Modesty is highly valued among Asian Indians and patients usually feel more comfortable with same-sex care providers. Direct eye contact from women to men may be limited. Sensitivity and care should be taken in situations that may cause the patient embarrassment, such as wearing an examination gown, which the patient may consider too short.
Value of Assertiveness
An active and commanding doctor who takes charge and gives prescriptions for medications may be preferred.
Physicians may be perceived as incompetent if they sound unsure. For example:
Dr. Johnson: “Mr. Sinha, I am not sure if what you have is late onset lupus or Sjogren’s syndrome. Your test results are inconclusive. I am going to start you on a medicine called hydroxychloroquin and see how you respond. What do you think?”
Mrs. Sinha’s interpretation of the statement: “This doctor does not know what disease I have. He wants to start me on a new medication and he is asking me what I think? I am not a doctor! What can I say? ”
A more optimal way of stating the same information:
Dr. Johnson: “Mr. Sinha, there are two diseases that can mimic each other and cause the symptoms you have. One is called lupus and the other is called Sjogren’s. Your test results are not helping us identify the exact disease you have. Your situation is not uncommon. I am going to start you on a medication which will help with your symptoms. I am also going to monitor your symptoms and blood work very carefully to see how you respond to the medication. I need you to take the medicines regularly and keep a log of your symptoms. I want you to come back to clinic in 4 weeks.”
Many older adults do not prefer counseling as an option for problem resolution.