The Locum Tenens Job — A Road to Cultural Competence

As anyone who has taken a locum tenens job in unfamiliar territory can tell you, point of care interactions can unfold in unforeseen ways. Patients present with a diverse set of expectations, beliefs, values and behaviors that require sensitivity if you wish to deliver high quality care. Though at one time the concept of culture was limited to ethnicity, today the term encompasses differing experiences and perspectives across all native backgrounds.  One must now consider myriad factors such as socioeconomic status, sexual orientation, disability and any other personal aspects that set the patient apart from the mainstream.

You are unlikely to be familiar with the nuances of every such community and the pursuit of such would take years – if possible, at all. Fortunately, true literacy is not about learning another language or becoming familiar with one demographic or community that differs from one’s own, but rather developing a set of affective and behavioral skills in concert with a deeper understanding of your own, sometimes surprising, biases. Though most medical education has now folded cross-cultural communication into the core curriculum, many health and human services professionals find the real-world application more difficult than they anticipated. If you’re ready to set your sails for distant lands or demographics, your locum agency can provide many locum tenens job opportunities to hone these essential skills.

Why is cultural competence important?

Culturally sensitive interactions lead to better outcomes for patients and practitioners alike. Studies show that increased sensitivity leads patients to follow through with treatment and seek medical care in the future. This simple difference bolsters patient safety and helps to ensure equal care for all. For healthcare facilities, benefits include lower costs and higher degrees of efficiency.

Embrace the challenge 

The best locum tenens company will do some groundwork to help prepare you for unfamiliar environments.  They will have formed a comprehensive picture of the patient population you will serve and give you some background on challenges and best practices for overcoming hurdles. But the best preparation may begin with your attitude towards the locum tenens job itself. Rather than giving in to anxieties and visions of the difficulties you may face, focus on the opportunity ahead to widen your horizons and gain a more nuanced understanding of others. Research indicates that this sort of attitude sets practitioners up for success, transforming resistance into curiosity which in turn leads to better affects when addressing patients interpersonally. This attitude adjustment is the first step in what is called “cultural humility.”

Practice cultural humility 

Cultural humility is not as simple as recognizing a deficit in one’s knowledge or understanding of others. According to health advocate Joy Fletcher, “cultural humility involves an ongoing process of self-exploration and self-critique combined with a willingness to learn from others.” Every sub-set of people has what’s known as implicit biases, those stereotypes or beliefs that stem from the endocentric nature of all cultures, the tendency to think of oneself and one’s social orbit as the baseline of “normal.” What you are able to discern of another culture on the surface is often seen through the lens of your own background and therefore skewed in unforeseen ways.

You must make a careful inventory of your assumptions and be ready to challenge them. Experts suggest that developing an ongoing mindfulness that you will, as a matter of course, approach a foreign group with bias is the first step to slowing down enough to avoid acting on them unknowingly. Many groups are hyper-aware of the erroneous assumptions of others and are quick to feel defensive and disengage when overtones of those stereotypes are detected. Instead of seeing your own experience as the point of reference, shift your paradigm to seeing yourself as part of the greater and diverse whole. When you run up against your own cultural conditioning and find it difficult to shake a belief, do some investigative work with the patient with whom you need to forge a connection. Asking questions in search of important differences can make all the difference in how you deliver care and in how successful any intervention truly is.

Communicate carefully

In any interaction with a patient, you’ll obviously need to assess the problem to arrive at a solution. Practicing cultural sensitivity means that you’ll begin this process with a conscious balance of both respect and curiosity. As you get to know your patient, practice active listening skills. Make eye contact and verify that the information you hear is what the patient is actually trying to convey by paraphrasing and fact-checking until you’re sure you fully understand. Again, be mindful that your implicit biases may be at play in your interpretation of even the most basic information.

Ask questions and fully engage as you develop a picture of the patient’s world. Guidelines offered by Tulane University’s School of Public Health suggest that you take time to learn about the patient’s unique perspective in all of the areas that may inform care. Seek the following information:

• How patients perceive symptoms and health conditions
• When and how patients seek care
• Patients’ expectations of care
• Patients’ preferences regarding procedures or treatments
• Patients’ willingness to follow doctor recommendations or treatment plans
• Who patients believe should participate in making healthcare decisions

Differences between practitioners and the communities they serve are inevitable. Even within a seemingly homogenous group, cultural diversity exists in terms of religion, sexuality, socioeconomic status and countless other aspects. Challenges and false perceptions are par for the course. Practitioners can excel by consistently challenging what they may at first believe to be a static or universal truth. Perceiving people as individuals with a unique perspective – and leveraging a sense of respect for the validity of that experience – will benefit patients and practitioners alike. Work with a locum agency to find your place, even if it’s somewhere you’ll feel out of place.