CanMeds Communicator
Understanding Difference

Understanding Difference



Communicating with patients from diverse cultures and backgrounds can take special skills.  Even though the world seems smaller and more multicultural, the dominant framework is Western, Judeo-Christian and heterosexual.  This influence dominants the teaching in medical school environments.   It also influences how we approach our patients.  Many of us continue to ask male patients if they are married and if they are, what does their wife do.   Have you ever done this?

Having an understanding of difference is really a part of providing patient-centred care. Each individual’s health-related beliefs and behaviours will be influenced by that individual’s culture. This will have an effect on the clinical encounter and the clinical outcome.



Compare the illness experience and impact on life for these two people both affected by Rheumatoid Arthritis.


45 year old carpenter, married (husband is a nurse) with three children, develops severe inflammatory arthritis.


21 year old Pakistani woman, recently married and living with in-laws, now diagnosed with severe inflammatory arthritis.