The Prescribed Flight: The Need for Cultural Competency

I cannot exactly remember when my passion of looking at health issues from an intersectional lens or from a cultural competency perspective started, but one thing is for sure, it all started because of my personal experiences with the healthcare system, both as a professional and recipient of services.

Guess that is why somebody said that experience is the best teacher.  

One of my first experiences was at a medical appointment which I remember vividly.  It’s at that appointment that I realized that the doctor and I were looking at the same issue but with different lenses.  As a new immigrant, there was a lot going on trying to settle in and navigate a new country; go to school, work full-time, and as a young teenager trying to keep up with a full-time social calendar. I was on go-mode 24 hours a day and after having deep discussions with my doctor, she drew out a conclusion that I was homesick and needed to take a break. Her prescription was for me to take a flight back home where my social support system was.  In her words, “just take a plane and go home”. Let’s just stay by the time I was leaving her office I had decided to look for another “competent doctor”.

After that encounter, I  was on a new quest to find a professional who was not only qualified with a medical degree but one who looked at issues from a biopsychosocial perspective.  I was lucky to find a doctor miles away who understood the intersections that impacted the life of an immigrant. I worked with this doctor for so many years and had a great doctor-patient relationship. For instance, one time I was required to take a TB skin test as part of a job requirement and this doctor was conversant with different immigrant populations. She understood that for most African immigrants who had received the BCG test (a vaccine used to prevent tuberculosis during childhood), the skin test results would probably come back positive which could be alarming to most medical professionals.  So from her experience, she would always educate her patients and would straight away request a chest x-ray for these specific populations which would save her patients’ time and resources.  

Years after working with that doctor, I had another doctor who was also well versed in working with immigrant populations.  In this specific situation, a family member had been diagnosed with Kidney failure back in Kenya and the next steps were to think of a kidney transplant.  I am not going to lie but I felt anxious but also needed more information about the process.  I went to my new doctor with a lot of questions about being a donor.  This doctor listened and luckily didn’t offer me a prescription of “take a plane” but spent time educating me about the process of a kidney transplant.  For the questions that she didn’t have an answer to,  she referred me to a Subject Matter Expert for further support and education.  This was all relevant information in order to make a well-informed decision.  I will forever be grateful for this doctor because of her support and knowledge, my anxiety level decreased from 100 to 1 within a very short time.  

So what were some of the intersections that this doctor was aware of about her patient? That I was an immigrant, was anxious about the situation, importance of family dynamics and the environment,  financial expectation with such a process, cultural values, she had a good understanding of her patient’s social context among many others.

So anytime I look for a medical professional I not only look for the educational and professional background but also for a professional who is well versed with the different intersections that impact me as an individual.  While I am not saying it is easy to find the “perfect doctor” it does help to get a health professional who has an understanding of intersectionality and cultural competency as it provides a “customized treatment plan” which has better health outcomes. Investing in your own research and being your own health advocate as a patient is vital for your health. Be proactive in it.  

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