Cultural differences in medical communication: A review of the literature

Abstract

Objective Culture and ethnicity have often been cited as barriers in establishing an effective and satisfying doctor–patient relationship. The aim of this paper is to gain more insight in intercultural medical communication difficulties by reviewing observational studies on intercultural doctor–patient communication. In addition, a research model for studying this topic in future research is proposed. Methods A literature review using online databases (Pubmed, Psychlit) was performed. Results Findings reveal major differences in doctor–patient communication as a consequence of patients’ ethnic backgrounds. Doctors behave less affectively when interacting with ethnic minority patients compared to White patients. Ethnic minority patients themselves are also less verbally expressive; they seem to be less assertive and affective during the medical encounter than White patients. Conclusion Most reviewed studies did not relate communication behaviour to possible antecedent culture-related variables, nor did they assess the effect of cultural variations in doctor–patient communication on outcomes, leaving us in the dark about reasons for and consequences of differences in intercultural medical communication. Five key predictors of culture-related communication problems are identified in the literature: (1) cultural differences in explanatory models of health and illness; (2) differences in cultural values; (3) cultural differences in patients’ preferences for doctor–patient relationships; (4) racism/perceptual biases; (5) linguistic barriers. It is concluded that by incorporating these variables into a research model future research on this topic can be enhanced, both from a theoretical and a methodological perspective. Practice implications Using a cultural sensitive approach in medical communication is recommended.