A reader asked me to comment on this article – Cultural competency now law in New Jersey

Physicians who want to obtain a medical license or be relicensed in New Jersey must take cultural competency training under a new law intended to help reduce health care disparities among racial and ethnic minorities.

Legislators and medical leaders say they believe New Jersey is the first state to pass a law requiring physicians to learn how to be culturally attuned to patients to be licensed to practice medicine.

But Arizona, California, Illinois and New York are considering similar bills that call for physicians and medical students to take courses to raise cultural awareness and sensitivity toward minority patients, according to the Federation of State Medical Boards.

Leaders in both medicine and licensure say that the measures signal a trend that states want to take greater steps to reduce health care disparities and ensure that physicians are more responsive to both cultural and language differences among their patients.

Wow – where to start. Cultural competency sounds so good. The name invokes a sense of wisdom. Most physicians try to understand their patients. Cultural competency gives the sense that we will better understand our patients needs.

Being Jewish, I often have heard Jewish patients give me positive attributes just because I understand the culture. I remember a patient who beamed because her urologist spoke to her in Yiddish! She was so happy that he could communicate in her native language.

So the idea of cultural competency is a good one. But we must always worry about what cultural competency courses would mean in practice.

If I were designing a course in Alabama, I would spend a lot of time on “red neck” culture, because if I do not understand this group, I will make mistakes. Will these courses include a section on rednecks?

How do we develop a curriculum that works for all physicians? Some physicians have exposure to many Latinos. But Mexican culture differs from South American culture which differs from Cuban culture. How do we balance all those issues?

How does one create a course that works equally well for all physician? Certainly Minnesota physicians have different cultural competency needs than Hawaiian physicians. Those in urban practice have different culture competency needs than rural physicians. We have a different culture in the South than in the West. How do we provide a course that really helps practice?

Training in a Southern urban environment, I learned much about inner city African-American culture. We (the residents) taught each other when we learned a new useful fact. Would a course have helped? Possibly, but I think I learned what I needed to know anyway.

So I cannot really support this idea, because the idea is too large. Cultural competency is desirable, but is it achievable. Physicians learn about the culture of their patients. We could provide courses for those who find a particular culture difficult to comprehend, but I do not think the New Jersey requirement is a good idea.