August 2003 ■ Journal of Dental Education 869 Cultural Competency: Dentistry and Medicine Learning from One Another Allan J. Formicola, D.D.S., M.S.; Judith Stavisky, M.P.H., M.Ed.; Robert Lewy, M.D., M.P.H. Abstract: The Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care is serving as a catalyst for the medical profession to re-examine the manner in which its institutions and training programs relate to cultural competence. This report found that racial and ethnic disparities exist in health care and that a lack of access to care does not fully explain why such disparities exist. The IOM study found bias, stereotyping, prejudice, and clinical uncertainty as possible contributing causes. The U.S. Surgeon General’s Report on the Oral Health of the Nation also pointed to oral health disparities related to race, ethnicity, and culture. This paper discusses how medicine is responding to the Unequal Treatment report and the lessons to be considered for dentistry. Recommendations on how dentistry can apply the knowledge from this report to help reduce oral health disparities are suggested. Dr. Formicola is Professor of Periodontics, former Dean of the Columbia University School of Dental and Oral Surgery, and currently Vice Dean of the Center for Community Health Partnerships at Columbia University, Health Sciences Division; Ms. Stavisky is Senior Program Officer at the Robert Wood Johnson Foundation; and Dr. Lewy is Associate Clinical Professor of Medicine and Public Health at Columbia University. Direct correspondence and requests for reprints to Dr. Allan Formicola, Columbia University, Center for Community Health Partnerships, 630 W. 168 th Street, P & S Box 100, New York, NY 10032; 212-304-5214 phone; 212-544-1938 fax; ajf3@columbia.edu. Key words: cultural competency, health disparities, race, ethnicity Submitted for publication 5/20/03; accepted 6/11/03 I n order to serve the public with the best health care possible, it is important that all of the health professions share information and apply common experiences in the delivery of health care. Although medicine and dentistry are two separate professions, sharing knowledge and information between the two was one of the imperatives of the 1926 Gies Report. 1 During the latter half of the twentieth century, both fields grew in their understanding of disease and in their ability to successfully treat and prevent disease. Today, however, one of the major challenges com- mon in both medicine and dentistry is how to effec- tively address the health disparities that exist among various ethnic and racial groups in the U.S. popula- tion. If we are to meet the national goals established to reduce those types of health disparities by 2010, 2 we need to understand the cause of racial and ethnic health disparities and design interventions to elimi- nate them. The Institute of Medicine (IOM) report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care 3 documents many of the causes of the disparities experienced by minorities in the United States. The purpose of this paper is to explore some of the findings from that IOM report, describe how the field of medicine is responding to its key recommendations, and discuss the findings and responses in relation to dentistry. Unequal Treatment : A Report of the Institute of Medicine Congress requested that the IOM assess whether there were differences in the type and qual- ity of health care between minorities and nonminorities in the United States. The study was conducted to “(1) assess the extent of racial and eth- nic differences in health care that are not otherwise attributable to known factors such as access to care (e.g., ability to pay or insurance coverage); (2) evalu- ate potential sources of racial and ethnic disparities in health care, including the role of bias, discrimina- tion, and stereotyping at the individual (provider and patient), institutional, and health system levels; and (3) provide recommendations regarding interventions to eliminate health care disparities.” After an exhaus- tive and critical review of the existing literature, com- missioned papers, and focus groups, the IOM study committee found that even in populations with equal access to health care “racial and ethnic disparities in health care exist and, because they are associated with worse outcomes in many cases, [that they] are unac- ceptable.” Among the diseases the study committee