MVT and cultural competency
Cultural competency is needed to be developed at organisational, individual and healthcare system levels, says Sivakumaran J
Medical Value Tourism is expected to grow at 20% over the next two years. The medical tourism industry will be worth $9 billion at the end of year 2020. While the medical value tourism is viewed as a commercial product, it is a fact that it is something to deal carefully with cultural aspects which will vary from country to country and cannot be altered by the patients. Seeking medical treatment in an unknown environment to an unknown doctor is a scary and risky decision. Most of the patients are going to disclose their problems and get treated in a hospital facility, which doesn’t know his language, culture, food habits, behaviour, customs, beliefs and values.
To create the confidence and to bring a comfortable feeling, hospitals need to bring cultural and linguistic competency apart from infrastructure and medical expertise. This may even become a deciding factor for choosing a hospital and location. Patient’s expectations are many due to the broader cultural exposure. Due to better communication systems, development of IT and exposure to social media they come across different cultural knowledge from which they understand newer ideas and views.
For international patients, hospitals need to provide healthcare delivery which includes infrastructure, technical expertise, social, cultural and linguistic needs. Cultural familiarity is also one of the deciding factors for choosing a location. Generally, British patients will be comfortable with Indian culture while Americans prefer Mexican. Chinese and Japanese prefer Taiwan than Southeast Asia. Hospitals need to have a system which will educate both patients and service providers about the variations in the cultural, beliefs needs and habits. While drawing the policies, SOPs and strategies it should be carefully drawn so that it enables the service providers to work effectively with cross cultural environment. Delivering a baby in an auspicious day, time and star may be an important aspect in Indian culture, where as this may not be given importance in other cultures.
Culture is a way of living accumulated and accepted by a society. Cultural diversity is the mixture of different societies, groups or cultures in a specific place. It is also having different races, ethnics, nationality, religions, languages of various groups of a community, region or nation. Through proper training and education, hospitals can emphasise the importance of culture and language. Understanding the culture, habits and beliefs of a patient by a service provider and understanding the culture of service providing country by patient is also necessary, to improve the medical service and clinical results.
Cultural competency plays an important, influential and invisible role. Cultural competency is the ability to understand, communicate and effectively interact with people across culture. Relationship building is a fundamental to cultural competency. There are four elements in cultural competency. Awareness, Attitude, Knowledge and Skills. Awareness is knowing different values and beliefs. Our emotional reactions on others’ values and beliefs is attitude. Knowing different cross cultures and avoiding rifts and understanding the power of culture in connecting the people etc. is the third element knowledge. Skill is an art or practice to manage cultural differences and bridging the gap, if any.
Cultural competency is needed to be developed at three levels. One at the organisational level, the other at an individual level, while third level is at the healthcare system level. Hospitals need to develop operational frame work, policies, procedures so that healthcare workers deliver their services more effectively and efficiently within cross cultural situations. Individual level is developing knowledge, skills, values, attitude and behaviour to manage different ethnic groups working within the hospital’s frame work. Another level could be at the healthcare system level, where the policies are framed at national level which will relate various communities and ethnic groups so that the patients prefer that country as their choice of preference. Cultural competence becomes an instrument to improve the access to quality care and a strategy to improve the business so that the market share could be increased.
Among other competencies, language competency is very vital and important to improve the quality of medical treatment. The service provider need to know the language of the patient to understand their health problems. An interpreter may not communicate with the same emotion and feelings what the patient themselves can do. Chances of misdiagnosis and irrelevant treatment may occur due to this gap. Research shows that patient who can communicate in the service provider’s language gets more satisfied and increases the efficacy of doctor/patient relationship. MVT need to understand the behaviour and preferences of medical tourism patients. These patients are weak both physically and mentally as they are not very familiar with the new environment in which they are going to undergo treatment. These patients need higher levels of protection. The approach of the local population towards MVT patients also has an important impact. Sick patients are very sensitive to new environment and hence it is our responsibility to remove the mental barriers by educating and training the service providers on cultural competency.
Sivakumaran J is COO of KMCH, Coimbatore.