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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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she was stereotypical and made and assumption about the patient and her family.

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I would contact the other members of the family beginning with the mother and then the closest member after and explain the situation of the patient

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I would contact the other members of the family beginning with the mother and then the closest member after and explain the situation of the patient

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Lisa made a generalized assumption based on stereotyping, since the patient comes from a Middle-Eastern family.

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Lisa made a generalized assumption based on stereotyping, since the patient comes from a Middle-Eastern family.

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Our desired outcome would be to approach another family member like the mother, maybe the father is in a stressful situation given the diagnosis of his 3y0 child. Including another member would allow a more collaborative approach and less load/stress on the father... maybe then the father would be able to understand and digest the information and consider the doctors suggestions.

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Our desired outcome would be to approach another family member like the mother, maybe the father is in a stressful situation given the diagnosis of his 3y0 child. Including another member would allow a more collaborative approach and less load/stress on the father... maybe then the father would be able to understand and digest the information and consider the doctors suggestions.

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At the individual micro level, a physician or HCW should take initiative in learning the basic cultural backgrounds of the major minorities in the community in order to understand and empathize with how cultural differences may change a families approach to healthcare. The physician should be careful however not project or enforce these stereotypes as per the principles of patient centered care, but instead treat the individual patient and take into account their individual beliefs. The point of cultural competence is to be aware of how people typically present and approach the healthcare system amongst differing minorities, and to simply be ready and receptive if they happen to align with such characterizations.

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In the patient centredness and cultural approach must be linked and avoid stereotyping at all cost to provide the best care management plan without causing any problems, such as misunderstanding and losing trust.

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people from high context societies that care about face would not admit to not knowing something easily.

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the patient didn't ask questions to save face. they wouldn't admit to not understanding something when phrased in such a manner. It's the doctor's role to make sure and verify that the patient truly understands what the doctor intends for them to understand.

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I would make sure to ask questions to verify the patient truly understands.

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to ensure the patient truly understands his care plan in order for them to be truly compliant and avoid adverse health outcomes

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awareness of high context society communication and saving face or tendency to nod along and avoid 'conflict' (questioning)

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awareness of high context society communication and saving face or tendency to nod along and avoid 'conflict' (questioning)

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inclination towards using natural remedies

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inclination towards using natural remedies