Why We Need Bilingual and Culturally Sensitive Doctors
Almost 7 million Californians lack adequate access to a family doctor. Many of these speak Spanish at home.
While 29% of Californians speak Spanish at home, less than 20 percent of physicians speak Spanish; even fewer physicians speak Vietnamese, Tagalog, Mandarin, Farsi, or other native languages of Bay Area residents. In the 50 largest U.S. metro areas, there are significant gaps between second languages spoken by physicians and those spoken by patients with limited English proficiency (LEP). Some 44% of Californians speak a language other than English at home, and at least 112 different languages are spoken in the Bay Area. In Santa Clara County, 51% of residents speak a foreign language at home. The disparity between physician supply and patient demand for those with non-English language skills means that many hundreds of thousands of patients have difficulty finding care providers who speak their language. While interpreters are an option, and while most Californians speak at least some English, in health care the impact of minor miscommunications is amplified. It is crucial for LEP patients to have crystal-clear communication in their own language for optimal care.
Everyone can benefit from access to doctors who understand their language, culture, and values.
Although Spanish is the most common second language for physicians in the U.S., most of those providing care to Spanish-speaking patients do not themselves speak Spanish as their first language. Several measures can be undertaken to help meet the need for bilingual and cross-cultural medicine in California. Michelle Aguilar, a bilingual pediatrician from Los Angeles, urges aspiring doctors and nurses to consider learning a second language before attending medical school. Cultural understanding not only helps doctors with correct diagnosis and treatment, but also with choosing the best methods of providing medical advice and support, because culture affects patients’ “motivation, perceived control and responsibility, and perceived support.” One patient-centered, culturally sensitive health care model that has been proven to improve health outcomes involves “engaging in behaviors and attitudes and fostering clinic characteristics and policies identified as important by culturally diverse patients” rather than being based solely off of the attitudes and beliefs of elite healthcare professionals and administrators.
Fortunately, significant progress is being made towards bridging the linguistic and cultural gaps in California’s healthcare ecosystem.
According to a 2010 study, 342 — or about one-third — of Palo Alto Medical Foundation’s roughly 1,000 affiliated physicians reported some non-English language proficiency. 40% of these physicians rated their proficiency as “very good” or “excellent” while the remainder reported it as “good” or “fair”. Overall, 47% spoke Spanish, 18% some form of Chinese, 10% a South Asian language, 10% another Asian language, and 16% a non-Spanish European language. Proficiency was measured via the five-level ILR scale used by the U.S. government; although proficiency is self-reported and physicians have a tendency to overestimate their proficiency in a given language, the trend over time is encouraging. Programs such as UCLA’s David Geffin School of Medicine, in which Spanish speaking medical students learn English and medicine at the same time. Chinese medical schools such as the American College of Traditional Chinese Medicine are bringing medical students into California from around the world, and training them to practice medicine based on a holistic, eastern approach that differs from the approach of traditional western medicine. These are just a few of the many examples of current trends in California’s healthcare industry which provide good reason for optimism regarding culturally sensitive medical care.
At Sami-Aid, we aim to help healthcare providers and patients speak each other’s languages in more ways than one.
Our Physician Search tool allows you to search for the best local doctors by language as well as price. We can help connect you with a doctor who speaks English, Spanish, Vietnamese, Korean, Cantonese, Mandarin, Tagalog, Farsi, Armenian, Arabic, Hindi, Punjabi, French, Russian, or Japanese.