Toward a cultural consciousness of self in relationship: from "us and them" to "we".

BACKGROUND AND OBJECTIVES: While skills and techniques can help family physicians and other health professionals achieve basic competence in working across cultural and social boundaries, perhaps their most important tasks are those directed inward toward attitudes, beliefs, and capacities for self-exploration. This essay links the practice and teaching of cross-cultural medicine to clinicians' and educators' exploration of their own self- consciousness. The more they are willing to explore the unfamiliar within themselves, the more emotionally and psychologically comfortable they can become in dealing with the joys and challenges inherent in cross-cultural medicine. Several practices can foster this development of a sense of self in relationship with others. As health professionals and medical educators recognize and promote an awareness of self in relationship, they can enhance their personal and professional roles to become more effective advocates of equity and social justice in every clinical encounter.