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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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Not every person will conform to expected cultural stereotypes, and therefore each patient should be treated as an individual.

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Everyone needs to be involved in the child's care, including the child and both parents.

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Open the discussion to involve the mother or other family members present.

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The doctor should understand her stereotypes and biases, and in the future make an effort to understand the unique situation of each family.

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Ask the family how they want to handle care

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Encourage the family to come up with a plan that best suits their family. Ensure everyone is knowledge about the management of DMT1.

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Mandatory training for doctors

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The man didn't want to embarrass the doctor or seem to disrespect the doctor.

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The patient may view the doctor as an authority figure and did not want to disappoint him. Also he left in a hurry suggesting he did not want to take up the doctor's valuable time.

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It is the doctor's job to ensure the patient understands. Ask the patient to teach back the information.

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The patient may have interpreted the doctor's question as a conversation end as opposed to an true (low context) question.

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Arrange follow-up sooner to prevent severe illness due to lack of understanding. Also give the patient opportunities to ask questions after the consultations as patients may need time to generate questions. Consider referral to support group.

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Ask questions throughout the consultation - do not wait until the end to ask about questions.

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Reflect on what went wrong and what could be improved.

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The explanation provided differed from his cultural perspective on medicine. If the doctor had framed the medicine in this context, he might have been more open to taking.

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Disagreement from the doctor may make the patient feel attacked and even less likely to comply. Herbal remedies can also have beneficial effects and should be incorporated. It is demeaning to dismiss the patient's views and beliefs.

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Herbal remedies are often beneficial and should be incorporated into the treatment plan. The doctor should be considerate to the patient's beliefs and cultural perspective. It would be demeaning to disregard their beliefs and opinions on their own health.

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Patient compliance is increased when they believe in their treatment. When there is collaboration between the doctor and patient, more positive outcomes can be achieved.

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The patient's mental and physical health will benefit from a collaborative rather than paternal approach.