Lose your cultural blinders and expect better outcomes!

When a parent of Southeast Asian background refuses to meet your eyes during an examination of her child, warning bells go off. The parent is uncomfortable, has something to hide, is trying to protect something embarrassing or inappropriate . . . Not so!

Actually, this parent is trying to show respect for the physician by averting the eyes, explained Lori Taylor, MD, FAAP, assistant professor in pediatrics at the University of California, San Diego. The physician who insists on meeting the parent's eyes is actually sabotaging the exam and treatment process.

"As a member of the American culture, I equate eye contact with honesty or with paying attention" she told the AAP 2004 National Conference and Exhibition. "Southeast Asians would avert eye contact with me out of respect for my position as a physician. I made an effort to try to catch the eye of the parents, and they tried equally hard to avoid mine."

Expect the frequency and number of similar cultural misunderstandings to increase, Dr. Taylor warned. As long ago as 1990, more than 28 million US residents spoke a language other than English at home. Of that group, 45% had difficulty speaking English. More than one in 10 US residents is foreign born. By 2020, 40%of school-aged children will be a member of a minority. In some school districts in California and other multicultural states, student populations are already a mix of different minority groups.

"Because we have become such a multicultural society, it is our responsibility as pediatricians to develop the skills needed to work with others from different cultural backgrounds," added Lindia Willies-Jacobo, MD, FAAP, associate professor of pediatrics at UCSD. "There is no question that cultural sensitivity enhances the doctor-patient relationship."