Culture, Professionalism and the Practice Of Pharmacy
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presented at FIP congress, Beijing 2007. Challenges pharmacy curricula to make provision for cultural competence. Includes notes,
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- Slide 1: Culture, Professionalism and the Practice of Pharmacy Billy Futter Rhodes University South Africa
- Slide 2: Key questions 1. What is Culture? 2. How does Culture influence: • Practice of Pharmacy? • Professional status?
- Slide 3: 4. Cultural Competence Communication 3. Professionalism 2. Culture 1. Pharmacy Practice
- Slide 4: 1. Pharmacy Practice Emphasis on Product Emphasis on People
- Slide 5: People Need medicine
- Slide 6: People have Medicine-related problems
- Slide 7: Pharmaceutical care services Based on Relationship of trust
- Slide 8: But . . . People are different
- Slide 9: See & do things differently How many legs?
- Slide 10: Young lady? Old lady?
- Slide 11: Need to understand differences between people
- Slide 12: So . . .? • Important differences? • Impact on pharmacy practice? What is Culture?
- Slide 13: 2. Culture Society has many sub-groups Each has its own culture Society
- Slide 14: 2. Culture Society has many sub-groups Each has its own culture Society
- Slide 15: 2. Culture Society has many sub-groups Each has its own culture Generic? Generic? Generic? Generic? Society Generic? Generic? Generic? Generic?
- Slide 16: Different cultural groups group Generic group group group Society group group group group
- Slide 17: Society GEOGRAPHIC Chinese Generic Indian Japanese American Society Australian Swedish European African
- Slide 18: Society LANGUAGE Chinese Generic Hindi Russian English Society Italian Zulu French Xhosa
- Slide 19: Society RELIGION Muslim Generic Hindu Tao Christian Society Jew Mormon Ancestor Sects worship
- Slide 20: Society AGE and GENDER Female Generic Babies Male Kids Society Elderly Teenagers Mature Early adults Adults
- Slide 21: Society ECONOMIC Middle class Generic Upper class Lower class Super rich Society Destitute Rich Poor Middle
- Slide 22: Society SIZE and POWER Generic MAJORITY Minority Minority Minority Society Minority Minority Minority Minority
- Slide 23: people people Therefore people people Society people people people people 1. No generic cultural groups! 2. Each group has its own culture
- Slide 24: people people people people Society people people Group Culture people people Group Behaviour Routine, Predictable Difficult to change Prescribed limits
- Slide 25: people people people people Society people people people people Cultural boundaries “Right way of doing things” B.E.V.A.N.S.
- Slide 26: people people Different B.E.V.A.N.S people people Society people people people people Beliefs Expectations Values Assumptions & Attitudes Norms Symbols
- Slide 27: people people Different B.E.V.A.N.S people people Society people people people people Beliefs – what is right and wrong Expectations – what should happen Values – priorities, standards Assumptions & Attitudes – positive/ negative Norms – traditional way of doing things Symbols - group identity, convey meaning
- Slide 28: Cultural Symbols age, gender, language, race
- Slide 29: Status symbols Wheels!
- Slide 30: Other Status symbols
- Slide 31: Cultural symbols The Five Friendlies Beibei JingJing Huanhuan Yingying Nini Bei jing huan ying ni Fish Panda Olympic Antelope Swallow Welcome to flame Beijing sea forest fire earth sky
- Slide 32: people Influence of Culture on Behaviour people people people Society people people people people ‘BEVANS’ Routine Qualityo Beliefs f life Expectations Values Behaviour Outcomes Attitudes Norms Symbols Patterns Quality of service
- Slide 33: So: How does Culture influence 1. Health behaviour? * Patients? * Health professionals? 2. Health outcomes?
- Slide 34: Health Beliefs of different cultures Yin yang Yoga
- Slide 35: Tai Chi
- Slide 36: Gym
- Slide 37: Traditional Healers Rituals
- Slide 38: Expectations Queuing for health care
- Slide 39: Values pyramid Care Courage Respect, Fairness Competition, Equality, Informality
- Slide 40: Values pyramid Care Respect Fairness, Honesty Cooperation, Status, Formality
- Slide 41: Norms Right hand Greetings
- Slide 42: Responding to Visual cues
- Slide 43: Responding to Visual cues Oprah
- Slide 44: How do you respond to HIV/ AIDS Response to HIV/ AIDS? LOGO?
- Slide 45: ACTIVISTS?
- Slide 46: VICTIMS?
- Slide 47: Beliefs – Diagnosis? Cause of illness? Stress Evil spell Yin Yang imbalance Hereditary Lack of chi Environment Hot cold Imbalance Bad habits Punishment for sins Old age Microbe or Virus
- Slide 48: How do you respond to Symptoms? Visit Doctor or Pharmacist Get a prescription Self-medicate Vitamins Herbal treatments Rest and relax
- Slide 49: Response to Symptoms? Restore balance Avoid hot / cold Remove “spell” Visit Traditional healers Consult ancestors
- Slide 50: Conclusions Culture influences Signs and Symptoms – Interpretation different – Response different Communication different
- Slide 51: Consequences Professional advice Not sought Not trusted Not followed
- Slide 52: Serious? Health outcomes Cultural inequalities Unmet medicine needs Medicine related problems
- Slide 53: Serious? Access Quality of care Quality of life
- Slide 54: 3. Implications Professional Status of pharmacists?
- Slide 55: 3. Professional status Level of authority given by society to – make judgements – give directions
- Slide 56: Who decides? Society decides the roles it needs Social institutions give and limit authority to practice
- Slide 57: Criteria for Professional Status? Competent Committed to satisfy needs that are: Valued Complex Personal
- Slide 58: Perceptual haze Evidence? Competent Committed to satisfy needs that are: Valued Complex Personal
- Slide 59: Combining criteria Hi Commitment Lo Lo Hi Competence
- Slide 60: Combining criteria Combining criteria Hi Commitment Professional Lo Lo Hi Competence
- Slide 61: Combining criteria Combining criteria Hi Commitment Caregiver Professional Lo Lo Hi Competence
- Slide 62: Combining criteria Combining criteria Hi Commitment Caregiver Professional Lo Robot Lo Hi Competence
- Slide 63: Combining criteria Combining criteria Hi Commitment Caregiver Professional Lo Thief Robot Lo Hi Competence
- Slide 64: Combining criteria Combining criteria Hi Commitment Caregiver Professional Lo Thief Robot Lo Hi Competence
- Slide 65: Therefore Professional status can be increased Show evidence of Competence Commitment
- Slide 66: Therefore Professional status can be increased Show evidence of Competence – applied Commitment – service before self
- Slide 67: But: REAL WORLD - not laboratory group Generic group group group Society group group group group
- Slide 68: REAL WORLD IS CHANGING In the next 20 years . . . Global drift more people visiting foreign countries Urban rush 60 - 80% will live in town Population explosion additional 1.6 billion people on the planet
- Slide 69: REAL WORLD IS CHANGING
- Slide 70: REAL WORLD Communication Digital Revolution Mobiles Information on Web Web based marketing
- Slide 71: REAL WORLD IS CHANGING Professional tools
- Slide 72: Communication challenges Digital divide - less access Efficiency Pressure - Impatience Cultural filters - Misunderstanding Minorities - Intolerant
- Slide 73: Conclusion Cultural diversity increasing Communication challenges
- Slide 74: So . . . What can pharmacists do Agenda Competence, Commitment? Communication? Professional status?
- Slide 75: The Solution? Develop Cultural Competence!
- Slide 76: Cultural Competence Ability of health system to deliver consistent quality health care to patients in cross cultural situations irrespective of the culture of fellow professionals or patients.
- Slide 77: Cultural Challenge Lo Hi Incompetent Competent 1. Intolerant 5. Empathy 2. Impatient 6. Concerned 3. Dismissive 7. Caring 4. Judgemental 8. Respect
- Slide 78: Cultural ladder Cultural Proficiency Cultural Competence Cultural Pre-competence Cultural Blindness Cultural Incapacity Cultural Destructiveness
- Slide 79: Pre-competence to Competence COMPETENT Hi (Empathy, concerned, caring, respect) Desire Encounter Skill Knowledge Awareness INCOMPETENT Lo (intolerant, impatient, dismissive, judgemental)
- Slide 80: Everyone benefits! Patients - better QoC & QoL Health professionals - higher esteem Health system - more cost effective Medicine - improved use Employers - Legal protection - Satisfied staff - Loyal patrons
- Slide 81: And Pharmacists improve professional status! Hi Professional Commitment Lo Lo Hi Cultural Competence
- Slide 82: This is not the end but the beginning!
- Slide 83: Thank you
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