Cultural Awareness in COVID-19 Care: Overcoming Barriers and Building Trust

Announcer:
You’re listening to VacciNation on ReachMD, and this episode is sponsored by Pfizer. Here’s your host, Dr. Brian McDonough.

Dr. McDonough:
Welcome to VacciNation on ReachMD. I'm Dr. Brian McDonough, and joining me to discuss the importance of cultural awareness and understanding COVID-19 care is Dr. Lance Sloan. He's the Medical Director and Principal Investigator at the Texas Institute for Kidney and Endocrine Disorders in Lufkin, Texas. He's also a Clinical Assistant Professor at both the University of Texas Medical Branch in Galveston and the Sam Houston State University in Conroe, Texas. Dr. Sloan, welcome to the program.

Dr. Sloan:
Thank you.

Dr. McDonough:
So why don't we start with the big picture, Dr. Sloan. What did the COVID-19 pandemic reveal about the ongoing role of cultural awareness and understanding in healthcare delivery?

Dr. Sloan:
Well, I think we first need to define what cultural awareness is, because I think it probably means different things to different people. To me, it's the environment that we grew up with and that we live in. So everybody is different. Nobody's exactly the same. Obviously, somebody who lives in a different country or with a different religion has a different culture, or maybe even sex would be different. And so we need to kind of respect that and meet people where they are.

I think what happened during COVID was that we learned that we didn't create the foundation that we thought we had. There was a lot of mistrust and misinformation, and patients weren't always listening to what we had to say. And some of that may have just been from not communicating the way we should and showing respect and compassion for their views.

Dr. McDonough:
When we talk about cultural awareness and understanding, it's often centered on race and ethnicity. And while these are critical aspects, what broader dimensions should we also be thinking about?

Dr. Sloan:
Well, I think the key really, again, is respectfully communicating with our patients. We shouldn't shy away from discussing things that maybe                                                                                 

they have gotten misinformation about or are uncomfortable with. We have to be open to answering their questions, but again, we have to be respectful and trying to meet them where they are. Sometimes this may require more than one interaction with a patient, but we need to respect their views and listen.                                      

Dr. McDonough:
So applying this knowledge to practice, how can personalized intervention help reach patients in their own environment? And what are some standard strategies that we can use?

Dr. Sloan:
Well, obviously, communication sometimes can be a problem if somebody speaks a different language, so that can be a challenge. And there are different things that we have out there to help us. In my office, we speak the three main languages that people speak in the Western Hemisphere, but there are many people that come from other countries, and we obviously can't have interpreters for everybody. There are things that are available online or over the telephone to help, but we're all busy physicians, so sometimes having family members there is helpful and supportive. So I think we need to be, again, cognizant of that. Sometimes we actually have to go out in the community to educate and communicate with people so that they understand and we can answer their questions.

Dr. McDonough:
For those just joining us, this is VacciNation  on ReachMD. I'm Dr. Brian McDonough, and I'm speaking with Dr. Lance Sloan about how we can engage patients from all walks of life when delivering COVID-19 care.

So Dr. Sloan, if we dive deeper into some common challenges for a moment, what barriers to cultural awareness and understanding are we still overcoming? And how can we navigate them more effectively?

Dr. Sloan:
Well, I think we're still dealing with a lot of misinformation. And again, even if we have the tools to prevent or treat disease, if we don't educate our patients and basically answer their questions that they have so that they don't have fears, it doesn't matter what our tools are, they're not going to be effective because they're not going to take them. So I think we need to continue to create that foundation of trust and understanding, and, again, a lot of it has to do with communicating with respect and compassion to our patients.

Dr. McDonough:
I know one of the things we've done in our practice is we're starting to replace those family translators with trained medical interpreters. We even have an app which we can bring something in, but you're so right, if you're not speaking the language, there is that barrier, and you really have to work hard to break through, and that's really important.

And what long-term steps can we take to integrate cultural awareness and understanding into our healthcare systems and reduce disparities?

Dr. Sloan:
Well, I think it potentially starts with our training. We certainly could be, even back in medical school, spending time practicing how we talk to patients and interview them. We really have to continue to increase our foundation of trust out there, particularly with so much misinformation and people not understanding the science behind medicine. As I said earlier, if we don't communicate and have our patients trust us—which most of them do, our doctor-patient relationship is very sacred—without that, they're not going to do the treatments that would potentially help them save their lives, stay out of the hospital, feel better, and not get sick.                                                                                                                                                                        

Dr. McDonough:
Before we come to the end of our program, Dr. Sloan, do you have any final insights you'd like to talk about and share and leave with our audience?

Dr. Sloan:
Well, I think the main thing that I was trying to kind of get across again is, again, we just need to be very respectful of where the patient is and kind of meet them there. And we do this by showing compassion, listening, and not being judgmental, but at the same time not shying away from telling them what we think is best for them. I know that many physicians sometimes just decide they're not going to breach a particular subject because the patient may push back, but you still need to have that conversation. But then again, have it in a respectful, compassionate way, so that hopefully, over time—if not even on that first interaction—they may change their mind and want to do something that maybe would be helpful for them. And again, this sometimes spreads to family and community, but you have to start at the beginning, and that's creating that base of trust.

Dr. McDonough:
I think that thoughtful approach is so important in building relationships. And with those final thoughts in mind, I want to thank my guest, Dr. Lance Sloan, for joining me today to share his insights on how cultural awareness and understanding in COVID-19 can help us connect with patients and improve outcomes. Dr. Sloan, it was great having you on the program.

Dr. Sloan:
Thank you, Dr. McDonough.     

Announcer:
This episode of VacciNation was sponsored by Pfizer. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!