Increasingly, healthcare providers are operating in a multicultural environment characterized by interactions with patients who hold different values, world-views and perhaps even differing perspectives and practices regarding their health and wellness. This reality across providers can lead to challenges in providing culturally competent and respectful care.
Take the case of Latin American, Asian or Middle Eastern patients traveling to the U.S. for care. These patients will have to interact with a culture that is often more direct, individualistic and independent than their own. These opportunities for interactions can set the stage for misunderstandings, anxiety and a poor medical travel experience. For example:
• Many Hispanic patients are strong advocates of folk and herbal treatments, which may frustrate American doctors who have been educated to primarily rely on orthodox medicine. 1
• Certain patients from Asia may find it disrespectful to make eye contact with doctors or other authority figures. Western doctors may mistakenly think that the patient is not interested in what he/she has to say or is simply not paying attention.2
• It is common for women in Arab cultures to defer to their husbands for important healthcare decisions. In some instances, they will only allow a woman doctor to treat them.3
Patients from various cultures may become upset or uncommunicative if healthcare professionals ignore or belittle their beliefs and social norms. Health care providers can avoid or minimize these types of situations when they have an awareness of the unique cultural beliefs and background of their patients.
How do you feel?
An often overlooked but critically important factor in the medical travel experience is empathy. Merriam-Webster defines empathy as “the feeling that you understand and share another person's experiences and emotions.” Studies have shown that empathy can be an important skill for healthcare providers and is often associated with improved clinical outcomes.
If you have ever stopped to help an older individual struggling to cross a busy intersection or simply sat down with a neighbor as they wept for the loss of a loved one, then you have probably felt empathy. Empathy in a clinical context is determined by a healthcare provider’s ability to understand patients’ emotions, which can facilitate a more accurate diagnosis and more caring treatment. In practical terms, if we try to understand the perspective of others, we are more able to display socially appropriate and compassionate behaviors. Empathy is important in any healthcare setting but is particularly essential in medical travel where patients face numerous challenges – real and perceived – related to having been dropped into an unfamiliar environment.
Unfamiliar environments can present challenges that may include:
• Concerns about being able to communicate effectively with medical staff due to potential language and culture barriers;
• Ability to observe cultural and religious practices during the hospital stay;
• Potential concerns about the treating physician’s qualifications;
• Lack of knowledge about their legal recourse in case something goes wrong;
• In certain instances, anxiety over what family, friends, or even their primary doctor may think about their decision to travel abroad for medical care;
• Concerns about finances and being charged more that quoted for the treatment;
• Lack of understanding about the medical travel process.
The first step to achieving empathy is to put yourself in your patient’s shoes. Ask yourself, what would you feel if you were traveling abroad for medical care? What fears and concerns would you have? Take time to listen to the medical travelers you are caring for to learn about their experiences and challenges.
Sorry, those are the Rules
Perhaps it is your hospital’s policy not to allow family members or companions in the recovery room immediately after surgery. While there are certainly valid reasons for this policy, did you ever stop to consider what a medical travel patient may feel when he/she wakes up in a daze, in a cold room, with people speaking a strange language? Or the anxiety of the family member or companion in a waiting room wondering about the wellbeing of their loved one? Understanding and being empathetic to traveling patients’ unique circumstances should motivate executives leading medical travel or international services lines to revisit policies and procedures to ensure they are promoting a positive and safe patient experience.
Common sense tells us that engaging in effective empathetic communication with international patients will lead to a better medical travel experience. How so?
• It builds trust between the patient and healthcare provider
• It may help the patient disclose information
• It enhances patient satisfaction
• It involves the patient more fully in health decision making
• Studies have shown that it leads to better outcomes 4
Understanding Empathy for Medical Travelers
A recent article published by the Cleveland Clinic Journal of Medicine called “Seeking medical care abroad: A challenge to empathy” provides an interesting overview and broad perspective on empathy in the care setting for patients that travel for medical care. The author, Dr. Nizar N. Zein not only draws upon his research, personal experience as a physician and professional insight at Cleveland Clinic’s Chairman of Global Patient Services.
 Geri-Anne Galanti, Caring for Patients from Different Cultures
 Academic Medicine, Journal of the Association of American Medical Colleges. http://journals.lww.com/academicmedicine/Fulltext/2012/09000/The_Relationship_Between_Physician_Empathy_and.27.aspx. Accessed 4/19/17