How to Embrace Culturally Competent Care

Cultural competence has been embedded in One Medical, a primary care provider based in San Francisco.

One Medical has made culturally competent care a priority for the primary care provider.

Cultural competence is critical in decreasing healthcare disparities through culturally sensitive care, according to the Agency for Healthcare Research and Quality. "Culturally competent care is defined as care that respects diversity in the patient population and cultural factors that can affect health and healthcare, such as language, communication styles, beliefs, attitudes, and behaviors," AHRQ says.

One Medical has a similar definition of culturally competent care, says Hemalee Patel, DO, senior medical director for chronic care management. "Culturally competent care is the ability to deliver effective healthcare that meets the social, cultural, and language needs of a patient. You need to understand that for any given patient coming in the door, they may have a different experience from a provider, and they come with their own norms that may be different from a provider's. You need to understand and meet folks where they are at and be able to deliver effective care with empathy."

Culturally competent care is essential to provide high quality care, she says. "As the nation is becoming more diverse, it is important to be culturally competent. You need to build trust and a relationship in order to help patients from a preventative standpoint but also from an acute standpoint. You want folks to understand that they can come into a healthcare setting and feel that they are being heard, and they have a trusted source of care."

One Medical has embraced cultural competence as an organization, Patel says. "One Medical is a very diverse place. I came from a traditional health system. I feel that even in the interview process it was extremely important that they took my values into account and that everyone's values were heard. That is part of the culture here."

One Medical clinicians receive training and feedback about culturally competent care, she says. "In terms of providers, we have a lot of training opportunities and resources. We have training courses that we have providers go through. We are constantly giving feedback to providers. We are sharing information about their patients that they might not necessarily have seen. Our clinical learning team develops modules and workshops for providers to get the training when they need it."

At One Medical, culturally competent care is helping to achieve positive health outcomes, Patel says. "In my program, we are proud to say that outcomes of improvement in areas such as cholesterol and weight are equal across all races and ethnicities. That is data that we continue to look at, continue to gather, and continue to learn from."

She gave an example of a patient who required culturally competent care. "I had a patient who came in who had diabetes, and she was of Filipino background. In her entire family, everyone has diabetes, including her mom and her sister, who were on insulin. She was scared. When I asked her about her understanding of someone having diabetes, it was insulin and a short lifespan. For her, it was very important that family meals are traditional. She didn't understand how she could turn her diabetes around."

Understanding that traditional meals were important to the patient was an important element of providing culturally competent care, Patel says. "We could still do a lot in terms of mitigating her disease state. In the course of about six months, she was able to see her glucose levels coming down. She was still able to enjoy family meals. By improving her own metrics and her family observing this achievement, her mom and her sister also become One Medical patients, and they have also been able to shift the way they think about food without compromising their values."