Intercultural communication competence in family medicine: lessons from the field.
OBJECTIVE
To describe the challenges for immigrant patients and their physicians and their skills in intercultural communication (ICC).


METHODS
We videotaped one clinical encounter for each of 24 psychologically distressed patients visiting their regular family physician. The physician and the patient, each separately, viewed the videotape of their clinical encounter and commented on important moments identified by the participant or the researchers.


RESULTS
Patients and/or physicians lacked knowledge of the effects of culture on the doctor-patient relationship and expressions of distress as well as the effects of immigrant-specific stress on health. Most subjects were motivated to have an interpersonal, rather than an intercultural encounter. Physicians and patients demonstrated the skills needed to achieve an interpersonal encounter. Some physicians and their patients achieved intercultural meetings as a result of their interpersonal interactions over a period of years.


CONCLUSIONS
Lack of formal training partly explains why most participants demonstrated an elementary level of ICC. In addition, Identity Management Theory and Co-cultural Theory explain some of the barriers to ICC.


CONCLUSIONS
Providing physicians with formal training in intercultural communication and empowerment training for patients is likely to improve the quality of care of immigrants.
Rosenberg
Ellen
E
McGill University, Department of Family Medicine and CLSC Côte des Neiges, 5700 Côte des Neiges, Montréal, Que., Canada H3T 2A8.
Richard
Claude
C
Lussier
Marie-Thérèse
MT
Abdool
Shelly N
SN
D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel / Q000208:ethnology; D001294:Attitude to Health / Q000208:ethnology; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D018864:Cultural Diversity; D004641:Emigration and Immigration; D005194:Family Practice / Q000193:education / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007697:Kinesics; D008297:Male; D009042:Motivation; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D011209:Power, Psychological; D011582:Psychological Theory; D036301:Qualitative Research; D011792:Quebec; D012111:Residence Characteristics; D012945:Social Values; D013240:Stereotyping; D014743:Videotape Recording