Multicultural Medicine

Multicultural medicine is the practice of medicine that incorporates the traditions and methods of different societies and groups. This type of medical practice also involves an understanding of and respect for the medical traditions and health care treatments from many cultures. Multicultural medicine comprises Western medicine, with its foundation in the scientific method, and Indigenous healing practices, with their base in natural remedies honed through experience and observation. This concept also includes Asian and Indian traditions such as acupuncture, herbal remedies, and Ayurveda (a lifestyle treatment focused on the body’s inner energies), which approach health problems and injuries from an entirely different perspective.

The integration and appreciation of these diverse worldviews and medical practices adds many avenues of care to traditional Western medicine while bringing the needs of people from diverse cultural backgrounds into partnership with their physicians as they explore treatment options from their cultural backgrounds. Many of these multicultural practices, long considered "alternative" in the Western world, treat and prevent a wide range of ailments through the use of herbal remedies or other practices that do not involve antibiotics or similar drugs.

Background

Medical treatments and healing ceremonies have always been integral parts of most cultures. For most of history, the materials available to indigenous peoples for healing were the natural resources in their local environment. Over time, indigenous peoples learned which remedies worked for fever, which for pain, which for curing injuries, and so on. The treatments they discovered and perfected were not based on testing in laboratories, but on the experience of generations of people who sought relief. These remedies, along with other cultural beliefs and practices such as religion, shaped the medical traditions of societies around the world. In many cases—such as the ancient practice of Ayurveda that arose in India—these traditions place an emphasis on establishing a harmonious balance between all aspects of a person’s body, mind, and spirit.

In contrast, modern Western medicine is based on the scientific process. Antibiotics, sterilization of instruments, and surgical procedures were studied and proven before they were put into place. The reliance on science brought many benefits, and is widely created with reducing mortality rates and other major advances in public health. However, it also led to the frequent dismissal of the practices of indigenous peoples and other cultures dependent upon the natural world. Some traditional practices did not fit with scientific findings, while others were simply ignored or assumed to have no real value, especially when connected to spiritual beliefs. However, as traditional practices were further studied through the lens of Western medicine, some were found to indeed be effective for a variety of purposes.

For example, East Asian medicine, and traditional Chinese medicine in particular, have long histories of remedies that were discovered before the advent of the scientific method. In many cases practices in these traditions revolve around the belief that the body must maintain a balance between the two forces of yin and yang. They were not tested through controlled laboratory studies but rather developed through a combination of observation and influence from other cultural elements. One result was the development of acupuncture, in which very thin needles are used to stimulate anatomical points in the body. While acupuncture was initially viewed with skepticism by many Western doctors, over time scientific studies showed evidence for many of the claims behind the practice. In 2012, for instance, the findings reported from a comprehensive study financed by the US National Institutes of Health verified that acupuncture may be effective for the treatment of chronic pain and a host of other ailments.

In the twenty-first century, there is a move toward blending Western and alternative medicine with a goal of greater health and quality of life for people of all cultures. This exchange of ideas is leading to hybrid practices in which remedies from more than one tradition are used in concert to effect a positive outcome. The overall result is an awareness that cultures dating back thousands of years have practices and beliefs that have stood the test of time and are worthy of investigation. Physicians are also able to cater to the often sensitive cultural needs of increasingly diverse populations when forming treatment plans.

Impact

As multicultural practices find their way into mainstream medicine, physicians have become aware of the benefits of these formerly "alternative" treatments. Techniques such as acupuncture have earned increasing prominence in Western health care as scientific evidence has supported their use. However, other traditions, such as Ayurveda, have seen somewhat greater resistance to widespread integration due to a lack of clear scientific support. Nevertheless, studies have suggested that using a blend of Western medicine as well as medicine from other traditions has resulted in better outcomes for patients than working in one tradition alone. The level of synthesis continues to vary from practice to practice. But even just increasing awareness and understanding of different cultural beliefs and attitudes toward medicine can help health care providers better support to patients.

Disparities in health care are an important consideration in multicultural medicine. The US Health Resources and Services Administration defines health disparity as "population-specific differences in the presence of disease, health outcomes, or access to care." In the United States, for example, minority populations experience incidences of many chronic diseases such as asthma at a higher rate than White populations. Hepatitis C, diabetes, and cardiovascular diseases are also more prevalent in the African American community. Such disparities are attributed to a variety of causes that include poverty, environmental factors, poor access to health care, and inadequate levels of education. A multicultural approach to medicine would take significant factors of the cultures of the affected groups and work to bring improved access to health care to those communities. It would also work to use health care and treatments that meet the societal norms and traditions as a starting point when working to make positive changes.

Health disparity is also a great concern in developing countries, where access to even the most rudimentary care is often limited. Procedures considered routine in developed nations—such as surgery for cleft lip and palate, prescription eyeglasses, or emergency medical care after a severe injury—may simply not be available. Patients must often make long treks to medical facilities that may not be equipped with electricity or running water. These conditions make even the most ordinary experience difficult and potentially fatal.

One of the most basic parts of a doctor-patient relationship is mutual respect and trust. The doctor must trust that the patient will follow instructions. The patient must trust that the doctor has their best interest in mind and respects what is important to them. By understanding and making use of the medical traditions of various ethnicities and societies, it is easier to establish such a relationship from the start. As a result, it is possible to create a baseline of good health. The practices of one group might involve massage for a sore wrist, while another might use acupuncture and still another might use an injection of steroids. The most important point is that each tradition is respected and given a chance to work before mandating a treatment that is unfamiliar or unacceptable to a patient from a cultural background other than that of the dominant culture.

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