Interaction in a Clinical Setting
Due to cultural differences, Hispanic patients will interact differently than American patients. Here are some of the cultural differences that are common among Hispanics which may affect interaction in a clinical setting. While these are common, not all Hispanic patients are the same, and they will have varying degrees of acculturation, which will affect their habits, customs, or cuture. It is a good idea to observe the patient's actions before assuming what practices they maintain and what values they hold.
La familia/The Family
La familia is very important in the life of a Hispanic person. Because of the interdependence of persons within la familia, family members often accompany the patient to the doctor’s office. These family members will want to be involved in conversation regarding the patient’s health, and a respected family member may respond to the healthcare provider’s questions in the place of the patient. La familia will play a key role in the patient’s compliance with treatment, so it is important to include family members in discussion about the patient’s illness and treatment options, making sure that the family members understand directions about treatment as much as the patient.
Respeto/Respect
If patients do not feel respected, they may terminate treatment.
Show respect by:
1. Maintaining eye contact with the patient.
Hispanics show respect by avoiding eye contact with authority figures; however, in this circumstance the healthcare provider
should still look at the patient, especially when using an interpreter.
2. Speaking some Spanish
If the provider does not know Spanish, it is important to show respect for the language by greeting patients in Spanish or
addressing men as “señor” or women as “señora.”
3. Asking indirect questions about personal matters, if possible
It is considered disrespectful to directly ask questions about personal matters such as alcoholism, mental health, and sexual
practices. If the provider needs this type of information, he or she must ask indirect questions.
4. Encouraging questions
In Hispanic culture, it is impolite to disagree or express concerns about treatment. In a survey on health, about 1/3 of
Hispanics report failing to follow the doctor’s advice because they disagreed with it (2). Therefore, in order to ensure
a patient’s compliance with treatment, the provider must encourage the asking of questions.
Show respect by:
1. Maintaining eye contact with the patient.
Hispanics show respect by avoiding eye contact with authority figures; however, in this circumstance the healthcare provider
should still look at the patient, especially when using an interpreter.
2. Speaking some Spanish
If the provider does not know Spanish, it is important to show respect for the language by greeting patients in Spanish or
addressing men as “señor” or women as “señora.”
3. Asking indirect questions about personal matters, if possible
It is considered disrespectful to directly ask questions about personal matters such as alcoholism, mental health, and sexual
practices. If the provider needs this type of information, he or she must ask indirect questions.
4. Encouraging questions
In Hispanic culture, it is impolite to disagree or express concerns about treatment. In a survey on health, about 1/3 of
Hispanics report failing to follow the doctor’s advice because they disagreed with it (2). Therefore, in order to ensure
a patient’s compliance with treatment, the provider must encourage the asking of questions.
Personalismo/Personalism
Personalismo, or the development of a personal relationship, is key in health care provider-patient interaction because it establishes trust.
Ways to develop personalismo:
1. Shake the patient's hand and family members' hands while greeting them
Because personal contact occurs much more frequently in Hispanic culture, a hand shake will help the patient and his or her
family members to feel more comfortable when entering the exam room.
2. Talk with the patient about family members
Because the family is so important, speaking with the patient about family members can help him or her feel
more comfortable.
3. Take notes about the patient's family or interests
Taking notes about the patient's family or interests and putting it in their file will help the next health care provider to interact
with the patient on a personal level.
4. Sit or stand closer to the patient
Hispanics have much smaller spaces between one another when they speak. Health care providers that stand the standard
distance from a Hispanic patient may be perceived as detached. Sit or stand closer to Hispanic patients or lean forward when
talking with him or her in order to display interest in the patient’s wellbeing.
5. Ask the patient if they are taking vitamins
Asking the patient if they are taking vitamins will be interpreted as an interest in keeping them healthy, and this will inspire
confidence in the health care provider (3).
Ways to develop personalismo:
1. Shake the patient's hand and family members' hands while greeting them
Because personal contact occurs much more frequently in Hispanic culture, a hand shake will help the patient and his or her
family members to feel more comfortable when entering the exam room.
2. Talk with the patient about family members
Because the family is so important, speaking with the patient about family members can help him or her feel
more comfortable.
3. Take notes about the patient's family or interests
Taking notes about the patient's family or interests and putting it in their file will help the next health care provider to interact
with the patient on a personal level.
4. Sit or stand closer to the patient
Hispanics have much smaller spaces between one another when they speak. Health care providers that stand the standard
distance from a Hispanic patient may be perceived as detached. Sit or stand closer to Hispanic patients or lean forward when
talking with him or her in order to display interest in the patient’s wellbeing.
5. Ask the patient if they are taking vitamins
Asking the patient if they are taking vitamins will be interpreted as an interest in keeping them healthy, and this will inspire
confidence in the health care provider (3).
Sources:
1. National Alliance for Hispanic Health. "Getting to Know the Culture." Quality Health Services for Hispanics: The Cultural Competency Component. Ed. Deborah Guadalupe Duran, Guadalupe Pacheco, and Leonard G. Epstein. 2001. 27-38.
2. Collins, Karen S., Dora L. Hughes, Michelle M. Doty, Brett L. Ives, Jennifer N. Edwards, and Katie Tenney. Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans. Rep. The Commonwealth Fund,
Mar. 2002. Web. 27 Mar. 2012.
3. Chong, Nilda. The Latino Patient: A Cultural Guide for Health Care Providers. Yarmouth, ME: Intercultural, 2002. Print.
1. National Alliance for Hispanic Health. "Getting to Know the Culture." Quality Health Services for Hispanics: The Cultural Competency Component. Ed. Deborah Guadalupe Duran, Guadalupe Pacheco, and Leonard G. Epstein. 2001. 27-38.
2. Collins, Karen S., Dora L. Hughes, Michelle M. Doty, Brett L. Ives, Jennifer N. Edwards, and Katie Tenney. Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans. Rep. The Commonwealth Fund,
Mar. 2002. Web. 27 Mar. 2012.
3. Chong, Nilda. The Latino Patient: A Cultural Guide for Health Care Providers. Yarmouth, ME: Intercultural, 2002. Print.