The Latino Patient – The Clinical Encounter

GREET: Characterizing the Latino Patient

After covering relevant cultural values and the belief systems of the Latino population and addressing variations in the beliefs due to generational differences, The Latino Patient moves on to present a culturally competent care model for Latinos. It begins by offering the acronym “GREET” as a way to characterize Latino patients. By gathering relevant background information about each individual, healthcare providers can increase their understanding of the personal and cultural history of each patient. Expressing an interest in the patient’s personal background can also increase the amount of respect that is perceived by the patient. The GREET acronym is as follows:

G = Generation

R = Reason for Immigrating to the US

E = Extended or Nuclear Family

E = Ethnic Behavior

T = Time Living in the US

Generation

It is important to determine whether the patient is an immigrant or a second-, third-, or fourth-generation Latino. The degree of acculturation varies with each generation and each brings to the table its own set of unique characteristics. The later generations are much more similar to the mainstream culture than recent immigrants

Reason for Immigrating to the US

Knowing a patient’s individual reason for immigrating to the United States can give the healthcare provider insight into the social, political, and economic stressors that may affect the mental and physical health of the patient.

*This category does not apply to second-, third-, or fourth-generation Latinos.

Extended or Nuclear Family

By gathering information about the living circumstances of the patient, the healthcare provider can have an increased understanding of the social support network that the patient may or may not have. Typically, in the Latino culture extended or nuclear family members live in close proximity to each other. This can present problems for immigrants if they are unaccustomed to living far from family.

Ethnic Behavior

It is useful to gather information about the patient’s personal preferences in regard to food, music, holidays, and recreational activities. This is important because habits such as consumption of alcohol at parties or celebrations can have significant health implications.

Time Living in the US

As variation in acculturation is seen from generation to generation, similar variation is seen as the time spent living in the United States increases. Patients who have recently immigrated will cling more tightly to traditional Latino cultural values, while second-generation Latinos who have lived their entire lives in the US will be more similar to the mainstream culture.

The Clinical Encounter

There are a few important points to keep in mind during the initial part of the clinical encounter with a Latino patient. While the healthcare provider may be accustomed to interacting with a diverse clientele, it may be a new, and sometimes scary, experience for the Latino patient. Cultural and language barriers can be equally, if not more, intimidating for the patient, who is making an effort to seek medical attention in a health system that may be entirely different from the system in the country of origin. With this in mind, there are a number of crucially important factors that should be taken into consideration during the initial interaction with the patient.

Eye Contact

As a sign of respect, making eye contact with the patient is critical; however, it is important to be careful with gender differences. Maintaining eye contact for an extended period of time with a person of the opposite gender may be perceived as an attraction towards that individual.

Facial Expression

A simple smile and friendly facial expression can work wonders in setting the tone for the entire clinical encounter. The combination of a smile and eye contact can make the patient feel accepted and welcome in the office. A stern face can send the message that the health care provider is unhappy with the language or cultural barrier.

Gestures and Touch

Gestures such as standing up when the patient enters the room and gesturing towards a chair while greeting a patient can send a welcoming message. It also shows respect for the patient. A warm, firm handshake upon greeting the patient can also contribute to the feelings of respect perceived by the patient.

Voice Intonation

Healthcare providers will be best-received if they talk in a friendly voice that is neither too loud nor too quiet. A loud, abrupt voice may give the impression that the healthcare provider is ill-tempered, impolite, or upset with the patient. A quiet voice may imply a lack of personality.

Titles

The use of titles is very important in the eyes of Latinos and conveys respect for the patient. By using titles such as Señor (Mr.), Señora (Mrs.), and Señorita (Miss) before the last name of the patient, the healthcare provider can show respect for the patient and gain respect in his or her eyes.