Blog, Chirosecure Live Event July 25, 2021

Cultural Competence 101 for the Chiropractor Part 3 – Charmaine Herman

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Hello? This is Dr. Charmaine Herman again with Agave Upper Cervical Health Center for another episode or part of cultural competence, 1 0 1 for the chiropractor. Thank you for joining me again today. We’re going to go ahead and start talking about cultural competence again and just keep, we’ll keep adding to the knowledge that we gained before. So let’s go ahead and get started. I have a slide show ready for you. So again, this is part three. If you haven’t seen part two in part one, please go back and watch them. So let’s go ahead and move forward into part three. For those who don’t know me again, I’m Dr. Charmaine Herman. I am a native New Yorker originally from the islands. I currently teach at Life University and I practice in Alpharetta, Georgia. I’m an upper cervical specific doctor of chiropractic, and I have some training in cultural competence and I do cultural competence training at Life University. So I’m bringing this knowledge to you as well.

So our goals today are to define what cultural competence is. We’ve been talking about cultural competence last week. We had a discussion last time we had a discussion. We’ll talk a little bit more about what culture is, and then also get into defining what cultural competence is. In addition to that, we’re going to discuss how cultural competence is seen in healthcare or for us chiropractic care. What are some of the benefits of cultural competence? So let’s define cultural competence. Now, last time we discussed what culture actually is now, culture is the whole person. When your patients walk in the door, they are one mass of their culture. So there are foods that they eat, the clothes that they wear the hell, the holidays that they celebrate, the language that they speak. That’s part of who they are. That’s part of their culture. We, as doctors of chiropractic, we also have our own individual cultures, but culture is the whole person.

We talked last time also about the hidden aspects of color, such as how people define modesty or how people define space or how people define what’s time, whether time is quality or quantity. I know sometimes we couldn’t. We’re concerned about patients that don’t show up on time, but certain cultures see time as a quality and not a quantity, not how much time being there on time, but spending more quality time with family members and friends is more important than being at our offices at three o’clock on the dot. So there’s a challenge with seeing the different cultures and how they interpret time. This is the way how they determine model determined or interpret modesty or how they interpret their communication style. Some people are more of a boast. Some people are very silent in their communication. So all of us have our own distinct cultures and that’s what makes us individuals, and that’s what makes it so important that we, as doctors of chiropractic understand the cultures of our patient, because that also dictates their behavior and even their compliance to care.

So other people have talked about cultural competence, the CDC defines cultural competence as the integration and transformation of knowledge about individuals and groups of people in specific standards into specific standards, policies, practices, attitudes, use to use them, sorry, inappropriate cultural settings to increase the quality of services, thereby producing better outcomes. So the theories is talking about better outcomes. Once we can understand the importance of our patients and their culture to the entire care process. So that’s one thing. So let’s move on to the next definition of cultural competence. And this is from the office of minority health, um, also for the, his, the health and human services office. So it says a set of congruent behaviors, attitudes, and policies that come together in a system agency or among professionals too, that enable effective work in cross-cultural situations just by defining the whole word of competence.

Competence itself means that it implies the capability. I’m sorry that having the capacity to function effectively as an individual or an, and as an organization with the context of cultural beliefs, behaviors, and needs that are presented by the consumers and their communities. So we’re talking about cultural competence in the vein of service, how we serve our communities, how we serve our patients. So in healthcare, cultural competence is a, just a little bit different. When we talk about chiropractic care of a healthcare professionals, it is understanding the importance of social and cultural influences on patient’s health, beliefs, and behavior, considering how these factors interact at multiple levels with how we deliver our care to our patients. So understanding our patient’s cultures helps us to do better as far as delivering our services to our patients.

So there are a lot of benefits that have been documented for cultural competence as far as better patient outcomes. So doctors of chiropractic who understand their patient’s culture are able to work with them in the confines of their culture. So they understand that maybe that they’re more modest than their culture. So when I adjust, I’m going to make sure that they have more of a recovery of their, of their more modest in some cultures, if it’s a female patient of male doctor cannot adjust her. So you have a female chiropractor on staff to adjust those types of patients who have that cultural separation as far as how they can be adjusted. So we also see that get better outcomes. We also improve the health, um, health disparities into communities where you’re dealing with poor social economics, communities, health disparities are something that are very common, but by working with the patient, understanding their social economic issues, even in your pricing and how you see patients, and even in your conversation with them, by them coming to your office, you’re helping that entire community and you get better outcomes, improve patient centered care.

That’s something that we’re, we’re w we get a lot of great compliments that chiropractors have great patient-centered care because we talk more to our patients. We have more conversations with our patients, but they feel better about talking to us when we’re more in tune with who they are and their cultural needs and their cultural beliefs. So that’s also important, and we want to improve our patient satisfaction. And again, we do well in patient satisfaction, but being culturally competent will help us even do better by understanding again, their social and their cultural needs as they’re in our offices, the things that they need, even if, as a mother that needs someone to watch your children in order to come to your office, I’ve known some chiropractors to actually offer, um, help with finding daycare for their patients. So they can actually come in to many of them have the children come with them, but some people are afraid to bring their children, or they’re in a situation where they can’t bring their children.

So that’s where we see a lot of chiropractors now doing the mobile chiropractic, going to the patient’s home to actually take care of them and the rest of the family. So they don’t have to bring them out, especially with COVID and coming through a pandemic, many people are leery about leaving their homes. So just by changing certain things, understanding the culture that your patients, who they are and what they’re experiencing can help increase the benefits of chiropractic care as well. So let’s move on now, based upon our census for 2050, it is estimated that the United States population is going to change drastically. So many of our minority populations are actually being considered as emerging majority communities. For example, our Latino, Hispanic community is going to grow to 24% of the population African-Americans with beads at 12%. And even our Caucasian white population is going to decrease from over 50 to just about at 50, 51%.

So we’re looking at a lot of changes occurring in our, in our world and our society in the United States of America. That’s going to change the, um, the dynamics of our community. The demographics are going to change. So we’re going to see more people hopefully of color in our practices because we’re getting more numbers. They’re increasing. We want to get them into chiropractic care. That’s part of our chiropractic mission, bringing the world, taking chiropractic to the world. So everyone in our communities are part of that world. So as doctors of chiropractic, we have to think about that when we’re setting our strategies for seeing our communities, what do we do? How do we reach more people for chiropractic?

So cultural competence is not just a term used in chiropractic or used by the, by the CDC or the office of mint office of health, minority health. There’s so many other areas where cultural competence is not just a buzzword, but it’s actually being incorporated into policies and practices, even in places such as the police department in business. It’s a very big thing because with now that we’re zooming and doing all that other stuff we can do now in niche people across the seas and have a total global economy, cultural competence is a big part of that global economy, understanding how to work on the cross cultural boundaries, dealing with, and working with people from other cultures. So cultural competence is becoming more and more important again, as I said, in our first episode, when I was working for the department of health many years ago, cultural competence became important to reaching people who lived in the mountain areas who had challenges, who, who, who had a challenge because they were burning rubber.

And now the federal government told us they couldn’t burn rubber on their property. So that caused a lot of contention between the state agency and the citizens, because we didn’t understand their culture. We didn’t understand that they’d been there for hundreds of years and telling them that they now cannot burn rubber. Was this totally against all of their understanding as far as their, their home, their community, their property. So we had to retrain culturally to be cultural competent, so we can actually understand the communities that we were working with on a public safety, public health issue. So we want to make sure we were able to do that. So cultural competence again, is going to becoming more and more important as we look at not just healthcare, but even in our, um, our police academies. They’re talking about that in the military. They’re talking about that. So cultural competence is becoming more and more part of our society. So we, as chiropractors should also be prepared to be culturally competent as work when we work with our patients.

So when, okay, cultural competence, I’m going to get more into this topic in our next coming episodes, but I’m going to talk about how important cultural competence is in our policies. We, when we set up our policies in our offices, our, our manuals, our SOP, our training, how that should be an important part of our training. Um, and in addition to that, things such as our attitudes, as doctors of chiropractic, you know, we can take a negative attitude, say, well, why should I care? You know, all I care about is there a spine? Cause that’s what we’re talking about. Just adjusting the spine, that’s all we do. But remember that spine didn’t just roll in by itself. It was attached to a person. So actually understanding the cultures of the people that we work with and, and meeting their needs. Their cultural needs is very, a big part of being, um, culturally competent and to actually give better care to our patients.

In addition to that policies, attitudes, um, things that documents in our office can be changed to assist our, our communities suppose you’re working in the community where there are mostly, um, Hispanic individuals. Do you have any of your income in income in intake forms in Spanish? It’s great to have someone at the front desk that speaks Spanish, but what about your intake forms? Your documents can that, can they read that? Because just because a person speaks a different language doesn’t mean that they’re illiterate. Um, in most cases they can read their own language. So changing, having forms that are more, um, that are translated into the languages of the patients that you serve in your community, say if you’re in a German community or you serve a, an Asian community, how are your intake forms? Do they meet that? What about pictures in your office?

Do they show patients that they are wanted? They are a big part of your community that you want to serve them, their pictures, their pictures represented in your office. So those are the little things that can make your office a little bit more culturally competent as far as just changing a few things in your policies. So we’ll get more into cultural competence. And I plan to do that in our upcoming episodes, talking about how to become culturally competent. So I can talk about this all day, but what do I do? How do I get there? Um, and can I get just culturally competent, overnight, or there’s some steps that I need to take. So that’s what we’re going to do when we have our upcoming sessions are going to talk about how do I start to become culturally competent? What can I, as adoptive chiropractic do to become more culturally competent.

We’re also going to talk about issues such as understandings bias. We all have biases. Some are conscious, some are subconscious, but what are our biases? What are they, how do we identify them? How do we understand them? A big part of being culturally competent is understanding our own biases and being able to put those aside so we can work with people and be fair and, and our judgements and things like that when we’re working with people. So we talk about culturally competent, culturally competent. There’s so much more to that. I’m just giving you guys just the tip of the iceberg. So in upcoming episodes, we’re going to talk more about that. So again, the next episode, we’re going to talk about how to become culturally competent and also how to identify some of these biases, both subconscious and unconscious that we have even as doctors of chiropractic. So that’s all I have for today. It’s been always a pleasure to come and talk to you even just for a few minutes. Thank you so much for your time. Thank you so much for ChiroSecure for giving me time to talk about this important topic. You all have a great day. And again, this is Dr. Charmaine Herman. I look forward to talking to you again soon. Take care.