Addressing culture within healthcare settings: the limits of cultural competence and the power of humility

For many years, social scientists have been stressing the important role culture plays in the work of healthcare providers in their clinical settings.1,2 This idea now saturates official statements and guidelines published by professional medical associations. In an article outlining the duties and responsibilities of physicians in Canada, for instance, the Canadian Medical Protective Association describes the importance of “provid[ing] culturally competent and culturally safe care.”3 Detailing the abilities and roles of a “competent” physician, the Royal College of Physicians and Surgeons of Canada CanMEDS framework similarly focuses on the delivery of patient-centered care, which involves understanding a patient’s values, beliefs, biases, and family dynamics.4 Appeals for enhanced “cultural competence” also abound from researchers and physicians working to improve Canadian Indigenous health.5 Together, such appeals and guidelines direct attention towards aspects of a patient’s culture that must be understood in order to effectively address his or her healthcare needs