Definitions
- Cultural safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities (Ahpra)
- It requires clinicians to reflect on their own biases and power as well as learning about other cultures
- Aboriginal and Torres Strait Islander people have higher rates of diabetes, renal disease, rheumatic heart disease and trauma
- They are less likely to receive joint replacement despite greater need
In Practice
- Ask every patient whether they identify as Aboriginal or Torres Strait Islander
- Involve Aboriginal Liaison Officers and Aboriginal Health Workers
- Include family and kin in decisions when the patient wishes
- Allow time, use plain language and check understanding
- Consider distance, travel and return to Country when planning follow up
- Recognise racism and its effect on trust and outcomes
- Respect cultural practices around gender, death and the handling of body parts
- Offer Aboriginal health services and interpreters for those whose first language is not English
- Use telehealth to reduce travel for remote patients
- Avoid assumptions about understanding and preferences
Orthopaedic Relevance
- Higher rates of bone and joint infection, including in children
- Acute rheumatic fever can present as arthritis
- Delayed presentation of fractures and infection is more common in remote areas
- Discharge planning should consider housing and access to care
Training
- RACS Aboriginal and Torres Strait Islander Health and Cultural Safety online module
- RACS Intercultural Competency for Medical Specialists module
- Ahpra Aboriginal and Torres Strait Islander Health Strategy
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.