Cultural Humility in Surgery: An Interview with Loretta Erhunmwunsee

Cross-cultural care is more important than ever in an increasingly divided world, but understanding how to implement this kind of responsible care is a complex endeavor. 

In this interview, conducted by CTSNet Global Senior Editor Emily Farkas at the 2023 Annual Meeting of the American Association for Thoracic Surgery, surgeon-scientist Loretta Erhunmwunsee shares stories and strategies for creating cross-cultural connections to understand patients’ needs and goals and identify appropriate care.

Dr. Erhunmwunsee, a thoracic surgeon and researcher at City of Hope Medical center in Duarte, California, splits her time between surgically treating patients with thoracic malignancies and researching health inequity. These interests come together in her effort to build evidence that structural inequities lead to thoracic oncologic disparities. (For more on Dr. Erhunmwunsee’s research, check out her recent featured profile interview.)

When recently asked about strategies surgeons can use to facilitate equitable care, in addition to active listening, Dr. Erhunmwunsee reiterated that it is important to acknowledge “the fact that we are partners. I am a surgeon, so I have skills and expertise in that lane, but they are the experts for their bodies and for their lives.”

She went on to discuss cases in which patients’ cultures and communities may suppress their communication about their health. It is important to understand that in these cases, care goes well beyond the hospital stay. Patients are enveloped in cultural implications as soon as they go home, which may dictate their care. “I’ve got to, as best as I can, try to understand that culture and dynamic, and not be disruptive to it…I’ve realized my thirty minutes doesn’t equate to the decades of years in the patient’s life.”

In addition to flexibility in the face of cultural differences, Dr. Erhunmwunsee addressed the importance of thinking beyond surgical techniques, length of stay, outcomes, and complications. “I am trying to integrate more of the patient’s social and environmental context into our treatment planning. As I assess the patient, I want to more fully assess that part of them,” she said.

To health professionals who are not currently integrating cross-cultural humility into their patient care, Dr. Erhunmwunsee emphasized data that shows outcomes are better when patients feel like they’re listened to. Depending on where they live, environmental factors and poor cultural understanding can mean that surgery is not enough. Patients need to feel heard, or their alienation can contribute to poor outcomes. 

Dr. Erhunmwunsee leaves fellow surgeons with a crucial question to ask about each of their patients: “Is the structure of their environment one that’s conducive or a barrier to what we’re trying to do for them?” With this in mind, along with the other factors addressed by Dr. Erhunmwunsee in this interview, surgeons can make informed decisions to give the best cross-cultural care possible.

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