What is Familismo?
Medical interpretation is so much more than repeating instructions and diagnoses back and forth in different languages. Medical interpreters are responsible for ensuring that effective communication takes place between the patient and provider, and that includes ensuring that understanding occurs amidst diverse cultural worldviews.
When it comes to medical treatment in the United States, much of it is handled at an individual level. Doctor/patient confidentiality exists between the patient and provider, the patient must provide their own informed consent, and HIPAA laws protect against the dissemination of protected health information. This approach of managing healthcare by oneself and making autonomous decisions as an individual is not as common in Latin and Hispanic cultures. Instead, Spanish-speaking families often engage in something called familismo.
According to Psychology Today, “Familismo, is a central Latin cultural value. It involves dedication, commitment, and loyalty to family. Regularly spending time with one’s immediate and extended family is part of familismo. It also involves seeking the family’s advice for important decisions. Sometimes familismo means putting the family above oneself. It may even mean helping one’s parents and siblings with money.” (source)
What this means within healthcare, is that medical decisions are often made as a group, and with a lot of influence from close family members. Our interpreters see it every day…a healthcare provider trying to get a direct answer from the patient, while the patient hesitates and looks around the room for support from their family members. When it comes to ensuring effective communication happens in these situations, both the interpreter and the provider must exercise cultural competency, the ability to interact effectively with people from different cultures. This could entail giving the patient time to confer with their family, at the same time ensuring that the patient him or herself fully understands and agree with any decisions that are being made.
After all, the Hispanic population within the United States is growing. Right now, there are more than 57 million Hispanic individuals living within the United States, and more than 16 million of those are considered limited English proficient (source). Last year, 69% of the video remote interpretation sessions we handled were Spanish.
Familismo is an important phenomenon to understand in order to ensure that Spanish-speaking patients are being treated respectfully, responsibly and effectively.
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