Creating A Recipe for Sales Success In California’s -Diverse Cultures A common thread running through the following articles is the need to go beyond assumptions to really get to know people in the diverse communities of California. Multicultural Healthcare Marketing by Michael Soon Lee, MBA There is a huge multicultural market for the providers of healthcare products and services, but only if they know how to meet the needs of people from Hispanic, African-American, Asian, Native-American, Middle Eastern, and other cultures. The following cultural assumptions cause many marketers to develop inaccurate perceptions of the populations they’re cultivating, although some of these beliefs may sometimes be true: People from Other -Cultures Only Want To Do -Business with Someone of Their Own Culture? In reality, members from many cultural groups prefer to get services from outside their own culture. Some may be concerned about their private information being disclosed to their community through someone from their culture. For instance, in the real estate industry, Asians often seek out non-Asian banks for home loans so their financial affairs are shielded from other Asians. Many Hispanics avoid going to Latin lending institutions for the same reason. Multicultural People Have Incomprehensible Superstitions and Beliefs We must remember that all cultures have beliefs and customs that seem strange to others. People in the United States have beliefs that often baffle outsiders, such as our fears of black cats crossing our paths, of walking under ladders, and of the number 13. Many Asians believe that the number four is unlucky because, when pronounced in Japanese or Chinese, it sounds very similar to the word for death. Thus, items arranged in groups of four, such as pills or syringes, can symbolize bad luck for those people who believe in numerology. Just as there are very few hospitals or hotels in America with a 13th floor, the same is true for buildings in Asia where they scrupulously avoid numbering the fourth floor. It’s Impossible to Get Accurate Personal Information from Multicultural People Because They’re So Secretive This is one belief that is a definite reality. Many people who are new to this country are extremely private about medical and other personal data. They may distrustful of healthcare organizations because of experiences in their home country. Unfortunately, healthcare organizations are receiving a great deal of publicity lately for their zeal in collecting personal information about patients. Even asking about the ability to pay for medical services may create an uncomfortable situation. Many new immigrants don’t believe in banks and keep much of their money hidden as cash in their homes. They may feel that to indicate what they have in the way of resources may make them the target of thieves. Just because nearly half of all working-age Latinos lack health insurance doesn’t mean they can’t afford healthcare. Members of this and other ethnic groups may be willing and eager to pay cash for the services they receive. Some cultures believe it is unacceptable to owe money and many do not believe in borrowing to pay for purchases. The fact that the multicultural patient does not have insurance doesn’t necessarily mean they’re not paying customers. People From Outside This Country -Insist On Negotiating the Price for Services There are two types of countries in the world – negotiating and non-negotiating. The United States is a non-negotiating country where we generally pay the price asked by vendors without question. In most other countries around the world, people haggle on everything from groceries to clothing to homes to medical care. This is not simply a way of getting a better price. It’s also a way to get to know those with whom one is doing business. Often, something as simple as giving a habitual negotiator a free sample can make them feel more comfortable with the relationship because they’re used to getting something extra from a vendor with whom they plan to do business for a long time. People from Other Cultures Are Just Too Much Trouble For the most part, multicultural customers can be more enjoyable to work with than many mainstream customers who have become jaded by the system. Minority consumers are likely to place a lot of emphasis on personal interaction and to develop a strong loyalty if that loyalty is earned. In addition, people from other cultures are very good about referring their friends and family if they are served with sensitivity and patience. People from Other Lands Should Do As -Americans Do When they’re In This Country While it’s difficult for us to leave our 200-year-old American culture at the gate when traveling abroad, it’s even harder for those coming here from cultures that are thousands of years old. The U.S. healthcare system may be one of the biggest challenges for newcomers. After all, even native-born Americans have a very hard time understanding their medical plans. A little effort in accommodating multicultural customers will go a long way in winning acceptance and loyalty. It’s Too Much Trouble to Customize Products or Services for People from Other Cultures Making changes to accommodate minority consumers doesn’t have to be hard. It does take some thought and an appreciation of the patients’ expectations. A good place to start is with promotional brochures and patient forms. They should be printed in the major languages of the patients who seek services with your organization. However, avoid carrying out word-for-word translations from English, since many concepts and words don’t convert easily to other languages. Marketing lore is replete with stories of gaffes in marketing campaigns that failed to appreciate linguistic and cultural distinctions. Recently, General Motor’s Buick division spent a great deal of time and money coming up with a name for a new car that they eventually decided to call “LaCrosse.” Unfortunately, GM neglected to check with its French Canadian distributors because, while that is the name of a popular sport, it also turns out to be slang in Canada for masturbation. It is not recommended that family mem-bers be used as translators because patients may not want to divulge their illness to those closest to them. Laypersons are also not aware of the correct anatomical terms or what might be involved in specific conditions, illnesses, treatments, and procedures. When children are used as interpreters, they often become embarrassed, confused, and afraid to discuss adult issues with their parents. Instead, consider using one of several telephonic interpretation services that are available by searching the Internet under “medical telephone interpretation.” The setting in which care is provided should be carefully considered. This may involve hiring a consultant to assess the office layout, color scheme, signage, and other factors that may represent cultural barriers. Issues to consider include feng shui (placement of objects for optimum energy flow); good and bad numerology; and the packaging of consumer health products. It’s important to be sensitive to privacy, personal data confidentiality, restrictions on male/female interaction, and other cultural concerns. While it’s impossible to be aware of all of these issues, it’s important to ask the patient about any restrictions. Everyone Should Be Treated Equally, -Regardless of Their Cultural Background Equality would dictate that you simply hand a printed medical booklet to someone who comes into your office with a seeing-eye dog and a white cane. The healthcare system has never treated members of different groups equally. The approach to care, the design of facilities, and the processes involved have been implicitly established to accommodate the needs of white, middle-class American patients to the exclusion of those who were “different.” Health professionals are beginning to realize this, and efforts are being made to create culturally sensitive environments that accommodate patients from a variety of cultural backgrounds. Don’t forget that we should not lump cultural groups together. In the Asian culture, Chinese are different from Japanese who are different from Koreans and so on. They speak different languages, have unique beliefs, and may even dislike each other for political, religious, or other reasons. Likewise, Hispanics are not homogeneous with large variations among Mexicans, Puerto Ricans, Cubans, South and Central Americans, and others. You must know what cultural group the client comes from. Clients don’t want to talk about their culture; they just want to be treated like everyone else This is probably the biggest myth when dealing with people from other cultures. Members of ethnic and minority groups know they are different. Unless culture is mentioned early in the relationship, it will always stand as a barrier to building true rapport. Taking a sincere interest in their cultural backgrounds will go a long way toward developing a trusting relationship. Even this process requires some cultural sensitivity. You should be open to talking about your own cultural background and history as a starting point. In everyday life, we find that multicultural people are asked about their cultural backgrounds in an accusatory way, “Where are you from, anyway?” Thus, it’s important that such information be received in an objective but personal manner. Knowing a word or two in the patient’s language is another way to help build rapport. In addition, it’s crucial that healthcare professionals recognize that ethnicity can play an important role in treatment. For example, Latinos and African Americans have higher rates of hypertension, diabetes, and asthma. Studies by the American Diabetes Association show that 13% of African Americans and 10% of Hispanics have diabetes as opposed to only 6% of Americans in general. Similarly, Asian Americans have been shown to face a higher risk for cardiovascular disease, depression, cancer, and diabetes than do white Americans. By opening up American culture to these clients and accepting aspects of their cultures, it’s possible to develop a mutually beneficial relationship that has the potential to create a loyal lifetime customer. –––––––––– Michael Soon Lee, MBA, is a diversity consultant specializing in multicultural marketing. He has written several books and speaks worldwide on the subject. In his new book, Black Belt Negotiating, Michael shows people how to use martial arts secrets to gain leverage in any bargaining situation He can be reached at Michael@EthnoConnect.com. His website is www.EthnoConnect.com