Cultural safety in general practice - webinar summary 

10 May 2019

Over 50 members tuned in to College President Dr Sam Murton’s second webinar on Tuesday 7 May. Joining her was Dr Sean Hannah who was invited as a guest speaker to discuss cultural safety. 

Sam kicked off the webinar with some College updates, including the CORNERSTONE® project, new recertification requirements from the Medical Council. and by the Health and Disability System Review. 

“Practices have been sent the draft Foundation Standard module and invited to take part in a pilot; so far we’ve had 40 practices signed up which is great. The Teaching Practice module will be sent out shortly, followed by the Continuous Quality Improvement and General Practice modules in June.”

Sam explained that the Medical Council had just released the new recertification requirements. 

“There’s a strong emphasis on professional development plans (PDP), so the College's Learning team will be working on ways to make that useful  – part of the PDP will involve having a detailed discussion with a peer.”

She noted the deadline for Health and Disability System Review submissions is 31 May. The College has received 120 submissions from members so far, and you can still send them via the Health and Disability review website.

“The College will be entering a submission saying that equity needs to be the cornerstone of the health sector.”

Sam then invited Sean to join her for a discussion around cultural safety in general practice, a topic she became motivated to discuss after talking to Te Akoranga a Māui and our Pacific Chapter members.

Originally from Australia, Sean went to medical school in Auckland, and his career has taken a journey through Māori primary health care. Sean is bilingual, so he can speak and consult in English or te reo Māori and sometimes a mixture of both.

“One of the huge privileges of being a GP in a community where everyone is related is getting to be a part of people’s lives and making connections with different people,” Sean said. 

Sam touched on the importance of connectedness with families, and Sean followed up explaining that there are some challenges we face in terms of relationship boundaries. 

“I find that that patients love asking me about my kids and stuff about me as a person, and I think we need to be generous in giving up a bit of ourselves to our patients if we want to have really good relationships – particularly with our Māori patients. 

“Another good tip is to ask your patient where their family is from; asking where they’re from sort of implies that they aren’t local,” Sean said. 

One webinar attendee commented that they were worried about making a mistake in terms of Māori and Pasifika cultural safety.

Sean responded, “Don’t worry about offending people; they’ll love that you’re making an effort. If you can work on connections, people will know you’re interested … go in full tilt – te reo Māori conversations are beautiful things.” 

Dr Alvin Mitikulena, a Pasifika GP from Wellington couldn’t attend the webinar as planned, but did share some thoughts with Sam and Sean. He said keeping conversations simple and using  pictures can help with communication. 

Sean explained that he uses images in his consults, and he believes bringing computers into the consultation in a skilful way has got to be part of medicine going forward.

“I often hear registrars saying they feel like it looks like they’re just Googling stuff, and they don’t know what they’re doing, but what you’re actually doing is modelling to your patient how to get the right information from the right source.”

Sean reminded us that GPs often need to become advocates for patients from Māori, Pasifika or other backgrounds and challenge things that are obviously not equitable within the health system and say, “that’s not okay.” 

“In Wellington the public-funded bariatric service includes a psychologist. A couple of years ago the psychologist told one of my patients they weren’t allowed any whānau in for the psychology interview – when she was challenged on that, she said it unfairly disadvantages those without lots of family.

“I emailed the consultant surgeon pointing to the Code of Rights. They reconsidered, and let her have her whānau there to ask questions and take notes.”

Sean and Sam wrapped up the webinar by saying that using cultural safety can help speed up consultations – your patients will trust you a bit more and see you as more caring.

Recording and feedback

Listen to the full recording and please send any feedback to communications@rnzcgp.org.nz – this will help us to improve the next webinar.