

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showing the patient a simple drawings, illustration, video, sending him a link to see the steps, giving him a cd or tape for reference, asking him to do it in front of you

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maybe hes on a harry and as a Asian cultures are high context they don't care about the little details generally speaking. it was the doctor responsibility  

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maybe hes on a harry and as a Asian cultures are high context they don't care about the little details generally speaking. it was the doctor responsibility  

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cultural sensitivity is a big part in patient care.

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ill tell the patient to explain what he understood

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ill tell the patient to explain what he understood

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maybe because he believes that the "teas" his culture or community takes are better, so he expects the other medications to have a negative affect 

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maybe because he believes that the "teas" his culture or community takes are better, so he expects the other medications to have a negative affect 

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good communication and make sure the patient understood what the doctor said 

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good communication and make sure the patient understood what the doctor said 

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doctors must make sure that patients understood what was told and doctor must explain in a clear manner and can differentiate between high and low context community

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doctors must make sure that patients understood what was told and doctor must explain in a clear manner and can differentiate between high and low context community

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probably because in his culture they believe natural remedy is better than western medicine

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his culture influences him to think any other medication than his natural remedy would have a negative influence on his condition.

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he does not have enough access to information on what these medications can do and how it can alleviate the symptoms.

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maybe he didn't use his medications correctly in the past (explains why had negative experiences)

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maybe he didn't use his medications correctly in the past (explains why had negative experiences)

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cultural beliefs and maybe the previous doctor didn't explain very well the benefits of the drug

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cultural beliefs and maybe the previous doctor didn't explain very well the benefits of the drug

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his culture has influenced him to make that decision about how a medication should work on the body and his lack of knowledge of the concept aids his ideology.

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maybe his cultural beliefs influence him

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maybe his cultural beliefs influence him

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not enough knowledge about how medication work  

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not enough knowledge about how medication work  

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in patient centered care the doctor should be aware of both medical and culture aspects when prescribing medications and further management.

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most likely due to cultural influence from childhood

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most likely due to cultural influence from childhood