Illness and treatment perceptions of Ethiopian immigrants and their doctors in Israel

Objectives. Patient-provider misunderstandings arising from disparate medic al and cultural concepts can impede health care among immigrant populations . This study assessed the extent of disagreement and identified the salient problems of communication between Israeli doctors and Ethiopian immigrant patients. Methods. Semistructured interviews were conducted with 59 Ethiopian immigra nts. Self-reports of health status and effectivenesss of treatment were com pared with evaluations by the primary care physician and supplemented by qu alitative data from descriptions of illness, observations of medical visits , informant interviews, and participant observations conducted by the anthr opologist. Results. Health status and effectiveness of treatment were rated significan tly higher by the doctor than by the patients. Low doctor-patient agreement occurred mainly for illnesses with stress-related or culture-specific asso ciations. Qualitative data suggested that more long-term immigrants may alt er their expectations of treatment but continue to experience symptoms that are culturally, bur not biomedically, meaningful. Conclusions. Misunderstandings between immigrant patients and their doctors emerge from the biomedical system's limitations in addressing stress-relat ed illnesses and from culture-based discrepancies in concepts of illness an d healing. Including trained translators in medical teams can reduce medica l misunderstandings and increase patient satisfaction among immigrant popul ations.