INTRODUCTION
Integral to the history of the United States, past and present, is the rich diversity of its inhabitants and the customs,
beliefs, and viewpoints that they bring to this nation. Beginning with the Native Americans who were joined by the British
in Jamestown, Pilgrims in Plymouth, Puritans in Boston, Quakers in Pennsylvania, and later blacks from the African continent,
and Latinos from the Caribbean and Mexico, America was and
still remains a melting pot. That is, people of different cultures,
ethnicities, and races have come together to not just coexist
but to also thrive. All of our inhabitants will require health care
and, at some point, will interact with health care providers. In
the United States, as diverse populations increase, it behooves
health care providers to become more sensitive to the unique
concerns of these inhabitants and identify how to best serve
these individuals. Understanding the tenants of cultural competence, which includes providing services that are respectful
of and responsive to the health beliefs, practices, and cultural
and linguistic needs of diverse patient populations, is critically important.1By becoming culturally competent, the health
care provider will achieve a combination of knowledge, clinical
skills, and behaviors that lead to positive outcomes for patient
care with these culturally diverse populations.
In the face of a health care delivery setting that increasingly pressures providers to see more patients and thus limits encounter
time, one must ask if it is important or even feasible to provide multi-culturally competent health care? In fact, we think that
through attempts to understand or acknowledge patients' cultural
beliefs and background, not only is better care provided, but in
many cases may result in easier, more seamless delivery.
What is the first step in providing cultural competent health care?
The physician or health care provider must begin by understanding his or her own multicultural identity. Careful consideration of
the following questions will serve to achieve this goal.
