Blog, Live Events May 22, 2021

Cultural Competence 101 for the Chiropractor Part 2

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Good afternoon. I’m Dr. Charmaine Herman and welcome to cultural competence. 101 for the chiropractor part two. We’re going to cover today, exactly what cultural competence is not as well as defining the term culture. So let’s go ahead and get on and move to the next side. Thank you so much ChiroSecure for allowing this program.

So we’ve been talking about cultural competence in our last episode. So as we move into the next part of part two on the next slide, we’re going to actually determine what we’re going to talk about today. So again, those of you who don’t know me again, I’m Dr. Charmaine Herman. I practice at Alpharetta Georgia. Agave Upper Cervical Health Center is the practice that I’ve been in now for almost 10 years. In addition to that, I teach at Life University. I am associate professor in the college of chiropractic in the clinical sciences division. So let’s see what our goals are for today. So on the next slide, our goals there to determine what cultural competence is not. What I found often is that when we start talking about training and talking about different topics, sometimes it’s easier to get rid of what things are not before we delve into what things actually are.

So some preconceived notions. Um, in addition to that, we’re going to actually define the word culture. What is culture? Why is it important? Um, why should I, as a chiropractor, be concerned about culture. When dealing with my patients, it’s not just a buzz word. It can actually affect how my relationship with my patient develops and help a lot with compliance to care. So let’s move on to the next slide. So again, our topic is what cultural competence is not, but also what it may include. So again, while eliminating certain things, we do want to know that some things can be part of our conversation. So cultural competence is not learning every culture in the world. I’ve heard people say that, how can you be culturally competent? Um, that means I have to learn the cultures of people in Asia and Europe and Africa. How can anyone learn all that information? Well, that’s not cultural competence. It’s not about learning everyone’s culture, cultural competence, narrows it down a little bit smaller than that, to a very simple aspect of what you need to know as a doctor of chiropractic. When working with people from various cultures, let’s move on to the next slide.


Cultural competence is not diversity. Training diversity training is important and is part of being culturally competent, understanding that we do have a very diverse community, a global community that we have to deal with even as doctors of chiropractic, not just in our communities, but also even outside of our communities, into the world, understanding how important the diversity is within our nation, within our world to think about it. If you had the same thoughts and everyone, you knew thought the exact same way, where’s the diversity in that? Where would be the inventions? What would be the ingenuity? There would be none of that because everyone would be exactly the same. So we ought to celebrate diversity and we, as doctors of chiropractic, definitely appreciate the diversity of our patients and what they bring to our practices. Okay, I’m the next slide? Cultural competence is not just being politically correct.

I mean, that’s a buzzword that a lot of people shy away from, but overall, when you’re dealing with people, not just in your communities, but outside of your communities, those who we want to reach as doctors of chiropractic being politically correct is helpful. We want to make sure we address people in terms that are not offensive to them, that we’re actually using words that people can understand and actually, um, agree with and attend and actually be an answer to. So whether you believe in and saying happy holidays or saying Merry Christmas, I mean, that’s all a person’s choice. So being politically correct means it’s accepting the person’s choice. If they want to say Merry Christmas or happy Hanukkah or happy holidays, then they’re being, that’s their personal opinion. That’s how they believe. That’s what they think. So being politically correct is just understanding that people do have the opportunity to express themselves in terminology that makes them feel more comfortable when addressing other people.

So being politically correct as part of also being culturally competent, it’s just a small piece. What is not the only piece now onto the next slide, we’ll see where cultural competence is not just sensitivity training. I like this slide because they use cats and I’ve never seen it before, until I was working on this presentation before, but it says, um, a black crap crossing the road that is bad luck, you know, and the person walking with this person happens to be a cat. So this person ends up in racial sensitivity training because that cat felt offended by them saying something about a black cat. It doesn’t matter whether the cat was black purple or green, or the fact is that they was still a cat. And the person said that that meant that they were bad luck. So sensitivity training also is not cultural competence training, but it is something that does come in play.

When we talk about being culturally competent, being sensitive to other people’s feelings and we’re working together. When we’re in a collaborative setting, when I’m working with a patient, I want to be sensitive to my patients feeling I don’t want to insult my patient. Um, when they’re sitting, laying on the table or what I’m scanning there, there’s fine. Or something like that. I want to say things that are actually going to be, um, commending and soothing and calming, but I don’t want to offend them. So being understanding that, um, sensitivity training is not culturally competence, what you should be sensitive to the feelings of those you work with and care for as a doctor of chiropractic. So let’s move on. So exactly what is cultural, the word is cultural competence. So I think it’s important to define both words separately in order to get a better understanding of the entire concept, where you’re dealing with cultural competence. So culture is defined. Let’s move on to the next slide as the way of life of a group of people, meaning the way they do things. You can also define culture as an integration and integrated pattern of human knowledge, belief, and behavior. Or we can also, um, define culture as the outlook attitudes, values, morals, goals, and customs shared by a society. That’s a lot of words. Every time I teach this class who said, boy, that’s a whole lot, but I put it this way on to the next slide.

Culture is the whole person. It’s what makes up every individual. My family was from Jamaica. So my Jamaican heritage is part of my culture, the foods I eat, um, the music I listened to, I grew up in New York. So the things I know about this country, um, where I live, I live in the South. So being Southern, everything that makes up the art, the music, the food, the clothing I wear, um, my faith, my belief, I’m a Christian. I mean my customs that I hold on to that my whole dear, all of this is my culture and everyone has their own culture. So a part of being cultural competent is understanding that everyone does have their own culture and the cultures that we espouse, we hold on to come so much from how we’re raised, where we grow up and the important things that our family has instilled in us.

So that’s what culture is. Culture is the whole person. As doctors of chiropractic, we talk about treating the whole person, looking at the nervous system, looking at the muscles, the how, the, how they respond, looking at all the different tracks and things like that. And assistant how everything works. So we look at the whole person we’re working with our patients. Culture is who that person is. Every person is their culture. So onto the next slide. So culture incorporates everything from a age, gender, identity, race, ethnic group, regional differences, social economic status, even education. I remember moving from New York to Alabama, where I went to undergrad and meeting people that were Southern. There’s a regional differences compared to the North and the South. And it was very interesting talking to students. I went to a historically black college, which was Tuskegee university. And I had a student tell me, well, you can’t be from New York.

Um, and again, this is a historically black college and I’m a stark, I’m a black individual. And she said, but you can’t be from New York because you’re not wearing, you don’t have gold teeth. You don’t have the earrings, the gold loops around your ears with your names. And I mean, this was back in the eighties when I went to undergrad. So it was amazing to me, the concepts of, and what people believed northerners looked like, especially black northerners at that time. And again, that’s based upon what the media showed them. And I actually said to her, I think you would watch a little too much TV, but people associate people based upon their culture and cultural corporates, their regional differences as well, as well as their education, which is very important, social economic status. So onto the next slide, please, for us as healthcare practitioners, um, chiropractic culture is very important.

When we think about how our patients actually see health and healing, if they’re raising a culture that believes that, um, healing is organic or whether healing is something done by traditional medical doctors or by, um, local, um, medicine, men, or healers in your community, that aspect of how they believe health and healing actually resides within each individual is part of their culture, their concepts of pain. There’s some cultures where showing pain, especially if you’re a man is not considered masculine. So how do they see pain as part of their culture? It also tells how people, what people believe as far as where chiropractic sits. Do they believe that chiropractors are actual doctors or because we don’t go to medical schools, we’re not doctors. All of that is part of a patient’s culture. And other people don’t even know what chiropractors are because their culture has never exposed them to that.

Growing up in New York, my father was in many car accidents and things like that. And he went to the doctor. It wasn’t until I graduated from chiropractic school that he actually told me he went to a chiropractor and I asked him, I said, when he said, every time I was in an accident, they sent me to a chiropractor. So at that time again, I did not know what a chiropractor was growing up in New York and the chiropractors he went to did not espouse for families to get under chiropractic care. It was only for the purpose of personal injury. So again, my exposure to chiropractic did not start until I actually started attending chiropractic school. So many people are, they grow up that way. They’d never met a chiropractor or they don’t know what chiropractors do. That is still part of their culture, their education, whether it’s the social economic status that they’ve not ever encountered a chiropractor or the no chiropractors in their communities that also shapes a person’s individual culture.

So culture does affect what we do as doctors of chiropractic, because it affects how our patients see us based upon how they were raised and the things that they were taught and the communities and homes that they grew up in. Let’s move on to the next slide. Now, there are many depths to culture. Culture can, again, like I said, be dressed food, language music, the gangs, people pay, play visual arts that they look at festivals that they attend, but there’s a depth that is invisible. And we’re looking at culture things such as, um, people’s notion of time, um, their personal beliefs, um, how they handle their emotions, um, that, uh, as well as how they feel about modesty. So even those lower depths of culture, for example, some cultures, people don’t are trained to not to look a person in the eye if they respect them.

So coming from another culture, you may take it as an insult of a person. Doesn’t look you in the eye because your culture says, look, every look that person in the eye, when you’re talking to them or another culture they’re taught out of respect, not to look people in the eye. So that’s a notion of concert as you can’t tell or see, but it is an invisible part of a person’s culture. Also, when you talk about communication styles, some people are very verbose and loud when they communicate, they’re a group of them get together and they’re excited and they’re having a great time where other cultures are more silent, more modest with their time with their, with their voices, very silent when they come together and you don’t even know they’re there. So even that notion of how people communicate as well as how people deal with time.

For me as a doctor of chiropractic, I try to be on time for all my patients. I don’t want them to have to wait, but there’s some cultures where quality of time is different from quantity of time. So a person who is in conversation with a relative at that time, when they should be in your office, that quality of time they’re taking with that relative discussing a situation is more important for them to be at your office at three o’clock precisely. So they may run a little late because that quality of time was more important than your quantity of wanting to be there at three o’clock. So I’ll get people’s notion of time is also part of their culture. So we, as doctors of chiropractic also should understand that our patients culture, each individual one has one. So we should try to understand that everyone does not think and believe the way we do.

So we should give some, um, some credence or just a little bit of understanding to incorporating a person’s culture. And we talk about our patients and the things that tend to occur when we’re in practice onto the next slide, please. Now, for example, people that look alike may not always have the same culture. Now I have a lot of Asian friends. I know a lot of Asian chiropractors people that I went to school with, um, people that I see, even my students that are Asian today, and because they’re Asian, I should not assume that their culture is the same, whether it’s from Seoul, Korea, or whether they’re from, um, Hong Kong or Taiwan, or many of the chiropractors that I know who grew up in the United States, I should never assume that because they look alike that their cultures are the same. And I think we tend to make that assumption too often when dealing with patients culture again is individual. And in most cases, if I’m not sure there’s something I really should do before I make an assumption onto the next


I should never assume when it comes to culture, it is better for me to respectfully ask. So just because someone looks the same, whether it’s they look like me or they look like another Asian person that I know, I should never assume that their culture is the same as the other Asian doctor. I know that maybe from Korea or that the PR was a doctor, I know this from Taiwan. I never should assume that a person’s culture is the same because they look the same, whether it’s their skin color, whether it’s just the way that they have resemblance, I should never make that assumption. You know what they used to say about when you assume so? I should never assume anything. When it comes down to culture, I should always just ask respectfully. So I understand that that person is not the same as the other person that I know who seems to be of the same culture, because I think they all look alike.

So that should, that’s a careful gap ground to tread upon. So it’s better to just ask and people appreciate when you ask. So when I look at culture, I have to defy the side who I am. So I do that a lot. So I always have my own cultural words. I’m a woman. I have certain agenda pronouns. I believe I am. She, I am her. Those are my gender pronouns. I’m black, I’m a wife. I’m a born again Christian. I’m a Jamerican is which I tell a lot of people cause I was born in Jamaica, but I grew up in the United States. So I have both of those cultures that I live with quite often, I tend to be urban. I am Southern. I’ve lived in the South more than 30 years of my life. I’m a chiropractor as a cultural bias itself, as well as being an educator or a teacher. So when I look at myself, I describe myself in my culture words, everyone has their own culture words. So I challenge you for this next few weeks until our next session to think about what your culture words are. So here’s your homework. Next slide.

So look in the mirror, look at yourself. Think about who you are, what are your culture words? How can you describe yourself? Those cultural words are important because if you understand who you are, your culture, it’s easier to respect and understand other people’s culture. And this is just the beginning of being culturally competent, knowing who you are, knowing your culture and understanding and respecting your culture, because you want people to respect who you are. So that’s the beginning of becoming culturally competent. Right? Next slide please. So that’s all that I have for today. Our next episode, we’ll actually define what cultural competence actually is. In addition to that, we’ll also talk about how cultural competence can be applied to healthcare. Again, we’re chiropractors. How can I use culturally competent cultural competence then? How can I become culturally competent? So that will be our next episode of cultural competence. One, one Oh one for the chiropractor. Thank you so much for your time, but a special thanks to ChiroSecure for allowing these programs and our, and hopefully have you join us next week. We will have another guest, I guess next week would be Dr. Chen Yen. Thank you again. And hopefully you’ll join for Dr. Yen next week. It’s been my pleasure. Have a great week.