Latin American Immigrant Health in the Baltimore Area: Provider Perspectives of Alternative Remedies

Abstract

Immigrant groups in the U.S. have been found to use complementary or alternative medicine (CAM), but little is known about biomedical health care providers’ perspectives on alternative remedy use and whether providers’ perspectives affect patient care. This research aimed to investigate health care provider perspectives on alternative remedy use within the Latin American immigrant community in the Baltimore area. The author conducted semi-structured audio-recorded interviews with five providers regarding their experiences working with immigrants during the transition from hospital-to-home care for chronic disease treatment. Using an anthropological approach to transcription, analysis revealed that embedded in the ways providers discussed their experiences with alternative remedies were clues to their perspectives on the patient population’s use of alternative remedies. Furthermore, these perspectives have implications for doctor-patient communication and health care delivery. Systematic coding demonstrated that providers expect patients to follow certain “Health Rules” that are drawn from the American biomedical system. Providers see immigrant patients’ alternative remedy use as breaking those “Health Rules,” since alternative remedies are viewed as originating from the patient’s home culture not the American medical system, and patients cannot combine behaviors or beliefs from both sides. This understanding of culture as mutually exclusive may lead providers to suggest that patients must choose between their cultural beliefs and compliance with the American medical system, possibly inhibiting communications with patients who wish to express beliefs or undertake practices from outside the American medical model. If providers adopted a broader understanding of culture, they might be able to deliver more culturally appropriateintegrative care and improve their interactions with diverse patients