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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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 acceptance the treatment plan + trust the physician 

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 acceptance the treatment plan + trust the physician 

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will try to talk to both parents and convince them 

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will try to talk to both parents and convince them 

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institutional: try to understand the cultural dynamic
macro: try to understand the hospital and community of diabetics

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Sterotyping
Making Assumptions about the family
Not involving the rest of the family
Communication

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doctor assumed he would understand english and direction 

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doctor assumed he would understand english and direction 

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Talk to both of the parents from the beginning to identify who is the decision maker

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from a different culture, they do not admit to not understanding and do not ask questions usually

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from a different culture, they do not admit to not understanding and do not ask questions usually

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 have patient re-iterate the directions to doctor to make sure they understand

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 have patient re-iterate the directions to doctor to make sure they understand

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doctor and patient talking to each other, asking/answering questions, developing more trust & communication 

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doctor and patient talking to each other, asking/answering questions, developing more trust & communication 

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Because it is not appropriate in asian culture

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Because it is not appropriate in asian culture

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I would answer questions that typically arise with similar patients. And try to have a more open conversation

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to re-explain for the patient knows how to take insulin so this never happen again

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to re-explain for the patient knows how to take insulin so this never happen again

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try to ask open ended questions so make sure that the patient really understood everything

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try to ask open ended questions so make sure that the patient really understood everything

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They might have a different idea of treatment.

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The patient might not have understood the whole concept of the medication

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cultural context and maybe distrust of taking medications. in some cultures, the people do not trust doctors and do not follow their suggestions

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cultural context and maybe distrust of taking medications. in some cultures, the people do not trust doctors and do not follow their suggestions

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Doctor didn't consider how patients are treated for the same disease in the patient's culture

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Doctor didn't consider how patients are treated for the same disease in the patient's culture

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People of different cultures might react and respond differently to questions

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People of different cultures might react and respond differently to questions

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doctor was very good at communicating with patient and their ICE

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doctor was very good at communicating with patient and their ICE

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Understand who disease are treated in the patient culture before prescribing medications

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Understand who disease are treated in the patient culture before prescribing medications

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a basis of understanding between doc and patient is very important

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a basis of understanding between doc and patient is very important