Most importantly for the Lees, they were no longer considered the ultimate decision makers for their children. Doctors have the power to call the police and to access state power which Hmong parents do not have" (84).
A Minnesota physician summarized this view: "Once the police are called and court orders are obtained… reveals that Western doctors' knowledge is considered superior to Hmong beliefs.
Had they done so, they might have been able to engage in cultural compromise, inviting a tvix neeb to work alongside the doctors who might have been able to convince the family that the amount of medication prescribed was beneficial.
Lia's former hospital has since successfully adopted similar practices.
Certain aspects of Hmong culture, such as taboos against medical procedures, beliefs about the origins of diseases, and power structures within the family and the clan often conflict with the culture of western medicine, resulting in misunderstandings between doctors and patients.
Other aspects, such as utilizing animal sacrifice in shamanic ceremonies, have lead to conflicts between the Hmong and their American neighbors; for instance, some Americans believe the Hmong are kidnapping and killing neighborhood dogs.
They place great importance on the clan; for instance, one reason that Foua and Nao Kao accepted Fadiman and her interpreter, May Ying, is that May Ying's husband belonged to the Lee's clan.
Fadiman notes that family obligations sometimes put enormous demands on people, such as Jonas Vangay, a community leader who lived with his wife, his three children, his two brothers and their wives, and his brothers' ten children.
They believe that most disease has a spiritual cause and can be alleviated through traditional forms of healing such as rubbing the skin with coins, creating a vacuum by igniting cotton soaked in alcohol under a tiny cup, or drawing disease out with an egg.
A tvix neeb, or shaman, could conduct more powerful healing; such a figure is thought to be able to get rid of evil spirits called dabs and retrieve lost souls.