Minorities feel let down by Swedish health service

Doctors often show less empathy and provide poorer information to patients from other cultures, leading to inappropriate treatments and unnecessary tests. Such has been established by international research, with studies concluding that there are major shortcomings when different languages and cultures meet in health care.

Researchers at the University of Gothenburg’s Sahlgrenska Academy have now looked at this the other way around, exploring how patients from a minority group view their encounters the Swedish health service.

Kristian Svenberg has worked as a general practitioner at Lärjedalen health centre in the Gothenburg suburb of Hjällbo for 18 years. As part of his doctoral thesis at the Sahlgrenska Academy, he interviewed people born in Somalia about their experience of Swedish health care.

The study reveals that patients from Somalia expect great things of the Swedish health service but often feel that they are brushed off. Many of the Somalis in the study described a sense that doctors do not take their problems seriously and that they are discriminated against.

“It’s vital for a functioning health system that the patient-doctor encounter features mutual respect and understanding,” says Svenberg. “Otherwise there is a real risk of misunderstandings, inappropriate treatments and unnecessary tests.”

One result of the Somalis’ bad experiences is that many go abroad for treatment.

Swedish trainee doctors were also interviewed as part of the thesis. This revealed that they often struggle to understand patients from Somalia. If an interpreter is used, the doctors can feel left out of the conversation, and they often find it hard to grasp patients’ descriptions of their symptoms.

“The interviews reveal that when problems arise, some doctors try to get closer to the patient by showing an interest and exploring the patient’s background to build trust and understanding, while other doctors adopt a very old-fashioned, authoritarian strategy to master the situation,” says Svenberg.

Somali refugees’ health and experience of Swedish health care are not well researched, and there have been no previous studies of Swedish doctors’ experience of dealing with these patients. Kristian Svenberg hopes that the example of Somali refugees will increase awareness of how interaction between the Swedish health service and patients from minorities can be improved, which includes doctors showing more interest in them.

“This will have benefits on a human level as well as financially and medically,” he says.

The thesis “The patient-doctor encounter as experienced by Somali refugees and trainee doctors” was defended at the Sahlgrenska Academy on 16 December.