Table 3.

Negotiation

Negotiating explanatory models

Explore patient’s explanatory model

Determine how the explanatory model differs from the biomedical model and how strongly the patient adheres to it.

Describe that biomedical explanatory model in understandably terms, using as much of the patient terminology and conceptualization as necessary.

Determine the patient’s degree of understanding and acceptance of the biomedical model as it is described.

If conflict remains, reevaluate core cultural issues and social context (for example, bring in family members or maximize interpretations).

Negotiating for management options

Describe specific management options (tests, treatments, or procedures) in understandable terms.

Prioritize management options.

Determine the patient priorities.

Present a reasonable management plan.

Determine the patient’s level of acceptance of this plan (do not assume acceptance – inquire directly).

If conflict remains, focus negotiation on higher priorities.

From material cited in Carrillo JE et al. Cross-cultural primary care: a patient-based approach.