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.