Socio-cultural Awareness: 5 Common Cultural Treatment Practices
Published on May 6, 2015. Updated on Invalid date.
By David Waters
As a medical student who studied anthropology it is easy for me to apply my socio-cultural lens to the practice of medicine. Throughout my first year of clinical medicine, I have run across a number of examples of alternative practices and cultural healing. Although we are being trained in Western medicine, it is imperative for best practice that we understand our patient population and what else they may understand to be good for their bodies. If anything, the true meaning of applying a socio-cultural understanding to the field of medicine is to keep objectivity. Understanding where your patient is coming from will strengthen the doctor-patient bond, and will only improve your ability to help them in the tradition of medicine you practice. Many practitioners and students have already experienced cultural influences in medicine without even being aware. Below are a few different cultural concepts of medicine that are fairly common that you may encounter during your tenure as a physician, all of which I have encountered in just my first year of clinical rotations.
1) Hot vs. Cold Medicine
The body’s balance of hot and cold is an old practice found in different Latino and Asian populations. Its basic theory is that illness and disease states are caused by an imbalance of these two core temperatures.1 So to correct an imbalance, the person is typically submitted to whichever temperature they are thought to be lacking. This is typically done through different food based on their physical temperature and certain ingredient affects on a persons temperature. In Chinese medicine for example, cooling herbs have sour, bitter and salty tastes, while heating herbs have pungent and sweet tastes.1 Of course these vary by differing culture groups. The hospital where I have trained has populations from South East Asia and from Latin America who have both been allowed to bring their own food into the hospital for such healing purposes. I was part of the treatment team for a woman with peritonitis from Myanmar, whose families brought special foods and tea for her to eat along with the antibiotics and medicines we used to treat her.
Acupuncture is the practice of stimulating certain points in the skin using needles in conjunction with temperature, pressure and sometimes light. This is extremely common and one of the better known cultural practices known to physicians. The practice comes from Chinese medicine and is now applied to many different settings with much success. In fact, many studies have proven its benefits in post-operative settings and to aid in pain control.2 The U.S. military has even spent significant time investigating this method of treatment to aid soldiers in both pain relief and anti-anxiety.
3) Bloodless Protocols
Another fairly well known cultural concept of medicine is that of different groups not being able to accept blood products. Most commonly in Jehovah’s Witnesses who believe that they are not to accept blood products based on scripture. During one of my internal medicine services we had a patient who was suffering from an unidentified GI bleed and was becoming severely anemic, but could not accept a transfusion. Our team worked together to research bloodless protocols that many institutions across the country have created for such situations. These protocols involve storing the patients’ own blood prior to a surgery so if they need blood they can receive their own.3 They also include plans for hematopoietic stimulation using erythropoietin and iron infusions.3 It is important that if your patient is declining a transfusion to understand why. If they are amenable to certain bloodless protocols it is important to involve your Hematology/Oncology team to respect the patient’s wishes and set the patient and yourself up for the best outcome.
4) Ayurvedic Medicine
The ancient practice of medicine that began in India from the Hindu tradition is one of the most common ancient medicine practices still seen today. This falls in a group with other ancient types of medicine such as traditional Chinese medicine. While the traditions stem from different religions and cultures they are fairly similar in their actual practice. Most rely on traditional healers or medicine-men/women to administer different therapies to patients, whether it is food, spices, ointments, creams, teas, broths, etc.4 The range for these practices is vast, covering things from small cuts and abrasions to treating heart failure and COPD. These different practices are important to understand because many can greatly conflict with Western treatments. It is important to know what other medicines your patient is taking because many spices and plants interact with modern Western medicines. For example St. Johns wort stimulates enzymes in the liver causing it to interact with many medications including many antibiotics and Warfarin. Many of the substances used in ancient healing practices are not dangerous and a number have proven health benefits, such as ginger and honey, but it is important to counsel your patient on the potential effects of mixing multiple therapies together.
This is another fairly common practice that has been studied for its benefits in helping battle mental illness and anxiety. However, meditation and biofeedback is also often used for other health problems as well, especially pain disorders.5 Both practices focus on self-awareness and using the mind to better control the body. This improves control of mental state, which may help the patient overcome pain, anxiety, and other stress.5 Many patients practice this in conjunction with their Western medical therapies to help them combat disease as a whole. Meditation practices are very diverse and include yoga and Tai Chi, which once again can aid patients with self-awareness and balance. It is important to understand the different modes of healing patients explore and to support them.
This small set of examples just scrapes the surface of cultural medical practices encountered by practicing physicians. It is very important to truly be an advocate for your patient to understand things through their eyes. Remember to have an open mind and be objective to get your patients the best results!
1. Juckett, Gregory, M.D., M.P.H. "Cross-Cultural Medicine." American Family Physician 72.11 (2005): 2267-274.
2. Chon, Tony Y., MD, and Mark C. Lee, MD. "Acupuncture." Mayo Clinic Proceedings 88.10 (2013): 1141-146.
3. Brown, Nicole., RN, Matthews, Barbara, OCN,RN, and Patricia A. Ford MD. “Treatment of a Jehovah’s Witness using a transfusion-free autologous stem cell transplant protocol.” Community Oncology. 2.12 (2006): 776-781.
5. Paturel, Amy, M.S., M.P.H. "Meditation as Medicine." Neurology Now 8.4 (2012): 30-33.