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In this MD Newsline exclusive interview with rheumatologist Dr. Maggie Cadet, we discuss how to provide culturally sensitive care and overcome language barriers.

MD Newsline:

How have you been able to implement culturally sensitive care in your practice? Do you believe doing so improves treatment adherence?

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Dr. Maggie Cadet:

“Absolutely. It’s important to make our patients feel comfortable. I have a large percentage of patients from minority backgrounds and who are Spanish-speaking. So, I make sure we have an interpreter there for them and a family member, too. Both serve to relate what I’m saying to the patient and make sure the patient understands the significance of diagnosis and treatment and the need to be aggressive with treatment to avoid disease complications.

In addition, for my patients that don’t speak English, I provide them with written material to help them take ownership of their healthcare. For example, the American College of Rheumatology website has patient education material in Spanish, and you can also look for materials in other languages.

Written material helps because it’s very overwhelming for patients to discuss all the therapeutic options in one visit. Patients get overwhelmed, and they may not want to start treatment right away. So, I always allow them to come back and ask questions when they’re ready.

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I also try to be cognizant of my patients’ cultural beliefs and how their beliefs might impact their decision-making. For example, I have patients who are Jehovah’s Witnesses, others who don’t want to take biologic medications because of their concerns regarding fertility, etc.

So, I check my implicit biases at the door and try to keep my patients’ cultural beliefs in mind, as well as any hesitancy they might have due to their mistrust of the medical profession.”


MD Newsline:

How do you deal with language barriers so that they don’t impede your ability to deliver quality care?

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Dr. Maggie Cadet:

“I like to make sure I have a trusted family member or friend come with my non-English speaking patients to their appointments. I do so to help my patients follow up and ask questions because sometimes my patients may not express all their beliefs and fears with me.

And that takes planning. Some practices have EMR systems with that capability, while others have to go through the patient roster and recognize which patients might need an interpreter. It’s critical to make sure we have interpretation services available before the patient comes in.

The other thing is getting patients to come back for a follow-up visit right away within 2 to 3 weeks. Providing my patients with medical interpretation services, the support of a loved one, and written material about their disease and treatment help to do just that.”


Responses have been condensed and lightly edited.