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Introduction
In their article, Culture, Language, and the Doctor-Patient Relationship , published in the May 2002 issue of Family Medicine and Community Health Publication and Presentation, Warren J. Ferguson and Lucy M. Candib present several reasons on how to determine the differences between physicians and patients in race, ethnicity, and language influence the quality of the physician-patient relationship. They cite the evidence for ethnic and racial disparities in the quality of doctor-patient communication and the doctor-patient relationship that can improve the outcome measures as the main causes of the influence of cultural difference between physician and patients on communication effectiveness. Based on this evidence, Ferguson and
Candib concludes that interviewing physicians or doctors perceptions of and attitudes towards patients personal and psychosocial characteristics, behavior, and likely role demands. They studied whether these perceptions or attitudes were affected by patient race or socioeconomic status as independent variables.
Summary
Background
For the past decades, differences in health outcomes especially in ethnic minority and racial group have become clear evident. These differences have contributed especially in building relationship within the patient and the physician. Studies on doctor-patient communication have provided evidence that effective communication with each other can improve the outcome measures. While the study on patient-physician relationship have shown that the cultural differences has no relationship on building effective communication. Ultimately, this study document and evaluates the culture, language, and the doctor-patient relationship involved in medical decision making. The research problem is that there are patients who are Limited-English speaking and on strategies to overcome the language barrier by using bilingual physician or professional interpreters. The writing on the doctor-patient relationship has not tended to the impact of social contrast between doctors and patients on communication adequacy. The quality of the physician-patient relationship requires the capacity to communicate with the people who have restricted English capability. Wellbeing status, get to obstructions, and care fulfillment appeared that dialect of meet was a more critical variable than ethnicity.
Objectives
The objective of the study was to find a literature that provides evidence regarding the patient-physician in terms of race, ethnicity, and language that influence the relationship between
the patient and the physician. Based on the study, the research goal or the review’s objective was to decide how contrasts between doctors and patients in race, ethnicity, and dialect impact the quality of the physician-patient relationship or communication strategy. The objective was to discover the evidence around the contrasts in dialect, ethnicity, and race between doctors and patients influence the quality of their relationship and communication and to decide the result measures to substantiate an impact of the relationship between the specialist and client.
Conjointly to move forward making a contrast in wellbeing care and in result of care. The researchers goal was to answer the following questions in their study that were also related to the factors of different cultures.
Methods
Literature review was used as a method to find an evidence regarding the physician- patient communication and relationship. To easily find a related literature, researchers used a key words that are related to the topic and the researchers only limited the related articles from year 1966-2000. University of Massachusetts were used as a reference on database development.
Also, researchers included articles reporting investigator- initiated research and secondary data analyses with quantitative method however they excluded the opinion bases articles. Based from the study, the researchers used MEDLINE in order to perform a literature review. Their searchers were constrained to articles distributed in English. The analysts looked a database created at the College of Massachusetts that incorporates distributed articles on get to and wellbeing result obstructions. The articles gave a spoken or written account of investigator- initiated inquire about and secondary data analyses with quantitative methods that controlled for covariates. The researches did not use qualitative research methodology as their particular form of procedure for accomplishing or approaching the study.
Critical Analysis
The researchers successfully provide an evidence on the relationship between the physician and the patients. First of all, the study is effective since it speaks to the target audience, it shows that communication skills facilitate participatory in decision making with patients and the provision of culturally competent care. the study promotes having distinctive attributes of the admonition that majority physicians need to be more effective in developing relationships and their communication with ethnic and racial minority patients. The article shows minority patients, particularly those not capable in English, get adequate data, and be energized to take an interest in therapeutic choice making. In the end of the article, they checked on report incongruities with ethnically or language-discordant physician-patient communication. Secondly, the researchers proved the language-concordant relationship in which minority patients are more likely to choose minority physician for them to easily understand the information. In this case, the researchers provided an evidence in relation with their goal that is to determine the patient
and the physicians relationship. Lastly, the researchers were able to provide evidences that supports to their study, findings on related studies or articles that were definitely fit to answers their questions. The tables and explanations shown in their study were acceptable because they started from the factors that means what could be the barriers or lacking to the relationship between the physician and patient that was why they into strategies or possible solution for the better communication that will build better relationship too. Also, the information has clarity because they focused only to ethnicity, race, and language that will easy to lead to the goal of their study.
Benefits and Drawbacks
There are few pros and cons on the study. First of all, using literature review as a method was efficient. Aside from giving answers to the questions needed for the study, researchers did not need to find a place and participants to answer their questions. However, this kind of method has also a disadvantage in which researchers only limits their sources in literature. Sometimes, face to face interview with the participants could help and gibe the researchers more detailed answers. The researches limit their review only to ethnicity, race, and language. In addition, the significant number of studies conducted in emergency medicine settings and involving beginners that may not generalized to a larger population of patients in relationships with professionals.
Secondly, the discussion of Culture, Language, and the Doctor-Patient Relationship have not specified its extent of the area or subject matter that the topic deals with or their scope of this review and their participants and measures were also not included because they use secondary article for the reason that it translates and analyzes essential sources and also in order to archive that relates or examines data initially displayed. Additionally, they could not find studies using reliable qualitative methods from peer-reviewed journals. As a result of the broad scope of work published in books, an accurate source of medical anthropology, was not reviewed or analyzed. Thirdly, the study outcomes have relied on self-reported patient satisfaction, which have been shown to be less reliable across language differences. However, the physicians and the patients who have demonstrated significant achievement in the study of the doctor-patient relationship and communication must take up the consequence of diversifying their populations of study.
Finally, validity and reliability testing of the instrument were not reported or formally announced. This actively illustrate that both physicians and patients were most satisfied with professional interpreters. Patients, but not physicians, were satisfied with use of a family members or with use of a bilingual physician colleague.
Recommendations
To improve this study, a few modifications are required. Based on their discoveries of their writing audit, the researchers only gave 20-minute training have been demonstrated for the patients to be more assertive when obtaining medical care which is not enough due to the fact that there are a lot of patients who are still adjusting to the issue of encountering in racially, ethnically, and linguistically discordant physician-patient relationships. The researches was not fully prepared to do or deal with conducting the study due to the fact that they are still looking for recommended strategies for improving the relationship between the doctor and the patient. They stated that the literature on the doctor-patient relationship has not addressed the influence of cultural difference between physicians and patients on communication effectiveness. In choosing method in the study, it is also better to use measurement tools like surveys, interviews, or observations because in conducting own research would give convenience basis information rather than literature review, the researchers will only depend on the information in the articles that they found. There are more significant edits need to be made before the article can be accepted. The researchers need to be more emphasize on training physicians or doctors to deal with concordant experiences for underrepresented minority patients.
Conclusion
In conclusion, this study successfully achieved its goal to determine how differences between physicians and patients in race, ethnicity and language influence the quality of the physician-patient relationship. The study also provided a clear literature that served as an evidence for the factors. While the study provided a logical and convincing beginning to support the Doctor-Patient Relationship , using another method can also be beneficial and provide an effective support for further research. The article supports the conclusion that professional interpreters are more likely to bridge the gaps in access experienced by non-English-speaking patients, although at least one study demonstrated persistently poor communication skills on the part of the physicians using such interpreters.
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