‘People-Centred Health Care’: how can that be without a healthy communication between doctors and patients in South Africa?

Abstract

South Africa fails to provide patients with access to holistic health care in their language of choice as stated in the Department of Health Language Policy of 2011. Linguistic and cultural differences of patients and doctors result in a compromised quality of care. About 80% of doctors in rural hospitals are foreign-trained, so it is imperative that effective communication policies, training and skills beneficial to foreign doctors be an integral part of the current health reform. This study reviewed the Policy of 2011 and determined English-speaking foreign medical doctors’ ability to communicate effectively with indigenous patients in Limpopo Province. The Policy of 2011 was content analysed. Communication during consultation was investigated using semi structured interviews of purposively sampled nineteen (19) doctors, thirteen (13) nurses and thirty-five (35) patients in ten government hospitals in Limpopo. The interviews were thematically analysed. The results showed that many foreign doctors were frustrated that they could not communicate with patients; they could not speak the indigenous language and the assumption that most patients could communicate in English often proved erroneous. This made it difficult to give equal medical care to all patients, and doctors resorted to avoidance strategies. The Policy fails to address the cogent issue of verbal communication between patients, interpreters and doctors. Understanding and being understood is critical in ensuring equal access to and quality of health care for all patients. Developing communication between doctors and patients is therefore central in reducing or eliminating health disparity.