In 1990, the share of the American population with white ethnic European roots stood at 75 percent. By the year 2020, however, this percentage will likely fall to around 53 percent, with Blacks, Hispanics, Asians, and American Indians showing a higher population growth. The U.S. Hispanic and Asian population will triple over the next quarter century, and the Black population will double. These growing groups expect health care that is in sync with cultural traditions. This will place greater demands on physicians to deal effectively with patients outside their own cultural scope.
Many physicians are simply unaware of their patients' diverse cultural needs.
The opportunities for culture collisions are particularly common in health care, notes Andrews, who has collected many examples. Even seemingly innocuous moves can carry a negative message. To sit with the soles of one's feet showing is thought insulting in some Asian cultures, and in many lands stuffing one's hands in one's pockets while speaking sends the message that you find your listener boring and inconsequential. On a larger scale, Andrews finds that western physicians, with a proven scientific, rational approach to health care, tend to be impatient with the more holistic philosophies of other cultures. She notes that the western view of health care is based on several key beliefs.