To better understand the actual nuts and bolts of providing culturally effective medicine, I had the opportunity to spend some time talking to Dr. Phuc Pham, a Phoenix-based internist. Dr. Pham is well known in the local Vietnamese American community and serves a large percentage of Vietnamese patients. I was curious to ask him about the differences in serving this population as compared to Anglo patients. Here were some of his insights:
- Vietnamese patients defer to physician authority more so than Anglo patients.
- Vietnamese patients are generally less knowledgeable about health and medicine, though this is changing as they are able to access Vietnamese language TV and radio.
- Vietnamese patients can be fearful of Western medicines, and some prefer to try herbal remedies first. They may faithfully take two or three medicines but seem resistant to taking more than that.
- Not surprisingly, Vietnamese patients that have been seen by non-Vietnamese physicians find communication difficult and prefer a Vietnamese-speaking physician.
- Vietnamese patients occasionally seek care in their native country, but sometimes have diagnostic tests run again in the US because of concerns about quality of care.
- Traditional practices such as “coining” (placing hot coins on the skin to alleviate fever) are still used in Vietnamese households.
- Vietnamese patients are more likely to discontinue taking medications after completing the first bottle because they mistakenly believe that completing the bottle is a “cure” rather than an ongoing form of therapy.
Dr. Pham believes that medical schools should offer courses in “cultural medicine” to better prepare medical students to serve diverse populations. Mandatory rotations among culturally diverse populations (e.g., refugee communities) would also assist.
I want to thank Dr. Pham for sharing his time and insights. He has become a valued APCA volunteer and supporter.
-Doug Hirano, MPH, APCA Executive Director
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