Thursday, March 11, 2010

Cultural Incompetency

Where to start? For my FIM class... you know the stupid class I hate... we have a section called "cultural competency". Which is the new bane of my existence. Not because I don't think the topic is important... because I do. But rather because in all my years in academia I have never once seen anyone worth respecting teach it in a respectable nor interesting way.

For instance, today we were required to watch a stream of staged videos which were supposed to demonstrate how culturally insensitive situations can occur. I shit you not, the patients were all black and the docs all white. Every scenario was ridiculously staged... and then we were required to answer a series of questions which were insane.

Here's an example of what happened today:

Video: White doc, black patient. Patient has uncontrolled hypertension, previous MI, etc. Doc is speaking a little overly scientific and parental and patient is being a little too apathetic about his unhealthy lifestyle and a little too defiant about physician knowledge. Not to mention, the video contained every stereotype you could ever come up with... about the doc as well as the patient. Patient uses wrong verb tenses, says he's unemployed, and brags about using the ED for his primary care doc. Doc rolls his eyes every time the patient uses sub-literary journal level language, suggests buying organic foods and joining an expensive gym to work out.

Question: What is the main issue in this video?

Answers:

A) The patient should be more concerned about his severely unhealthy habits and should take more responsibility for his own health

B) The patient and the physician are talking past each other instead of communicating well

C) The patient should be re-assigned to a black physician

D) The physician is not being sensitive and is not picking up on cultural cues that would help him to appropriately solve the patients problems.

After a group discussion we settled on the best answer B (heaven forbid the answer is A). However, one of my group members says "Hey guys... I know B is the right answer... but I know how these assignments work. I bet my life that the answer is D. If we want the points for getting the right answer, we should pick D"

He managed to convince us... so we chose D for the points. And freakin-A... he was right.

Now, tell me that this situation doesn't in effect PERPETUATE racism. Instead of both parties taking responsibility for the miscommunication... which would imply equality...it's the "superior", white doc's responsibility to figure out how to solve the black patient's problems.... thus implying that the patient doesn't have the ability to assess and solve his own issues. Right there, in class, we just affirmed the notion that white doctors, in fact, are superior and should take the higher moral road. The whole thing is pure insanity.

I mean... if we're going to address racism... lets do it. But nix those lame-ass videos for god's sake.

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