I have studied and published research on African American(AA) experiences with healthcare providers and systems for over 20 years. During this time, "culturally competent care" became a commonly used phrase to denote treating patients consistent with their culturally-guided values and health beliefs. Yet, this only became an important issue for healthcare leaders and providers when Patient Experience Scores began to be used to modulate reimbursement. Otherwise, those leaders were not interested in investing in this kind of care as it did not have a financial Return on Investment.
During my 30 years working with cardiologists and cardiology patients from the African American culture, I seldom heard or observed a discussion with a patient regarding their values or beliefs. Often, the discussion centered around what was wrong and how it needed to be fixed. As an AA Baby Boomer, I could relate to the glazed looks on many of the patient's faces as their expression was one of defeat and fear. Seldom did I hear the words "Yes/No Sir" "Yes/No Ma'am" which are viewed as a common expressions of respect for our generation.
I observed providers using loud and commanding voices when speaking to AA patients who were not hearing impaired and standing over them in a position of power. I observed providers wearing gloves for AA patients, but not other patients and I have observed the use of medical jargon that I had difficult understanding as a trained specialist in cardiac arrhythmia technology.
These observations are consistent with the body of published literature that while improvements have been made in delivering culturally competent care, there are significant opportunities for improvement in building trust with my generation, which is the generation that experienced and fought against racial injustice and remember the Tuskegee Experiment. Moreover, mistrust has been shown to significantly contribute to costly episodic care and low compliance with medical care advice.
Hence, I personally developed a learning model that represents my 35 years in the healthcare profession, personal experience, research and best-practices. The strategic intent of this module is not to place blame or point fingers. Instead, it is designed to help providers apply one of Stephen R. Covey's Habits of Highly Effective People...Seek First to Understand, Then to be Understood. It is designed to be thought-provoking, motivational and inspirational.