"What do you think I should do?": Understanding intercultural medical communication in general practice

Adequate communication between doctors and patients is a crucial aspect of good quality health care. Research has shown that medical communication between doctors and patients from different ethnic and cultural backgrounds is less effective than medical communication between doctors and patients sharing the same background. Given the lower participation levels among ethnic minority patients and the well-established positive effects of patient participation on medical communication outcomes, the aim of this dissertation is to investigate differences between ethnic minority and ethnic majority (in this dissertation Turkish-Dutch and Dutch) patients in general practice (GP) in the determinants of patient participation and its relationship with communication outcomes. The results show that both culture-related and communication-related barriers are important factors that hinder Turkish-Dutch patients to be active communicators during the conversation with their GP. Turkish-Dutch patients report different information needs than Dutch patients and have other preferences and expectations regarding the relationship with their doctor, the doctor’s communication style and the treatment approach in the Netherlands. In addition, patients with a higher match between their preferred level of participation and their perceived level of participation during the consultation report more positive communication outcomes. Hence, GPs need to stimulate Turkish-Dutch patients to express their needs better in order to be able to accommodate them during the consultation. By enhancing awareness and empowerment on both sides of the table, intercultural medical communication can be improved, ultimately resulting in better health care for migrant patients.