At the recent 2025 Doctors Nova Scotia annual conference in Membertou, Cape Breton, the education session explored how physicians can help Indigenous patients feel safe and respected in healthcare.

Presenters Dr. Margot Latimer and Ms. Julie Francis provided a brief overview of the history and geography of the Mi’kmaq in Nova Scotia and Indigenous people in Canada, as well as content related to health, healing and care strategies. They reviewed landmark documents calling for action.

Two-eyed Seeing approach
Before colonization, Indigenous people had their own systems, knowledge and practices related to health and well-being. The Two-eyed Seeing approach combines Indigenous and Western knowledge systems, taking the best from both worldviews to overcome challenges and barriers.

The Aboriginal Children’s Hurt & Healing Initiative (ACHH, pronounced “ache”) is research led by Mi’kmaw people to gather Indigenous knowledge to improve the healthcare experience through education, research and practice. ​The initiative began to understand the experience and expression of pain for Indigenous people, but the Mi’kmaw language has no words that translate to “pain” – instead their word is hurt.

Healthcare disparities
In its research, ACHH has found that Indigenous patients experience pain in four dimensions: mental, physical, spiritual and emotional. ​Disparities exist between Mi’kmaw and non-Indigenous Nova Scotians in how chronic conditions are assessed, diagnosed and treated. Poor experiences, discrimination and miscommunication can occur when Mi’kmaw and Indigenous patients seek care, resulting in treatment delays​

Healthcare providers have little knowledge of Indigenous peoples’ history and health needs​. In addition, there is little understanding about conducting research with Indigenous peoples​. Non-Indigenous people make decisions for Indigenous people in education, research and practice, but a lack of knowledge may translate to decisions that do not benefit the Indigenous patient.​

Start with the four Rs
Culturally safe care happens when clinicians have more awareness and knowledge, and feel confident in using that knowledge. Healthcare providers can begin by following the four Rs: respect, relevance, reciprocity and responsibility. Culturally safe care respects Indigenous people’s cultural integrity by providing health leaders and providers education that is relevant to Indigenous perspectives and experience; by fostering reciprocal relationships; and by demonstrating responsibility through participation.

Boost your knowledge to build trust
Healthcare providers can create cultural safety by learning about Indigenous history to better understand the care needs of Indigenous patients. It is important to bring humility to care and meet Indigenous individuals where they are, considering social, language and geography contexts.

It’s key to recognize that generations of trauma have created emotional pain and hurt that transcends physical pain and time, permeating communities’ ways of being. The presenters also recommended that physicians recognize that stoicism is an expression of pain and hurt, and may be a coping mechanism born of intergenerational trauma. Being a good communicator, such as listening to stories, can help healthcare providers improve trust, relationships and care.

Photo: Dr. Margot Latimer and Ms. Julie Francis present the education session at Doctors Nova Scotia’s annual conference in Membertou, Cape Breton.

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