USING LANGUAGE TO OVERCOME PATIENTS’ CULTURAL DIFFERENCES
Even though the human body is shared among all the nationalities of the world, the way we express symptoms and illnesses are very much connected to our culture and native language.
The language-culture barrier is especially important in the medical field where misinterpretation of symptoms by caregivers can lead to misdiagnosis and ultimately to mistreatment.
Language barriers are present in many countries where varied cultures live together. Japan is no exception and health professionals have stated the need of an established interpreter service for foreigners in Japanese healthcare system.
In the 1990’s, when the number of foreign workers started to rapidly increase, the death rate of non-Japanese residents recorded by medical institutions scored higher than Japanese residents. Although at the beginning this was influenced by foreigners’ health insurance related issues, in 2017, Takashi Sawada, a physician and director of the Minatomachi Medical Center in Yokohama, stated that the lack of language support for foreign residents in the healthcare system was the main reason. This was in contrast to the original idea of poor health of foreigners. In a survey of foreign residents conducted in February 2017, many said this as one of the main disadvantages of Japan’s healthcare system. It can be said that patients’ health might be compromised by a language gap.
In response to this problem, some non-profit organizations (NPO) were created and have been sending interpreters to support foreign residents in some communities. One example is a pioneering NPO based in Yokohama, that covers 12 foreign languages. In 2015, the group worked in 6,699 medical cases.
Nevertheless, the mortality gap remains even though health insurance coverage among foreigners has increased. The existing NPO’s are not sufficient to cover the demands across the country.
For Japanese medical doctors, learning English at any level, is a good start to increase cultural knowledge. This knowledge can help to empathize with foreign patients. Doctor-patient interaction and communication is vital for diagnosis. In the best case, informal vocabulary and the patient’s own culture should be understood to precisely explain procedures or treatments to patients. But even basic English knowledge can at least demonstrate a positive attitude from caregivers towards foreigners in outpatient consultation. This can help to build trust with foreign patients.
Here are some advantages of caregivers speaking English:
- Improving patients’ information sharing by showing empathy: Patients are individuals with ailments who seek not only relief but also a trustworthy professional. When they realize that the doctor is trying to communicate in a language they are familiar with, they are more likely to openly share their symptomatology.
- Overcome misdiagnosis by getting much more information about the symptoms; as previously mentioned, interpreters are still needed in most of the cases where patient and caregiver do not share the same language in order to reach a correct diagnosis. Nevertheless, if the caregiver has basic knowledge of the patient’s language, they might be able to think of possible diagnoses quicker and indicate the right tests, as well as requiring less interpreter`s assistance.
- Proper treatment and follow-up.
- Avoiding patients getting very sick: foreigners who feel misunderstood at the beginning of symptomatology would be hesitant to further consultation. Also, early interventions are critical to counter infectious diseases for example, which can spread to communities, not just individuals.
It is important to keep in mind that as advantageous as this might be, language itself might not be enough to understand what people are trying to express. To successfully communicate in other language, learners must develop “an awareness of and sensitivity toward the values and traditions of the people whose language is being studied” as Tucker and Lambert stated in their 1973 study Cognitive and attitudinal consequences of bilingual schooling. For example, a patient who is hysterically yelling while trying to express his/her symptoms may be regarded as someone in need of psychiatric help when, in fact, this reaction is considered normal behavior in his or her culture as Lynch and Medin mentioned in their 2016 article, Explanatory models of illness.
In addition to medical specialists, any other health professional involved in patient care should become sensitive to this issue, including nurses and medical researchers. An appropriate approach could be to teach the English language and more important cultural competence as part of the curriculum in health professionals’ formation.
1. Robert W. Putsch III and Marlie Joyce. Dealing with Patients
from Other Cultures. Clinical Methods: The History, Physical, and Laboratory Examinations.
(1990), 3rd edition. Chapter 229.
2. Yuri Kumagai. The Effects of Culture on Language Learning and
Ways of Communication: The Japanese Case. University of Massachusetts Amherst.
(1994), Master’s Capstone Projects, 80.
3. Lynch. E. & Medin, D. Explanatory models of illness: A
study of within-culture variation. Cogn Psychol. (2006), 53(4):285-309.
4. Liang Morita. Why Japan needs English. Cogent Social Sciences
(2017), 3: 1399783
5. Liang Morita. Language Difficulties in kyosei “living together” of Japanese and Foreigners. Studies in Asian Social Science (2016), Vol. 3, No. 1; 2016
Author: Jankie Bajoon M.D.
*Board Certified Doctor of Medicine in Venezuela
*Graduated from Romulo Gallegos National University
*Awarded an MEXT scholarship in 2016
*Completed a Master’s Degree in Human Health Science at Shinshu University in 2019, majoring in Anti-agin
Besides his medical experience, Dr. Bajoon has had a lifelong interest in nutrition and fitness. He has joined Creek & River’s team as a specialized English trainer with medical expertise.