The historical backdrop that has been presented above illustrates that, in the case of the black patients, these ingredients and necessary precursors of trust have been painfully missing.
In order to build trust, it is necessary that we must first correct this situation, which means that we have to begin by acknowledging its existence. Denial of the transgressions of history must be eliminated, starting with the proper education of practitioners and
students of medicine.
In the case of medical practitioners, it is important for them to be re-educated about the cultural, ethnic, racial, and religious distinctions and differences that characterize minority patients. As a first step, these practitioners need to learn what cultural diversity is and how to develop cultural competence. For example, they must learn that there are differences in the way that illness and disease are perceived by different ethnic groups, and also in the way that diseases are expressed.
A patient who is of Maya Indian origin who was born in Zincantan in the highlands of Chiapas, Mexico might not understand illness in the orthodox Western context, and instead may think of disease as a foreign process or spirit invading the body.
Another example is the Haitian patient who comes to the American physician with…