When Doctors, Nurses, and Patients All Disagree: What are cultural barriers in the clinic and what to do about them?

Cultural barriers are an important issue in healthcare in the U.S. – a predominantly white institution serving an increasingly diverse patient population. Based on 110 qualitative interviews, this research analyzes the conflicting perspectives of doctors, nurses, and immigrant patients regarding what are cultural barriers and, relatedly, cultural competency. Doctors tend to locate the source of the problem in immigrant patients’ cultural values and practices. Immigrants experience the norms of hospital bureaucracy as the fundamental cultural barriers. Bicultural immigrant nurses face racialized discourses of medical “deservingness” as the key challenge in their cultural brokerage work. Contrasting these diverse perspectives, this project reveals how intersecting hegemonies shape the most expensive healthcare system in the world.