Every doctor in New Zealand is about to be required to do some soul-searching as part of a new cultural safety training programme to be introduced over the next year by specialist medical colleges.
It will be the first compulsory programme introduced around the world, although there are voluntary programmes in Australia, Canada and the US.
But Te Ohu Rata o Aotearoa chair Professor David Tipene-Leach points out that the nursing profession has made this a training requirement since the 1990s.
He says the NZ Medical Council had ruled that doctors needed to make cultural safety a part of their work but a recent survey found little had changed, which is why the training plan for the colleges is being set up.
He says it’s not about Māori, Pacific or other peoples. “It’s about how do I look at myself, what are my biases, my attitudes, my stereotypes about my patients – how do these things affect the way I work in consultation with patients?
David Tipene-Leach leads cultural safety work in the health sector.
The Big C word
“It asks doctors to think through their wider relationship with equity so in some ways this is about thinking through the big C word – colonisation.
“It’s about me as a doctor, us as providers and how we are doing our best – or not so well – for our patients and groups of patients.”
Tipene-Leach says one definition of cultural safety includes aims like being able to pronounce names correctly and being able to live with big whanau in consulting rooms.
“We would think these are cultural competence skills whereas the big picture of culture safety is about us questioning ourselves, for instance looking at all the results of a particular outcome. Did I recommend someone to a stop smoking programme? And then going through and asking what happened to my Māori patients and what happened to my non-Māori patients. Gosh, is there a big difference? Did I not recommend a proportion of my Māori patients to stop smoking programmes and why. How come I did it like that?
Providing a good service
“So cultural safety is essentially asking about your own attitudes and biases and how they play out in you providing service.”
Tipene-Leach says the medical schools have engrained cultural safety in their training for some years now. “
But those of us who are getting on in years didn’t have that. In fact it’s not just the older medical practitioners, it’s anyone from the age of 30 upward.
He acknowledges that the medical workforce is under pressure and resources are small but argues the training programme is meant to be useful. “It might even be fun.”