1. Running head: COMMUNICATIONS IN THE HEALTHCARE SYSTEM 1
Miscommunication in the Health Care System: Doctors and Nurses
MaryBeth Sanders
University of Kentucky

2. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
Abstract
Miscommunication can happen in many ways in a workplace. In the healthcare workplace,
miscommunication happens most often in a form of cultural barriers. Cultural barriers can be
happen through language differences, religion differences, cultural norms, education, and gender
roles. Through these types of cultural barriers, miscommunication can happen to anyone in the
healthcare system. Whether it be a doctor, nurse, patient, or an administrator. Miscommunication
can happen to anyone in the healthcare work place. Miscommunication can affect the healthcare
world very easily through cultural barriers. People in the healthcare field are constantly dealing
with people, culture is something that is dealt with every day.
Keywords: miscommunication, language, religion, norms, education, gender, healthcare,
workplace

3. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
Miscommunication in the Health Care System: Doctors and Nurses
When working in the health care system, miscommunication can happen on a daily basis.
The health care world has a wide range of careers that interact with each other. Each career has
its own potential to grow and connect with other jobs in different places. This being said,
miscommunication is an easy action that can have a heavy occurrence. Miscommunication
comes in many manners; however, the most prominent barrier in the health care system is
culture. Culture differs in every country and can have an impact on how a group of people
interact with each other. In other words, culture is a serious miscommunication barrier when it
comes to the health care world.
When thinking about culture, the term cannot be described by one simple meaning.
Culture has multiple meanings that intermingle to create one large understanding of a country.
These meanings can include language, religion, cultural norms, education, and gender roles of a
culture. Culture is something that is taken seriously is the medical system. According to
McLaughlin and Braun, strategies for working with patients in settings with different cultures are
to learn about the cultural traditions of the patient, ask open-ended questions to gain more
knowledge, and do not judge when told information that differs from yours (1998, 116-126). To
some people, culture is what their lives are based upon and how they go about everyday life.
Culture is something that is taken seriously is the medical system but can cause
miscommunication at a drop of a hat.
When dealing with culture the one part that can cause most problems is a difference in
language. Language does not just have to be verbal, most often body language is one of the main
ways a doctor and patient will communicate. When a language difference (verbal or non-verbal)
appears, this can have multiple effects on the relationship between people. In the health care

4. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
field, language barriers are the most detrimental to a doctor and his/hers patient. For example, if
a patient, who does not speak very well English, goes to an American medical center; the
chances of a doctor fully understanding the patient will be slim. Since verbal language is not the
only type of communication, a doctor can determine several things due to a patient’s body
language. If a patient is in pain, feels uncomfortable, or is fatigued, the doctor should be able to
interpret the
body language
of the patient
and determine
what they
should do to
help with
whatever is
wrong.
McLaughlin
and Braun
state, “…pay close attention to body language, lack of response, or expressions of anxiety that
may signal that the patient or family is in conflict but perhaps hesitant to you. (1998, 116-126).”
Language is the most pertinent way doctors and patients are able to connect on a more emotional
level. Medical doctor Steven Woloshin states, “… because of language barriers, millions of US
residents cannot have a connection with their physician (1995, 724).” Whether it be verbal or
nonverbal, when language becomes a miscommunication because of someone’s cultures, it
affects anyone that is involved in the situation.

5. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
When culture is broken down, religion has a huge role. Religion has become a very
controversial topic in today’s modern world and also plays a big part in the healthcare career
field. Throughout all of history, medicine was looked at as a simple task. However, in the
modern world things have begun to change. It is now becoming more and more apparent that due
to religious beliefs, certain cultures are taking medicine to a
different
level.
Like most
things,
each
country in
the world
handles
healthcare
differently. According to the Loma Linda University Health System, different religions deal with
treatment, death, and just simple care in very different styles (4-33). In some of those countries,
religion is what the healthcare system is based upon. In countries that are populated with
different religions, it is hard to come up with a consensus on how the healthcare system should
work. For example, a young girl goes to the doctor and needs to be put on birth control; however,
her parents will not allow it due to the fact that their religion does not believe in forms of birth
control. This becomes a form of miscommunication between the doctor and the family. This also
becomes a miscommunication between the hospital and the family; purely due to the law,
separation of church and state. In certain places, most hospitals are ran by the government and

6. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
not allowed to base the morals of the hospital on religious beliefs or become involved with
problems that deal with religion.
When thinking about culture, a person’s culture comes with a set of norms that the person
is used to continuously doing. One cultural norm that is most prevalent in the health care world is
honesty. This one act of miscommunication through cultural barriers that often happens between
the doctor and patient. In some cases, this may happen between doctors, nurses, or even
administrators. Dishonesty comes in many forms and fashions; for example, failing to take
charge, billing entirely too much, or just straight lying to a fellow coworker or patient.
Dishonesty is something that can continue throughout the whole healthcare world. When
thinking about dishonesty, most people often think of a patient lying to a doctor, which in most
cases can be right. However, dishonesty is something that can happen all throughout a doctor’s
office or a hospital. For example, some may argue that physicians who either own or operate
their hospitals have financial incentives to refer patients to their facilities (MD Fred Herbert,
2008, 26). The act of dishonesty is a manner that can expand and forgo a level that should not be
reached in the healthcare field. Fred L. Herbert, a licensed M.D., states that, “…dishonesty in
medicine has grown substantially…” Overall dishonesty has become a cultural norm among the
healthcare provider world.
Culture is a term that is always changing. Just like culture, the healthcare world is also
changing. Most often when things change, people do not keep up. One very big cultural
miscommunication is that when the way healthcare changes, most often people within a specific
culture do not become educated. This usually is based off of technology that reflects back to the
culture of one’s country. For example, a young man is sick and needs to have a MRI. The
country he lives does not have the machine due to the fact that their culture is known for living

7. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
poorly and cannot afford the MRI machine. Since the culture is known for not having much
money they cannot afford the machine and are not educated on what they need to do for the boy
in order to make him better. Most education of medicine is ran through technology and this
usually leads to being why most people are not educated on certain matters. According to
medical doctor, George Rosen, he states that, “Pharmacist, dietitians, and other professions in the
medical care field recently have begun to publish journal aricles related to “their role and
responsibility” for patient education. While each discipline concentrates on its particular
professional group, one single common thread emerges that the patient and family need to know
(1971, 1278).” Education has be a part of culture for a long time and has made such an impact on
the healthcare system do to the miscommunication between coworker, patients, and family’s.
All over the world, male and females are looked at differently. Some countries think of
men and women being equal and others do not. When talking about miscommunication it is easy
to talk about the miscommunication between a doctor and patient, however, miscommunication
may also happen between coworkers. Depending on the culture, certain countries tend to play
hierarchy when it comes to female and male power. How this becomes a miscommunication
through culture very easily explained. For example, say there is a male nurse who group up in a
culture where woman were thought of as less than men and he has a female doctor as his boss.
Due to his way of his culture he was raised up in, he now begins to not listen the doctor and
decides to do what he thinks is best for the patient. This not only becomes miscommunication
between the doctor and the nurse; this becomes an issue for the patient and his/hers wellbeing.
When gender roles emerged in the work place, it can be detrimental to everyone and anyone
involved. According to Jenny Andersson says that medical student enter their training program
with culturally shared stereotypes about male and female patients that could cause bias during

8. MISCOMMUNICATION IN THE HEALTHCARE SYSTEM 2
their future careers as physicians (2013, 4). With physicians coming into the medical field
preprogrammed stereotypes, this leads to miscommunication on a serious level. If a physician
were to go off of what he or she only previously knew, the patient could end up getting seriously
hurt. Gender roles have become a part of cultures all over the world and have made such a large
impact on the miscommunication between people in the healthcare field.
Miscommunication can happen at any time and any place; with the wide range of
healthcare jobs, miscommunication can happen often. Culture is a serious miscommunication
barrier when it comes to the healthcare world. When thinking about culture, there are multiple
descriptions that go into the meaning. Of those are language, religion, cultural norms, education,
and stereotype of men and women. These descriptions give an idea about what happens when
culture becomes a miscommunication in the workplace. From the examples given, it is easy to
see how those problems can appear. It is up to the doctor, patient, nurse, or whoever it may be to
make sure that when a cultural differences appears that they think about the other person and
think what would be the best way to approach the problem. Overall cultural miscommunications
are inevitable in the health care work place and can effect anyone involved at any time.

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Work Cited
Andersson, J., (2013). Using patients’ narratives to reveal gender stereotypes among medical
students.
Cultural Competence in Behavioral Health Care (2012). U.S. Pharmacist [Data file]. Retrieved
from: http://www.uspharmacist.com/continuing_education/ceviewtest/lessonid/108684/
Fred HL. Dishonesty in medicine revisited. Tex Heart Inst J. 2008;35(1):6–15.
Improve Patient Care with InDemand Interpreting (2013). InDemand Interpreting [Data file].
Retrieved from: http://www.indemandinterpreting.com/patient-care/
Mc Laughlin, L., & Braun, K. (1998). Asian and Pacific Islander cultural values:
Considerations for health care decision-making. Health and Social Work, 23 (2), 116-
126.
Perry, P.B., Sorajjakool, S., Yelland, T., McMillan, K. LOMA LINDA UNIVERSITY HEALTH
SYSTEM: Health Care and Religious Beliefs. Loma Linda, CA. 4-33
Rosen, G. (Eds.). (1971). Public health: Then and now. 1277-1278
Woloshin, S., Bickell, N., Schwartz, L., Gany, F., & Welch, G. (1995, March 1). Language
Barriers in Medicine in the United States. Retrieved November 1, 2014.
Retrieved from: http://www.indemandinterpreting.com/patient-care/