Episode 028: What Cultural Competency Really Means

You've practiced how to extract from a patient their chief complaint.  You've memorized lists (and lists and lists) of drugs, treatment modalities, and other interventions.  You've learned all the physical exam skills on the test, and you've got every organ system down pat.  You even remember the Kreb's cycle.

Now, your patient has walked into the exam room looking for help with her headache (although she turns out to have none), doesn't appreciate your blank stare when she says her soul is lost, and is very confused about why you're treating her clearly 'hot' illness with a 'hot' medicine.  Time for a psych consult?

Nope.  Time to delve into the patient's cultural beliefs about illness, treatment, and doctors, and reach some sort of understanding between you and your patient that allows for a good outcome.  That's what cultural psychiatrist Hendry Ton, the Medical Director of the Transcultural Wellness Center and Director of Education at UC Davis School of Medicine Center for Reducing Health Disparities, advised UI student Lisa Wehr to do when she encounters a patient whose beliefs just don't line up with those taught by Western medicine.

Recommended:
National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care

Listen to Episode 028: What Cultural Competency Really Means.

Episode 027 - A real life Dr. House: Gurpreet Dhaliwal

All our listeners are familiar with the archetype of the master diagnostician, probably best represented in pop culture by Dr. Greg House, the irascible, pill-popping doctor of the eponymous television series.  Every week, House put together the clues and discarded the red herrings to come up with a diagnosis that only he could have thought of.  It’s a great trick, and there are people out there who can really do it.  Some even do it for their peers, at grand rounds that are akin to displays of medical prestidigitation.

But it’s about more than tricks.  For instance, in April of this year, a Hopkins review of 25 years of malpractice claim payouts found that diagnostic errors—not surgical mistakes or medication errors—made up the largest fraction of claims, the greatest harm to patients, and the highest total payouts: almost $39 billion during that time.  All this despite the common practice of defensive testing, in which tens of billions are spent each year on unnecessary tests in the hope of protecting doctors from the possibility of lawsuits.

Our guest on this episode is Dr. Gurpreet Dhaliwal, Associate Professor of Clinical Medicine at the University of California San Francisco School of Medicine.  Among Dr. Dhaliwal’s professional interests are clinical reasoning, diagnosis and diagnostic errors, and how physicians can improve in those areas.  He is also much less angry, and students Eric Wilson, Dwiju Kumar, and Alison Pletch found him a lot more fun to talk to, than Greg House.

Listen to Episode 027 - A real life Dr. House: Gurpreet Dhaliwal.