Issues in the provision of health care to Soviet emigrants.

Political and economic unrest in the former Soviet Union has been associated with an influx of refugees to the United States. The medical staff at our health maintenance organization perceived health care provision to the Soviet refugees as a goodwill opportunity, but soon realized that providing health care to this subpopulation of patients was very difficult. This was often related to cross-cultural differences regarding disclosure of medical information to the patient, acute care provision, and payment systems. Immigrants' expectations of US medicine are incredibly high. The interpreter plays a key role in facilitating communication between the health care team and the immigrant, yet the use of an interpreter has several inherent problems. Recognition of the problems and knowledge of the cross-cultural differences will likely improve rapport between health care personnel and immigrants.