Culture and health care: What urologists should know

Very few urologists have a culturally homogenous practice in which all of our patients have the same ethnic, cultural, and religious backgrounds. Most of us have patients who come from many different backgrounds, speak different languages, and have different attitudes toward Western medicine.

Whether you practice in Chicago or rural Utah, you are likely to encounter patients of Hispanic, Muslim, Jewish, Native American, or Asian cultures. As a result, we need to know a minimum amount of information about our patients' cultural backgrounds and habits and their ability to understand and comply with our treatments and recommendations. The Joint Commission on Accreditation of Health Care Organizations points out that awareness of a patient's culture is a key factor in the safety and quality of patient care.

Hispanics and Latinos

Dependent elders often will live with their children and are cared for emotionally and financially. In most Hispanic cultures, families will make every effort to provide financial support to keep their elderly relatives at home, rather than place them in a nursing home facility. Placement in a nursing home or extended-care facilities may be seen as inconsiderate and disrespectful to the elderly, and children may even feel guilty about such placements. Therefore, when caring for an elderly Hispanic patient, recognize this cultural attitude and make every effort to avoid recommending extended-care placement.

For an excellent overview of the Latino culture and health care issues, see http://www.health.ri.gov/chic/minority/lat_cul.php.

Muslims

During Ramadan (usually mid-October to mid-November), Muslim patients may not take medications, eat, or drink from sunrise to sunset. Thus, you may need to adjust the timing of medications to early morning or evening or impress upon patients the importance of taking the drugs during the day in order to help their particular problem. If at all possible, doctors should respect this dietary restriction and work with patients to adapt their treatment plans with their fasting schedule. A similar dietary practice may also apply to Hindus, who may fast on different days, limit their eating entirely, or to just one meal daily.