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 is adding 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 indigenous peoples, the materials available for healing were the plants and animals in their environment. Over time, these peoples learned which remedies worked for fever, which for pain, and which for curing injuries. The treatments they discovered and perfected were not based on testing in laboratories, but they were tested on generations of people who sought relief. These remedies, along with cultural beliefs and practices, shaped the medical tradition of these groups.
Asian medicine, and traditional Chinese medicine in particular, also have long histories of remedies that were discovered before the advent of the scientific method and that revolve around the belief that the body must maintain a balance between the two forces of yin and yang. They also were not tested through controlled laboratory studies. Practice led to the development of acupuncture, in which very thin solid metal needles are used to stimulate anatomical points in the body. In 2012, the findings reported from a comprehensive study financed by the National Institutes of Health verified that acupuncture may be effective for the treatment of chronic pain and a host of other ailments.
In India, Ayurveda—a whole-body system that strives to establish a harmonious balance between all aspects of a person’s body, mind, and spirit —has been a system of medicine for several thousand years. While scientific study has not yet proven the effectiveness of this system, as of 2014, the American Cancer Society reported an increased interest in incorporating certain aspects into contemporary medical practice.
Western medicine has its roots in the scientific process. Antibiotics, sterilization of instruments, and surgical procedures were studied and proven before they were put into place. With a reliance on science, the practices of indigenous peoples and other cultures dependent upon the natural world were dismissed at first. As these other practices were discovered by Western medicine, they were found to be effective for a variety of purposes.
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. Bringing them into their practices and 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. There is still work to be done in integrating acupuncture or Ayurveda into a traditional medical practice. In the time it takes to reach a true synthesis of medical traditions, there will be disparities in the care received by people of different cultures and circumstances.
Health disparity is something to consider regarding 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, minority populations experience incidences of 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.
These 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 nonexistent. Procedures considered routine in developed nations—such as surgery for cleft lip and palate, prescription eyeglasses, or emergency medical care after a severe injury—are simply not available. Patients must typically make long treks to medical facilities that are often not 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 his or her best interest in mind and respects what is important to him or her. 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.
Bibliography
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Drench, Meredith E., et al. Psychosocial Aspects of Health Care. 3rd ed. Upper Saddle River: Pearson, 2012. Print.
Gurung, Regan A. R., ed. Multicultural Approaches to Health and Wellness in America. 2 vols. Santa Barbara: Praeger, 2014. Print.
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Lyttleton, Jane. The Treatment of Infertility with Chinese Medicine. Oxford: Churchill, 2013. Print.
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