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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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Dr Lisa is assuming Middle Eastern culture practising patriarchy 

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Dr Lisa is assuming Middle Eastern culture practising patriarchy 

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The father might be assuming since the doctor is a female, she might be incompetent and therefore not taking the doctor's suggestion

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The father might be assuming since the doctor is a female, she might be incompetent and therefore not taking the doctor's suggestion

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Involve other family members too (maybe the mother)

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Involve other family members too (maybe the mother)

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discuss with the father the reason why he does not want to agree with the doctor

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discuss with the father the reason why he does not want to agree with the doctor

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make sure every family member understands what the doctor is saying

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make sure every family member understands what the doctor is saying

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The patient might not understand because of language barrier 

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The patient might not understand because of language barrier 

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The patient might be ashamed to question the doctor

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The patient might be ashamed to question the doctor

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Both the patient and doctor share the responsibilities to understand the information

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Both the patient and doctor share the responsibilities to understand the information

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use interpreter if there is a language barrier between doctor and patient

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use interpreter if there is a language barrier between doctor and patient

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I would ask the patient to repeat back on the instructions and perhaps show a demonstration in front of him

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I would ask the patient to repeat back on the instructions and perhaps show a demonstration in front of him

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Get a follow-up plan for the patient and his family member to check up on him with his insulin technique

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Get a follow-up plan for the patient and his family member to check up on him with his insulin technique

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Patient is compliant with insulin intake and diet. Have a comfortable relationship with the doctor so that he is not afraid or ashamed to disagree/question.

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Patient is compliant with insulin intake and diet. Have a comfortable relationship with the doctor so that he is not afraid or ashamed to disagree/question.

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the previous doctor might not explain about the medication in detail

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the previous doctor might not explain about the medication in detail

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Maybe the other medication is not explained? Patient's preference might be herbal remedies?

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Maybe the other medication is not explained? Patient's preference might be herbal remedies?

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It doesn't do any harm and it helps the doctor's way of prescribing the medication.  Placebo effect

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It doesn't do any harm and it helps the doctor's way of prescribing the medication.  Placebo effect

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Helps to communicate with the patient and understand their lifestyle, way of life etc

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Helps to communicate with the patient and understand their lifestyle, way of life etc

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For the first one -> Reduced quality of life.

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For the first one -> Reduced quality of life.

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Second one -> Yes, because he did integrate the patient's approach of medication into the patient care

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Patient would not trust the doctor and not take the medication/compliant with the management plan

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Patient would not trust the doctor and not take the medication/compliant with the management plan