Imagine this scenario: A patient is discharged from the hospital following surgery for a complex fracture and finds herself without prescriptions to treat the pain. She comes to her primary care practice looking for relief. The resident seeing the patient notices that the inpatient record used “drug-seeking” as the reason for her not receiving medication.
But the patient had no prior history of documented substance or prescription abuse; she is a Hispanic female and the victim of a hit-and-run accident. After the discrepancy between her record and reality is brought to the attention of an attending physician, the patient is put on an effective pain management regimen. At her next follow up appointment, her primary care physician finds that the patient is thriving and successfully tapering from treatment.
The patient ultimately thrived because the resident used cultural humility. The practice of cultural humility ensured she was being charted correctly and received proper treatment for her pain, despite the potential role of implicit bias in her original inpatient record. The literature suggests that the patient would be more likely to be perceived as drug-seeking when requesting pain relief, compared to her white counterpart.
It’s a growing area of emphasis at Penn Medicine and the Center for Health Equity Advancement (CHEA) describes cultural humility as the ongoing process of developing a set of skills to approach any individual from any culture at any time. Cultural humility focuses on lifelong learning, self-reflection, removing power differentials (such as provider and patient), and demonstrating equal respect for different beliefs and points of view. In other words, an individual’s knowledge of someone else’s culture will always be limited because they cannot walk in their shoes.
“The practice of cultural humility involves viewing every encounter, be it with a patient or colleague, as a negotiation between two worldviews—yours and theirs,” says Jaya Aysola, executive director of CHEA and an assistant dean of Inclusion and Diversity at the Perelman School of Medicine. “It’s about approaching each person with the understanding that everyone has a culture and background, which may need to be unpacked to reach a common understanding.”
This story is by Dinah Schuster. Read more at Penn Medicine News.
