Culturally competent practices can drive up good will -- and patient traffic

A column about keeping your practice in good health

By Karen Caffarinicovered practice management issues during 2008-09 and writes for us occasionally on the topic. Posted Aug. 15, 2011.

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With the U.S. population becoming increasingly racially and ethnically diverse, having a culturally competent medical practice not only is good medicine, it could be a good marketing strategy to boost patient volume and revenues.

Experts point to the sheer numbers of minorities as a reason for physicians to be more conscious of the impact they will have on their practices. U.S. Census Bureau's figures show that there were 50 million Hispanics living in the United States in 2010, a 43% increase since 2000. The minority population comprises 33% of U.S. residents 18 or older, but 46% of those 18 and younger.

Physicians can tap into this growing demographic by providing a medical practice where all patients feel comfortable and can receive quality care through such measures as having someone on staff who shares their color and background and understands their culture, experts say.

"In general, it is important to have not only physicians, but staff that mirror the makeup of the community," said Nick Fabrizio, partner with Medical Group Management Assn.'s Health Care Consulting Group. "When you have a person who shares their background or has cultural sensitivity or understands their culture, news spreads very quickly. When you walk the walk, the practice will market itself."

Experts say practices that are culturally competent provide quality care, and that's what drives business.

"If you have an accepting environment, the business result is increased market share," said obstetrician-gynecologist M. Natalie Achong, MD, director of health equity for the Connecticut State Medical Society and assistant clinical professor at Yale University School of Medicine. "I hear a lot of requests from people of color, for instance, who want to know where they can find a doctor who understands them."

A 2007 report by the Alliance of Community Health Plans Foundation found that practices that implemented one or more of the National Standards for Culturally and Linguistically Appropriate Services in Health Care had increased market share among insured patients with limited proficiency in spoken English.

In one instance cited in the report, the Young Children's Health Center in Albuquerque, N.M., created a program to address the communication needs of deaf children and their families. As a result, the center increased its insured members from five to 70.

Holy Cross Hospital in Silver Spring, Md., found that its deliveries increased from 7,300 to 9,300 annually after creating maternity suites with a substantial cultural competency component to meet the needs of a large population of Latinas.

Celia Szelwach, DBA, program manager for women's health at Atlas Research in Washington, said being a culturally competent practice is a good marketing strategy, because patients with increased satisfaction tend to have more regular visits and generate more revenue and word-of-mouth endorsement.

"Being culturally competent encourages patients to come back to the doctor and bring family members, too. Multicultural communities rely on word of mouth," she said.

Experts say physicians also can make their practices more attractive if they are aware of different customs. It is also an understanding of a variety of biases, including toward overweight people, religious groups and women. For Atlas Research, it also includes a bias toward rural populations.

Dr. Achong said there are disparities in health outcomes among people of color across the board, and a disconnect between doctor and patient is thought to be the reason.

"They don't believe their concerns are being heard," she said. "That could be why they're not taking their medications. This is an awareness. If they see a doctor that understands them, the results could improve."

Fabrizio said it is hard to market a practice as culturally competent. Instead, experts say marketing should reinforce the message that a practice understands the needs of different populations.

For example, Guadalupe Pacheco, senior health adviser at the U.S. Dept. of Health and Human Services' Office of Minority Health, said that if a practice has a staff photo in its literature or an ad that shows people with a variety of backgrounds, it indicates that the practice is receptive to its community.

Practice management advisers say marketing should be broad enough to include all members of the community the practice serves.

Another form of marketing cultural competency is something physicians have done for ages. Pacheco said some doctors do volunteer work in the neighborhood, which gets their names out.

Website and marketing materials should contain images that reflect the community and describe the practice's commitment to including others, according to Beyond Translation & Tolerance Cultural, Competence in Health Care Organizations, a project funded by the Healthcare Georgia Foundation.

The project advises health care practices to be "certain that marketing materials are offered in the language of the consumer whenever possible" and that they speak to the consumer about the core message of the organization. "Competent health promotion should show healthy images and contrast the images with unhealthy alternatives, but the contrast should be sensitive to the consumer's world view," the project stated.

Karen Caffarini covered practice management issues during 2008-09 and writes for us occasionally on the topic.

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External links

"Making the Business Case for Culturally and Linguistically Appropriate Services in Health Care: Case Studies from the Field," Alliance of Community Health Plans Foundation, 2007 (link)

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