How Language Barriers Affect Healthcare

Effectively communicating with patients who are native English speakers can be challenging enough, but imagine how language barriers affect the level of care a patient receives. Providing quality health care for people with Limited English Proficiency (LEP) presents a great challenge for healthcare professionals who only speak English.

Over 20 million people in the U.S. are not proficient in English. Their limited ability to successfully discuss symptoms with healthcare providers sets the stage for inadequate and perhaps, fatal treatment. Hospitals in states such as California, Mexico and Texas, hire translators to act as a bridge between patients and doctors. Some institutions however, are not nearly as fortunate.

“Lack of interpreters translates into impaired health status, lower likelihood of being given a follow-up appointment, greater risk of hospital admissions and more drug complications,” Glenn Flores, a professor at the Medical College of Wisconsin-Milwaukee told USA Today.

Flores went on to describe the horrible impacts of lapses in communication including the story of how “a 2-year-old who fell off her tricycle was taken from her mother by social workers because a doctor misinterpreted the Spanish words ‘Se pegó’ to mean ‘I hit her’ rather than ‘She hit herself’.”

These unfortunate stories are becoming regular occurrences as the shift to a global environment brings people of different racial, ethnic and cultural backgrounds together in the same communities. Communication failure and culture clashes are an inevitable result of such interaction.

Katherine E. Clarridge, Ernest A. Fischer, Andrea R. Quintana and James M. Wagner, MD, posed the question “Should All Doctors Speak Spanish?”  Their article in the American Medical Association Journal of Ethics offers an interesting take on addressing language barriers and examining the physician’s role as a patient advocate. How can a medical practitioner solve a problem he or she does not understand? International Community Health Services, a clinic with four locations around Seattle, Washington, has a medical staff where everyone speaks at least one language other than English. The clinic’s approach to meeting patient needs may represent a new wave in health care delivery.

Since federal laws stipulate no one can be denied or forced to wait for medical care due to language barriers, some healthcare providers resort to secondary strategies like drawings and hand signals to compensate for gaps in communication. Still, the possibility for error is simply too high. To help alleviate these issues, patients are often urged to bring a bilingual friend or familiar member to explain their medical problems. Hospitals and healthcare facilities, based on the population they serve, translate documents to ensure patients complete all required paperwork properly. Brochures and resources are provided to those who speak limited English to help facilitate their participation in American society and encourage them to take ownership of their health.

It’s worth pointing out Americans are at the same risk of receiving poor care when traveling overseas. Current copies of health records are of little value if no one can read them.


Voice Your View: How does your employer overcome language barriers? Should medical institutions require that all healthcare employees be bilingual?