Posted by Suzanne Salimbene. As the population in the United States grows increasingly multicultural, the US patient population and healthcare workforce grows proportionately diverse. In order to deliver high-quality health care to people from a wide variety of cultures, healthcare workers must become both linguistically and culturally competent. In my textbook, What Language Does Your Patient Hurt In, Third Edition, culture is compared to an iceberg. Like an iceberg, the easily noticeable aspects of culture exist “above the surface”. However, much of one’s culture is not visible, lying “below the surface”. To become culturally competent, we need to look deeper than what is readily apparent—looking beyond physical features and appearance, manner of dress, native language and accent when speaking English, food preferences, and even neighborhoods of residence. We need to discover the deeper aspects of each person and look “below the surface”. Understanding a human being—even one who belongs to the same culture as you—requires that you explore what is less visible. Educating oneself in the beliefs, attitudes, perceptions, communication style, values and practices of various cultures (including one’s own) allows one to treat patients with respect as they define it, communicate more effectively with both patients and coworkers, and provide the best possible health care to patients from all cultural backgrounds. Here are some ways to improve your linguistic and cultural competence:

• Understand how cultural influences—including those of your own culture—affect a person’s beliefs and practices as well as his or her needs and expectations regarding health care.
• Follow federal, state, and healthcare facility accreditation standards, as well as laws regard­ing the appropriate care and treatment of culturally and linguistically diverse populations.
• Avoid stereotyping patients. Each person is unique, belongs to a number of subcultures, and may adhere to or reject components of the primary culture to which he belongs.
• Ask appropriate questions to help reveal each individual’s unique belief system and health­care needs.
• Better interpret and understand patient behavior based on the cultures, health beliefs, and health practices of the patient’s population group.
• Communicate and work more effectively with both patients and colleagues of any cultural, ethnic, or language group.

How do you promote positive communication and relationships with clients and colleagues who are culturally different from you?