Importance of Cultural Safety in Medical Tourism
We all speak about the cultural heritage while promoting our countries as popular destinations ,but from a patient's perspective we should be well aware of cultural safety , as this is one of the most important aspects of medical tourism and in direct and indirect ways, can affect medical tourism business.
Cultural safety : The concept of Cultural safety was introduced by a nurse named Irihapeti Ramsden , a maori nurse. The concept became popular subsequent to deterioration of health care status of Maori community .The reason was under utilization of healthcare provided due to cultural difference. Though initially cultural safety was confined to nursing practices , over a period of time the concept has gained importance in other sectors also and has been given importance. The two aspects of cultural safety are like a double edged sword. and deviation creates loss to both provider and the healthcare seeker.
In this context the hospitals should be very careful about this aspect and take necessary action along with educating all healthcare workers. Medical Tourism consultants may like this while conceptualizing a framework and should stress on this.Patients should be educated to know their rights to demand .
In this regard a few questions arise
- Do you feel the providers are aware of cultural safety in developing countries ?
- Is there a need of incorporation of cultural safety in medical tourism and provider set ups ?
- Are the stake holders of Medical Tourism ( top to toe , and laterally) aware about the importance of medical tourism
- Are accredited hospitals vouching for the patient safety practicing cultural safety ?
- Is holistic healthcare provision important ?
- Would the practice of cultural safety bring any difference ?
- Should all the healthcare workers be trained in Cultural safety
Kind request to put your valuable inputs and critique.
Replies to This Discussion
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Permalink Reply by Mubbashir on -
Dear Mr Ashok Kumar,
Greetings from Kuala Lumpur.
Very well said. Please find my comments as below:
Do you feel the providers are aware of cultural safety in developing countries ?
No, I think, it is not easy to understand and build such a diverse knowledge base on this. But over all it is relatively
unattended and new to many. Though sometimes provider do know, bu they do not pay much attention.
Is there a need of incorporation of cultural safety in medical tourism and provider set ups ?
Yes, certainly it is very very important.
Are the stake holders of Medical Tourism ( top to toe , and laterally) aware about the importance of medical tourism?
Yes, stake holders are aware of this booming industry, its not just because it is called Medical Tourism, but it is the new dynamics of healthcare provision, and it is certainly growing rapidly, one can call it Medical Tourism, Health Tourism, Global Healthcare etc.
Are accredited hospitals vouching for the patient safety practicing cultural safety ?
Yes, some partially are doing this and they are trying to make it better.
Is holistic healthcare provision important ?
Yes, it has its own importance, without a doubt.
Would the practice of cultural safety bring any difference ?
Yes, it will bring a good change, better patient outcomes and certainly less frills in increasingly diverse, global healthcare phenomena.
Should all the healthcare workers be trained in Cultural safety?
Yes, if properly trained, there will be better results.
Kind request to put your valuable inputs and critique?
Yes, I have put, Thanks
Best wishes and regards,
Mubbashir
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Permalink Reply by Ashok Panda on -
Dear Dr.Mubbashir
Cultural safety is not easy to implement and as far as understanding all the cultural aspects is not easy, but there are some basic approach which is to involve patient and family in decision making and treatment planning which makes easier on part of the provider. This is a basic practice which has to be inculcated .. and preparedness to be flexible in multidisciplinary approach to provide culturally safe care is to be prevalent.In Medical Tourism this is easy to implement because , the medical tourism process is a revenue generating process for the hospitals, rather than in public hospitals which is mostly contributory aspect of a welfare government.
Ashok
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Permalink Reply by sunny sengar on -
This is a wonderful opinion. The things mentioned are unanimous and needs to be appreciated by everyone.
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Permalink Reply by Roberta E. Winter on -
Ashok has brought to light an important concern for medical tourism, which is patient safety. This includes more than clinical outcomes, but also other things like religious considerations, modesty, preference for male or female practitioners, and also social customs when dealing with strangers. For example, in paternalistic cultures it may be normal for men to conduct most business matters for women, but western women are used to directing their own affairs, especially in health care and their expectations may differ than those of women in the host country. A western patient is going to expect the physician to engage in a consultative nature, not a directive.
Holistic medicine I think is a separate topic and deserves its own discussion
Roberta Winter
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Permalink Reply by Ashok Panda on
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Thanks Roberta for your kind words. Cultural safety is a kind of legally accepted measure in Australia and widely practiced in the continent. however in late 90s has spread to other developed countries. Sometimes clinical outcomes and prognosis might interfere with the cultural safety aspect but considering the bigger picture there should be diligent approach in addressing the issues and keeping the whole process in line of mutual acceptance. As far as medical tourism is concerned , I don think this has been discussed earlier in this forum or anywhere else to create a voice for cultural safety and adoption in medical tourism practice.
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Permalink Reply by Quality Care Mexico on -
Hi Ashok,
I agree that this is a very important issue that most don't address. I think that sometime physicians forget that some cultures are more modest than others. One example..I am as an American use to going into a Dr's office and not being examined unless a female nurse is present. This is not usual practice in Mexico but I think it should be. In Mexico's defense though it's highly unusual for the Dr to sexually asault his Patients..It's almost unheard of here. It's in their normal Nature to be Kind, warm and understaning in this Country...
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Permalink Reply by Roberta E. Winter on
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I completely agree with this forthright sharing of an actual MT experience. Also, in some countries western women are automatically assumed to have low morals and can be treated with less respect than women from the host country. Though I was worried that my article may have been offensive, I can see that the concerns are shared. Bay Watch is still one of the most watched television programs in the world and I think we can emphatically state that it does not depict typical American women.
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Permalink Reply by Ashok Panda on
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Dear Roberta
Thanks for your views . On a broad prospective The Physicians are very professional when dealing with a medical tourist. ( I hope there is no obvious maltreatment is prevalent , or if there would be very rare and a matter of shame) However, Cultural safety is a much finer form of communication and dealing with patients and management.One example of cultural safety I would like to raise here, balanced positioning in a population following feng sui may be objected by any specific position. Sometimes racial discrimination due to color of skin of patient ( even little extra attention to patient might create strange feeling in the patient) There is a very finer line between adequacy and excessiveness . India's medical tourism key service areas are still maldives, SAARC countries and few African countries, ( though in vicinity , the cultures have some significant differences and practices. These need to be addressed very carefully.N.B. One problem with Indian hospitals is , the management feels they can do anything without involvement of any skilled person ( unknown reasons for consulting practice , though it has grown minimally in some discipline of hospital management ).
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Permalink Reply by Ross Taylor on
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Hi Ashok,
Very good post on connecting medical tourism with culture. The patients will feel very much in home when the hospitals give them a bit of their culture. But how difficult it is going to be for the personals in hospital to implement this?
Thanks,
Ross
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Permalink Reply by Roberta E. Winter on
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I think this is a very cogent reply, but for the millions of clinicians out there currently in practice, we just want to raise awareness a bit. Of course the medical schools need to do their part. When I was working on my Masters at the University of Washington School of Public Health, we did have a cultural component to the program and it was very stimulating. Seattle has always had a large immigrant population, including a large population of east Africans, including Somalians, who have very different cultural norms in terms of females.Most importantly, for the medical tourism consumers who are going to go overseas for treatment, they need to be empowered with information on what to look for and what to ask for in the process. Thanks for such a thorough response.
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Permalink Reply by Ashok Panda on
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Welcome Ainsley . I have been collecting articles on cultural safety online and did some research on this last three months ( limited to secondary data only ) , however I wish i could do some primary research in relation to medical tourism in coming days.
You are right, as you have worked as a nurse and also cultural safety evolved in your region , supported by government regulation, you understand the applicability of cultural safety. Cultural safety can not be limited by a definition , it is widespread and a picture bigger than just patient care but extends its circumference to continuous inclusion of new areas of humanity and holistic approach.
Absolutely., cultural safety needs to be an interdisciplinary approach and becomes easier with top management decision and participation.
I would like to discuss more with you in this regards.Please drop me a line if you would be interested.
Ashok
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