INTRODUCTION
In recent years, patient-centeredness and cultural competence have been promoted as integral to improving health care quality. Although patient- centeredness and cultural competence have grown out of separate traditions each with its own focus they have many similarities. Health care that is patient-centered is likely also to be culturally competent, and culturally competent care is likely to be patient-centered. Proponents of patient-centeredness may therefore view cultural competence as within its purview; likewise, proponents of cultural competence may view patient-centeredness as an essential element.

THE EVOLUTION OF PATIENT-CENTEREDNESS
Patient-centered care supports active involvement of patients and their families in the design of new care models and in decision-making about individual options for treatment. The IOM (Institute of Medicine) defines patient-centered care as: "Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions." The term “patient-centered medicine” was originally coined by Balint in 1969 to express the belief that each patient “has to be understood as a unique human being (Balint)".The concept has evolved and expanded, and today, no one would deny that health care should be patient-centered.2 However, despite universal endorsement of patient-centeredness, there is considerable ambiguity in its definition and use across settings. To understand this variability, it is worthwhile to examine the evolution of the concept.

CULTURAL COMPETENCE
Cultural competence is defined as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations (Cross).
The issue of