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Multicultural Medicine : Patients want doctors and nurses who speak their language--and know their fears. Hospitals try to keep pace by providing everything from sushi and salsa to CPR seminars in Spanish.


When Takehiko Kobayashi of Gardena underwent surgery in December at Torrance Memorial Medical Center, he was surprised to find that many nurses spoke his native Japanese.

"To me, that makes a lot of difference," said Kobayashi, 58. "When you are sick, you're not in the mood to try to communicate things in a foreign language."

Spurred by that same feeling, Lisa Torres of San Pedro scoured her health plan physicians' list for a Latino name.

She and her husband chose Dr. Andres Jimenez, a young family physician with ties to San Pedro Peninsula Hospital, and she turned to him last month when her 6-month-old son, Rudy, fell sick with a stomach virus. Even though she and Jimenez communicated in English, she felt reassured that he understood her concerns.

"It's not that I'm prejudiced or anything. I just felt comfortable with a Latino physician," said Torres, 27, a local cable company employee.

This desire for a cultural common ground in medicine--a nurse who speaks the same language, a doctor who understands one's heritage--is helping forge changes at some hospitals in the South Bay.

In a medical world that can seem harsh and impersonal, even when patients and doctors speak the same tongue, new attention is being paid to the barriers that can be posed by language and culture. Such concerns helped create the hospital wing where Kobayashi recuperated, a wing that will formally open this month as the East-West Pavilion, the South Bay's first inpatient hospital unit designed for Asians.

Here, nurses speak Japanese or Chinese, and meal trays have chopsticks, Japanese garnishes such as shredded cabbage or radish, and, of course, the traditional warm towels. Pavilion planners even designed a sushi assortment nicknamed "the Torrance pack" that contains tuna, shrimp, whitefish, eel and California roll.

This wing is perhaps the most ambitious example of how some local hospitals are retooling their services amid the sweeping demographic changes in Southern California.

Asians accounted for nearly 10% of the patients treated at Torrance Memorial in 1991, up from 5% eight years earlier. Another 69% were white, 14% were Latino and 8% were black.

"The South Bay demographics have changed and are going to continue to change. That's what we're responding to," said Carlene Reuscher, senior vice president for patient services at the 340-bed nonprofit hospital.

She described the East-West Pavilion as a starting point and says the hospital is planning other changes, such as more materials in Spanish. "Our first desire is to meet (patients') needs better. Our second hope is that patients will prefer to come here."

Some say this trend toward multiculturalism is simply good medicine; others call it good business sense. But since the South Bay's Asian and Latino communities have grown dramatically in recent years, other hospitals have begun trying to appeal to a more diverse patient market.

Little Company of Mary Hospital in Torrance is expanding a program that provides physicals for executives of Japanese companies.

The same hospital now sends new mothers home with a baby-care video in English, Spanish or Japanese.

Dishes such as fajitas , tacos and menudo were added last year to the patient menu at Robert F. Kennedy Medical Center in Hawthorne, where the Latino community nearly doubled in the 1980s to account for more than 30% of the city's population.

And Inglewood's Daniel Freeman Memorial Hospital and the Great Beginnings for Black Babies program are opening a clinic targeted at African American and Latino patients in a Hawthorne shopping mall this week. Those two groups comprised 68% of the hospital's patients in 1991.

Some say these changes are long overdue. One Latino doctor, for instance, said hospitals have ignored the Latino community too long in favor of patients considered more likely to have private health insurance.

"There's not always been a willingness on the part of the provider to treat (patients) on an equal basis," added Virginia Apodaca, regional manager of the Office for Civil Rights for the U.S. Department of Health and Human Services. "I'm seeing improvement now, because providers are taking steps to communicate with patients."

In many cases, those steps are being taken because Los Angeles County has evolved into the Ellis Island of the late 20th Century, where residents come from 140 countries and read more than 50 foreign-language newspapers published here.

Just four months ago, California created a new Office of Multicultural Health, explaining that the state's African Americans, Native Americans, Asians and Latinos experience a disproportionate share of disease, disability and early death.

But more than humanitarianism is helping kindle this interest in patients from diverse cultures.

In the turbulent world of health-care economics, some hospitals have concluded that marketing to racial and ethnic groups makes economic sense--and may be a key to their survival.

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