Culturally competent care respects diversity in the patient population and cultural factors that can affect health and health care, such as language, communication styles, beliefs, attitudes and behaviors. Cultural competency is the foundation to reducing disparities by being culturally sensitive and providing unbiased, high-quality care.
Cultural proficiency is not just the acceptance of cultural differences, but rather is a transformational process that allows individuals to acknowledge interdependence and align with a group other than their own. Culturally proficient health care, in particular, makes use of a patient’s language and culture as tools to improve outcomes for that individual.
There is a critical component of cultural humility — having a humble and respectful attitude toward people of other cultures. It involves ongoing self-exploration combined with a willingness to learn from others. This helps the recognition of cultural biases and the realization that as healthcare providers, we can’t know everything about a culture.
The concept of cultural humility was developed by Melanie Tervalon, MD, MPH and Jann Murray-García, MD, MPH, more than 20 years ago to address health disparities and institutional inequities in medicine.
Tervalon and Murray-García described three principles of cultural humility. These include:
- continued learning throughout our lives because we are ever-changing based on what is going on with us and with our patients
- being humble about our level of knowledge regarding our patients’ beliefs and values, aware of our own assumptions and prejudices, and active in redressing the imbalance of power inherent in the physician-patient relationship
- recognizing the importance of institutional accountability
Cultural humility provides a greater understanding of cultures that are different from our own and helps us recognize each patient’s unique cultural experiences. Healthcare providers treat the whole person, are involved in the local communities, and maintain ongoing patient-physician relationships. We learn from patients and their families and acknowledge their cultures and how these cultures affect health, without making assumptions. Through these efforts, we are able to promote accessible, affordable, culturally proficient and high-quality care.
Patient-centered care is respectful and responsive to the individual patient’s preferences, needs and values, and it ensures that these values guide all clinical decisions. To achieve this, the interdisciplinary team must be not only culturally competent and strive for health equity, but also culturally humble.