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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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Lisa stereotyped the family. This is a wrong interpretation of middle eastern culture. This misinterpretation resulted in the wrong approach to the conveying the message

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- why is he not open to the considerations
- does he understand the severity of type 1 diabetes and ensuring proper management
-  ask about his thoughts and what his concerns are. perhaps he isn't open to suggestions because of these concerns

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Lisa was stereotyping the family, instead of addressing the whole family collectively, she mainly talked to the father who she believed to be the authority figure

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Ideally after proper and considerate communication from the doctor, with attempt to include the entire family into the discussion, the family would understand the importance of the decisions taken by the medical professional and would agree to and accept the treatment plan

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Individual: understanding the family's point of view. Ensuring their thoughts and opinions are considered. after which, using proper, compassionate communication to convey the importance of the treatment plan.

Institutional: bringing in other members of the hospital department involved, to help discuss the decisions.

Council/regulatory bodies: if family still does not agree to the pediatric patient's treatment plan. Including regulatory body of the hospital to take action, and potentially child services board.

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Patient may have felt ashamed to ask questions

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involving a medical interpreter to thoroughly communicate the treatment plan, its importance, risks, and risk of non-adherence to the patient.

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Ensuring the patient has a means of asking questions, both during that communication and for the future

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The doctor could have been more aware of the patient's culture. And generally with patients should ask them to explain what they learnt to make sure they understood.

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perhaps there was a communication barrier potentially language barrier

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ask the patient to repeat the instructions I gave them to make sure that the message has been received and well understood, maybe have written instructions

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The patient was ashamed to ask

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- a thorough discussion would take place between the doctor and the patient, patient would understand entirety of the treatment plan, convey their concerns, and adhere to the treatment plan with future follow-ups

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Doctor communicates is clear simple language (or use interpreter) and patient fully understands the instructions they need to follow

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offer reassurance to the patient so they feel comfortable, tell them there no shame in not understanding and they can always ask questions

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Avoid stereotypes and preconceived judgement about a patient's culture

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A doctor should take great care in communicating instructions to the patient about their condition care and treatment.
Ensure the patient feels comfortable to ask questions if they are unsure about anything.
Make sure the patient is involved in their treatment plan.
Ask patient to repeat the doctor's instructions for the management, to ensure they fully understand.

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Dr should apologize as they might have offended the patient family

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always take into consideration negative experiences that the patient might have had or side effects with previous medications prescribed to them

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Patient has more trust in the teas his community drinks than conventional medicine (perhaps due to bad past experiences)