Culture counts has long been a rallying cry among health advocates and policymakers concerned with racial disparities in health care. A generation ago, the women s health movement led to a host of changes that also benefitted racial minorities, including more culturally aware medical staff. Many health professionals would now agree that cultural competence is important in clinical settings, but in what ways? Shattering Culture provides an insightful view of medicine and psychiatry as they are practiced in today s culturally diverse clinical settings.Shattering Culture shows the human face of health care in America. Building on over a decade of research led by Mary-Jo Good, the book delves into the cultural backgrounds of patients and their health care providers, as well as the institutional cultures of clinical settings, to illuminate how these many cultures interact and shape the quality of patient care. Co-editor Sarah Willen explores the controversial practice of matching doctors and patients based on shared race, ethnicity, or language and finds a spectrum of arguments challenging its usefulness, including patients who fear being judged negatively by providers from their own culture. Seth Hannah introduces the concept of cultural environments of hyperdiversity describing complex cultural identities. Antonio Bullon demonstrates how regulations meant to standardize the caregiving process such as the use of templates and check boxes instead of narrative notes have steadily limited clinician flexibility, autonomy, and the time they can dedicate to caring for patients. Elizabeth Carpenter-Song looks at positive doctor-patient relationships in mental health care settings and finds that the greates successes in relationships are based on mutual recognition patients who can express their concerns and clinicians who validate them. In this book s final essay, Hannah, Good, and Lawrence Park show how navigating the maze of insurance regulations, financial arrangements, and paperwork compromises the effectiveness of mental health professionals seeking to provide quality care to minority and poor patients.
Few opportunities exist to enter the world of medical and mental health clinics and see how diversity on one hand and bureaucratic regulations on the other are influencing patient care. Shattering Culture provides a rare look at the day-to-day experiences of psychiatrists and other clinicians and offers multiple perspectives on what culture means to doctors, staff, and patients and how it shapes the practice of medicine and psychiatry.
