Discourse Analysis of Cultural Competence in the Journal of the American Medical Association

• In Event: 029 - Regular Session. Sociology of Knowledge

Abstract

Recently “cultural competency” has gained significant traction as a strategy to improve the quality of health care, and address racial/ethnic, class, and LGBTQ healthcare disparities (Betancourt, Green, Carrillo, and Park 2005; Campinha-Bacote 2002; Cohen and Goode 1990). Major sociological perspectives on the training of medical students was by Samuel W. Bloom and Howard Becker during the 60s and 80s. The aim of this study is to provide a contemporary perspective contributing to the sociological literature. I examined eighty-nine articles published in the Journal of American Medical Association, JAMA, concerned with cultural competence to examine the discourse. Qualitative Discourse Analysis reveals the articles concerned with cultural competence 1) marshaled the term in rather vague ways, often not defining it and 2) reduce the concept of cultural competence to communication and literacy skills, incorporating the “other” albeit in often stereotypical ways, or transform it into something about the culture of medicine. how the framing around cultural competence seems to fail to address issue of power and get to the crux of the issues around health disparities. I draw out the implications of this rhetoric on limiting a richer understanding of cultural differences in ways that could potentially better address inequitable and poor delivery of care. The argument in this paper as presented by the evidence supports the superficial, “thin” way in which doctors understand, operationalize and try to incorporate cultural competence.

Author

• Cirila Estela Vasquez Guzman, University of New Mexico