Culture and Latino Patients

Communication runs deeper than the words that arereading "The Latino Patient: A Cultural Guide for Health
exchanged between two people. Words are importantCare Providers" by Nilda Chong, MD, 2002.
for sure, but often times when we're working withYou may have noticed some differences in your
patients of a different culture than our own, wordsLatino patients with respect to their family's
alone are not sufficient to motivate a patient to makeinvolvement in the healthcare choices of an individual.
a lifestyle change, or to accept a suggested treatmentThis Latino cultural value termed Familismo often
plan. We must take cultural norms and values intostands in contrast with the typical North American
account when working with patients who don't sharevalue of Individualism. As Dr. Glenn Flores from the
the same set of assumptions and values.Division of General Pediatrics at the Boston Medical
What cultural factors influence your success with aCenter observes:
Latino patient, and how likely is it that your Latino"Familismo can be described as a collective loyalty to
patient doesn't share the same set of norms andthe extended family that outranks the needs of the
values as you? These are complicated questions toindividual. Important decisions are made by the
answer for several reasons. First and foremost weextended family, not the individual alone. The three
assume that it is possible to describe and understandbasic dimensions of familismo are: (1) familial obligations
unique individuals through generalizations. For example,(providing material and emotional support to family
the term "Latino" includes anyone who traces theirmembers), (2) support from the family (the perception
origin to Latin America; lumping together the Mexicanthat family members are reliable providers of help and
immigrant who has been in the country for 1 monthsupport in solving problems), and (3) family as referents
and the Mexican American family who has been(decisions and behavior should be based on pleasing
established here in Colorado for 3 generations (not toand consulting with family members)."
mention all of the other nationalities ofIn his article "Culture and the patient-physician
Spanish-speaking immigrants that we see as patients).relationship: Achieving cultural competency in health
Other confounds that complicate our discussion arecare" (The Journal of Pediatrics. January 2000), Dr.
various levels of acculturation to North AmericanFlores goes on to describe that if healthcare
norms and values, religious beliefs, gender roles, levelsprofessionals fail to recognize familismo they run
of education, etc. With this in mind, the generalunnecessary risks. Latino patients who have this sense
differences discussed below are just that. They areof family ties but who are treated medically based on
not rigid prescriptions that apply to every Latino patient,values of individualism are likely to be dissatisfied with
rather they are general descriptions that help youcare, not adhere to treatment plans, experience
understand and help your Latino patients better.avoidable conflict with their providers and their families,
Most authorities on the subject of Latino culture andand receive poor continuity of care. Your Spanish
medicine agree that there are anywhere from 5-10language skills could be impeccable, but if you fail to
significant cultural differences that affect theunderstand the powerful influences of cultural norms
relationship between non-Latino providers and Latinoand values, you will still face many challenges on the
patients. For a concise yet practical description ofroad to effectively treating your Spanish speaking
some of these important cultural factors considerpatients.