This newsletter is made possible with the support of the American Diversity Group (ADG), based in Maryland. ADG is organized to bring together a diverse group of people to build and sustain a healthy community and enrich lives. Contact the ADG by visiting their website.
Being raised in either an Asian or Asian-American household, we tend to regard Doctor visits differently. Cultural aspects condition how we perceive doctors and how they perceive us. Incorrect assumptions, clichéd thought patterns, and limited ability on both sides to consider the others’ perspectives create unnecessary barriers in communication. These barriers, in turn, prevent the South-Asian patient from seeking a doctor’s care altogether, or even if they do, they come back with a sense that they just wasted their time and money sitting in the doctor’s office. Thanks to our cultural beliefs, these issues are amplified even further regarding mental health care. Our distinct cultural unwillingness to acknowledge mental health problems exaggerates these problems exponentially.
Doctors have a tool to prevent such cultural issues from creating problems and misunderstandings, but they hardly ever seem to use it. It remains a mystery to me why it is so. In all my visits with various therapists and psychiatrists, I don’t remember anyone taking the time to use this simple but highly effective tool.
It is called “The Explanatory Model.” Learning about it will help you, the potential patient, and maybe even the physician who may be reading this article.
The model is simple and it was created by Dr. Arthur Klineman specifically for cross-cultural medical interactions, and it focuses on the doctors using proper cultural perspectives when speaking with the patient about their illness or conditions. It has eight questions that the doctor should be asking you when they start treating you:
What do you call your problem? What name do you give it?
What do you think has caused it?
Why did it start when it did?
What does your sickness do to your body? How does it work inside you?
How severe is it? Will it get better soon, or take longer?
What do you fear most about your sickness?
What are the chief problems your sickness has caused you (personally, family, work, etc.)?
What kind of treatment do you think you should receive? What are the most important results you hope to obtain from the treatment?
Arthur Kleinman, an American psychiatrist, psychiatric anthropologist, and medical anthropology and cross-cultural psychiatry professor at Harvard University created this tool. He is a member of the National Academy of Medicine and the American Academy of Arts and Sciences.
Dear reader, the next time you have to see a doctor regarding a new illness or condition, print these eight questions out and take them with you. If the doctor forgets to ask any questions that resemble the eight listed above, give the printout to the doctor and have them pose these questions to you. They may look at you quizzically, but as soon as you tell them they need to listen to you on your terms and not treat you as a generic patient, they should understand. If they do not understand still, tell them that your responses to those questions will help them understand you as the patient, and also provide valuable insight into the illness or condition.
Tell the doctor that you wish to receive treatment as a human being - not as a carrier of symptoms!
If they still do not work with you, it may be time to look for a new doctor.