In the 1990s, before I started my second year of medical school at University of California, San Diego (just 30 minutes north of the Mexican border) I made a decision that would change my life. The second-year curriculum allowed for a number of elective courses. We were supposed to select from a catalogue of options—radiology, advanced anatomy, medical ethics, and many others. Most students chose two per semester. I chose one that spanned the entire year: Medical Spanish.
This content was originally presented as part of our live learning event, "Expanding the Role of Interpreters in a Value-Based System," by Dr. Alexander Green. View the recorded event here.
As a primary care physician, I take care of a large Spanish-speaking population, among other culturally and socioeconomically diverse patients. I’m fluent in medical Spanish and communicate directly with my Spanish-speaking patients. But regardless of whether I’m speaking Spanish or working with a medical interpreter, visits with limited English proficiency (LEP) patients always leave me with a worried feeling in the pit of my stomach. I’m keenly aware that most healthcare takes place outside of the doctor’s office, and this is where LEP patients fall through the cracks. I wonder, “Did Mrs. Ramirez really understand how to prep for her colonoscopy next week?” or “Was Mr. Luan actually convinced that he needs to take the medication I prescribed for his diabetes?”
Address the patient, speak clearly, avoid jargon, and check for comprehension
If you’re a healthcare provider who works with some of the 25 million limited English proficient (LEP) patients in the U.S., you know how important interpretation is to successful patient outcomes. Poor communication increases the chance of medical errors with any patient, and LEP individuals are especially vulnerable in this regard.
In this week's News Roundup:
- Near-Miss Mothers: For Every Woman Who Dies Post-Childbirth, Thousands More Come Close
- Surging Opioid Overdose Rate in Latinos Tied to Language Barriers
- More Transgender-Inclusive Healthcare is Essential
Near-Miss Mothers: For Every Woman Who Dies Post-Childbirth, Thousands More Come Close
The maternal mortality rates in the U.S. are grim, but the number of women who suffer postpartum complications that nearly cause death are even worse. For every woman who dies after childbirth, at least 70 come close. Some estimates put the number of women who suffer "severe maternal morbidity" at around 80,000 per year. A report by NPR/ProPublica finds that many of these complications are preventable, and there's a common theme that postpartum mothers don't feel their concerns are taken seriously by healthcare providers.
Racial Bias Isn't Just a Problem at Starbucks
A video of two black men getting arrested at a Starbucks in Philadelphia has sparked widespread outrage directed at both Starbucks and the police. In response, Starbucks announced that it will close 8,000 stores in May so employees can engage in racial bias training. "While this is not limited to Starbucks, we're committed to being a part of the solution," said CEO Kevin Johnson. The problem certainly isn't limited to one company, or one industry, or one region of the country. There are any number of examples of white Americans calling the police on black Americans without real justification. Deeply ingrained and unconscious racial bias routinely leads to instant, often fear-based judgements about people that can have dire consequences. The question is, what can we do to break this cycle?
Medical Residents Lack Comprehensive Training in Cultural Competency
A report from the Accreditation Council for Graduate Medical Education (ACGME) presents data from medical residency and fellowship programs, which shows that clinical learning environments (CLEs) vary widely in their application of strategies to address healthcare disparities. Among other findings, the data demonstrate a lack of comprehensive training in cultural competency.
This has been a banner year for Moffitt Cancer Center, with five national distinctions honoring their steadfast commitment to equitable care, including recent recognition from the American Hospital Association (AHA) naming Moffitt an Equity of Care Award honoree.
Effective communication is essential to the healthcare interactions at all levels. When patients have limited-English proficiency (LEP), or speak different languages, it is nearly impossible for clear communication to take place. Interpreters provide an essential bridge to effective communication with LEP patients. However, simply having a qualified interpreter in the room (or on the phone) will not automatically guarantee success. Make the most of interpreter-mediated patient interactions with our five tips for working with interpreters.