A Cultural Compass for the Modern Optometrist

Multiple times over the course of a single day, we must adapt our approach to care for each individual patient. For some, these adjustments may involve refining treatment strategies for ocular conditions. However, a great clinician also takes a patient-centered approach to providing care by demonstrating cultural competency and navigating deeper conversations that improve overall care, foster patient trust, and promote lifelong loyalty to your clinic.

Beyond making the patient feel more comfortable, demonstrating cultural awareness and emotional intelligence can improve the effect of each interaction. It has been shown that such an approach leads to more patients investing in their own health and complying with follow-ups and medication.¹ Invested patients may even be more likely to consider your recommendations for purchasing frames, lenses, or treatments.

BUILD TRUST WITH YOUR PATIENTS

As primary eye care providers, we have a duty to instill a sense of trust in our patients as we introduce them to various facets of medicine, which reinforces the collaborative nature of our profession. Connecting with patients on a personal level by understanding their differences (eg, religious, cultural) can help you start to build a sense of trust early on in the patient-provider relationship.

Connecting with your patients on a deeper level does not require extensive note-taking at each interaction. Simple gestures, such as acknowledging religious holidays, sharing personal anecdotes, or inquiring about aspects of a patient’s culture, can go a long way in showing you pay attention and that the patient is more than just a set of eyes. Moreover, acknowledging the concerns of patients who express culturally diverse perspectives or reservations regarding treatment options can significantly transform the patient interaction by easing the tension around health care experiences.

The following are some example areas you may consider working on to strengthen your cultural competency when interacting with patients.

FAITH AND RELIGION

When engaging with individuals within a faith community, it’s essential to bear in mind that faith can affect a patient’s decision making, family dynamics, health practices, risk perception, and health care use.^2,3 Patients may feel cautious or guarded when visiting a practice outside their religious community, and small gestures can be instrumental in alleviating their concerns.

For example, when interacting with patients who wear a hijab or practice Islam, I may wish them a happy Eid or Ramadan during the respective seasons. Similarly, acknowledging Jewish patients with greetings for Hanukkah, Purim, or Passover when seeing them with a yarmulke can also be appreciated.

GRIEF AND LOSS

For patients who may be grieving a recent loss, prioritizing eye care may not be their immediate concern. In some cases, patients may break down in clinic when reminiscing about their loved ones. Although offering condolences such as, “I am sorry for your loss,” is appropriate, asking about their favorite memory of the deceased often brings a smile to their face, validating their emotions and leaving them feeling happier.

CULTURAL DIFFERENCES

Acknowledging the challenges international patients face within US culture can offer them comfort. Validating the stress associated with dealing with insurance and legal complexities upon moving to the United States can help alleviate the patient’s anxiety.

It can also be beneficial to express genuine interest by asking about the patient’s country of origin. Seizing this opportunity to learn about their home country and their reasons for being in the United States—whether they have family in the area or are alone—can establish rapport. Questions such as how frequently they visit home and their favorite and least favorite aspects of living in the United States can shift the dynamic positively. Engaging in these types of conversations not only makes the patient feel more at ease, but also provides insights for future referrals and anecdotes that might benefit other patients.

LGBTQIA+

Creating a safe environment for members of the LGBTQIA+ community to discuss family and medical history can be transformative. Including a place to list pronouns in your medical record documents shows respect for your patients’ gender identity and allows you and your staff to address patients appropriately. In addition, organizing frame displays by brand instead of gender promotes inclusivity, while also modernizing the patient experience, moving away from traditional gender-based distinctions in eye wear.

LITERACY BARRIERS

Considering literacy is crucial when dealing with any patient. This encompasses not only the question of general literacy, which may be a challenge, especially for patients of lower socioeconomic status, but also their comprehension of health care information and treatment plans. Assessing literacy levels can also be advantageous when encountering patients whose native language does not use the English alphabet.

MEDICAL AND FINANCIAL SENSITIVITY

When discussing complex medical details, I will often ask if a patient prefers me to explain this information while a family member or friend is on the phone with them. This approach has proven successful in making medical decisions and navigating through large amounts of information if the patient is overwhelmed.

Overcoming financial barriers in health care can pose challenges, even with commercial insurance coverage. When presenting treatment options to patients, I have found it beneficial to offer a range of choices. I frequently say, “Given that this is a chronic condition, there are numerous approaches to manage it. We can begin with conservative measures and OTC treatment, or more aggressive options, which may be longer-lasting but are more expensive. What kind of treatment option works best for you?” Allowing patients to navigate their own financial circumstances without judgment facilitates open and realistic conversations, helping to prevent the patient from shutting down.

EARN LOYALTY WITH EMPATHY

A multifaceted approach to patient care, encompassing both medical and cultural considerations, is crucial to ensuring personalized and compassionate health care. From acknowledging cultural nuances and showing emotional intelligence to navigating faith-based sensitivities and addressing financial barriers, the clinician’s role extends beyond medical expertise.

Building trust through fostering inclusivity for diverse communities and accommodating individual needs contributes to a patient-centered model of eye care. By recognizing the effects of cultural, emotional, and financial factors, eye care professionals can not only address immediate medical concerns, but also promote lasting patient loyalty and satisfaction.⁴ Ultimately, the synthesis of medical proficiency and cultural competence forms the foundation for comprehensive, holistic, patient-centered eye care.