Improving communication between physicians and patients with a focus on cultural awareness is crucial to facilitate more effective medical care for people of Asian descent, according to researchers from the Georgetown University Medical Center.
Due to cultural beliefs held by many members of the Asian community, developing a mutual understanding on both sides of a patient-doctor relationship is essential, according to Dr. Judy Huei-yu Wang, an associate professor of population sciences at Lombardi who studies the impact of culture on cancer screening and survivorship experiences among Asian-Americans.
Wang is currently directing three studies about mammography and colon cancer screenings in Chinese-Americans, in which she is studying culturally appropriate responses and from which she drew insight into improved practices for physicians.
Wang highlighted cultural practices as a significant factor affecting the medical care Asian cancer patients receive.
“Many of them have cultural beliefs that affect communication between physicians and patients,” Wang said. “For example, they aren’t accustomed to preventive concepts like screening, and they may lack knowledge about their cancer risks. They often think that seeing a physician is only for when they are sick and need to be treated.”
Fatalistic views of cancer, a lack of trust in professional medical care and deference to authority are also integral components of cultural norms that impact the physician-patient relationship, according to Wang.
“It’s really about the communication with the physician,” Wang said. “Some physicians may not understand that Asians might be trying to respect the physician’s busy schedule by not raising additional questions or asking for further explanations. But the physicians could take that to mean the patients already understand all of the information.”
Wang and Dr. Aiwu Ruth He, a Lombardi oncologist who specializes in liver and stomach cancers, are using their research to navigate the difficulties of increasing both cancer screening and clinical trial enrollment rates among Asians.
The local D.C. population is more than 9 percent Asian, and that demographic is increasing.
However, according to a 2014 study Wang co-authored, the rates of cancer screening and clinical trial participation among Asian Americans remain low, despite other studies indicating cancer as the leading cause of death among the demographic group.
Encouraging Asian participation in clinical trials is essential not only to aiding individual patients, but also to contributing to the development of more effective treatments for the population group as a whole, according to He.
“We know that the U.S. is a melting pot,” He said. “Yet if you look at clinical trials, the majority of patients participating are Caucasian. So we might not be able to identify benefits or effectiveness of specific treatments to certain racial or ethnic groups. If Asian patients don’t participate in clinical trials, we don’t have that data, which otherwise could potentially help the whole community.”
According to both He and Wang, an emphasis on self-care in Asian communities, which typically involves taking a natural approach to health through a balanced diet, herbal medicine and regular exercise, is an important cultural aspect to consider when providing medical care.
In terms of other factors influencing the medical care of Asian patients, both researchers said that language barriers are not significant issues in themselves, but are rather rooted in cultural differences.
“You need to look at what we mean by language barriers,” He said. “Patients may understand the surface meaning of certain words, but may not understand their deeper implications, especially if they aren’t exposed to a certain part of history or culture that most people, if they had been raised here, would have had exposure to.”
Among other possible solutions, both researchers highlighted culturally sensitive communication and education as crucial aspects of a medical process that could enhance Asian patient care.
“The main thing is to educate patients using tools they view as acceptable,” Wang said. “For example, we use videos of breast cancer survivors’ testimonials that they can relate to, which triggers their participation in screening tests. We need to make information culturally understandable.”
Wang hoped that her research would contribute to improving overall health incomes among patients from varied cultural backgrounds.
“There are not many researchers who understand how culture can influence people’s behavior,” Wang said. “Patient care needs to take into account different cultural beliefs — only then can we truly reduce health disparities.”
Joyce Zheng (MSB ’18), a Chinese-American student from New Jersey, said that the research highlighted issues in medical care for Asian patients she had not initially considered.
“I think it’s interesting that this research has been able to link cultural beliefs and Asian medical care,” Zheng said. “Especially the point about an emphasis on self-care, that’s something I’ve personally experienced growing up in an Asian household. I’ve never really thought about medical care in cultural terms before.”