Primary Care to Oncology – Conversations for Change: Jordan Chavez Discusses Cultural Competence and Patient Centered Communication
Speaker:
Jordan Chavez, LCSW, Stanford Health Care
Conference:
2025 Health Equity: Primary Care to Oncology—Conversations for Change
Introduction: Culture Is More Than We Think
At the 2025 Health Equity Primary Care to Oncology—Conversations for Change conference presented by Total Health, Jordan Chavez, a Licensed Clinical Social Worker at Stanford Health Care, challenged the traditional lens through which many healthcare professionals view the concept of “cultural competence”. Rather than limiting the term to a general understanding of ethnicity, religion, or nationality, she offered a more nuanced framework—one that includes institutional culture, team dynamics, and communication habits among providers. “Culture isn’t just where a person comes from. It’s also the culture of a clinic, of a specialty, of a team—and how that affects how we talk about and treat our patients…” she noted. In her presentation she emphasized that, the way providers talk to each other about patients matters just as much—if not more—than how we talk to the patient themselves. In this regard, Ms Chavez encouraged attendees to critically examine how their own bias, burnout, and systemic frustration can impact a patient’s movement through the oncology care continuum.
The Hidden Weight of Provider-to-Provider Communication
Ms Chavez emphasized that communication among care providers directly impacts patient outcomes—whether it’s speeding up or delaying an initial diagnosis, eroding trust, or shaping provider perception before a patient even enters the room. She illustrated this through a common scenario, for example, when a well-liked patient would be described as “sweet,” “easy,” and “lovely,” while a more complex patient can be labeled “difficult,” “noncompliant,” or “needy.” These narratives, Chavez explained, can prime the next provider to unconsciously shift their own expectations and behaviors. “When we call a patient ‘difficult,’ it’s not about their character… It’s about the system that’s failed to understand what’s really going on.”
Social Determinants of Health: The Unseen Contributors to 'Noncompliance'
The heart of Ms Chavez’ presentation revolved around the recognition of social determinants of health (SDOH)—factors such as housing instability, food insecurity, income, early trauma, and systemic racism. As such, she encouraged providers to dig deeper, and shift from simply labeling patients as “noncompliant” to asking the more insightful and useful question of, “What’s getting in the way?” She emphasized that many barriers that providers perceive as personality-based—things like missed appointments, anxiety, resistance to treatment—are more often rooted in external stressors for the patient. “This is what’s behind noncompliance… This is what’s behind anxiety… This is what’s behind that 45-minute appointment you didn’t plan for.”
A Practical Framework: Pause, Perspective, Problem-Solve
In an effort to translate this awareness into daily practice, Ms Chavez introduced a simple, but powerful, three-step framework for improving provider communication around patients. The first step she noted is to Pause, literally, take an actual breath, reset, and disarm. She encouraged providers to disrupt would-be emotionally- charged interactions by taking this pause, even mid-conversation. The break, she emphasized, allows for reflection and de-escalation and serves as a signal to others that you’re open to changing the tone of the interaction. Some practical “words that work” in this situation include:
“I’m going to start over.”
“Let me rethink how I said that.”
“What do we actually want for this patient right now?”
The second step, Ms Chavez noted, is to seek Perspective. Step outside of your own frustration and consider the context of others—patients and colleagues alike. She emphasized curiosity over judgment. “Words that work” might include:
“Is this about our communication… or about the patient?”
“I’m sure neither of us can see the full picture.”
“What am I missing?”
In this regard, Ms Chavez also reminded attendees that even a “hostile” colleague may be carrying invisible burdens—an overflowing clinic schedule, a denied prior authorization, a personal crisis, and so on.
The third step, Ms Chavez outlined is to Problem-Solve. She emphasized that, only after grounding in the pause and the perspective, should the team move into action planning. “Start small” she emphasized “…focus on just the next step.” She offered these “words that work”:
“If we could wave a magic wand, what would this look like?”
“How can I make this less bad?”
“Let’s reconnect in 15 minutes.”
Lastly, she urged the audience to resist the urge to rush through these steps, noting that time spent aligning communication early often prevents greater inefficiencies and missteps later.
Centering Equity: Not All Patients Need the Same—Some Need More
In the spirit of the health equity conference, Ms Chavez also gave a powerful reminder to attendees that true health equity means tailoring care—not flattening it. For example, a young person with late-stage lung cancer, or a patient with no reliable transportation to get to their appointments, will need more advocacy and navigation through the system than someone who has ample support and means. “Your young patient with ALK-positive lung cancer doesn’t just need the same care—they need more… That’s what equity looks like.” Citing a quote from James Baldwin in her final slide, Ms Chavez concluded “Not everything that is faced can be changed, but nothing can be changed until it is faced.”
A Final Takeaway
Summarizing her presentation, Ms Chavez put forth a call to intention, where oncology care providers need to go beyond well-meaning, administrative ‘checklists’ to true examination of how their words, their assumptions, and their interactions with others can create ripples for patients throughout the system. By doing so, she noted, providers won’t just improve care—they will make it more human for the patients they serve.
Speaker Disclosure Information: Ms Chavez reported no relevant disclosures for this presentation.