Language Barriers in Healthcare

Dr. Realba Rodriguez

Dr. Realba Rodriguez is a PGY 3 in Internal Medicine at Montefiore Medical Center, North Division, Bronx, NY.

When I was asked to share my experience with language barriers in health care, I felt there was so much I could share, because the lack of physicians who are able to speak Spanish in NYC was my motivation for moving here from Puerto Rico, where I was born and raised. Given that the Latino community is one of the biggest populations in the city, I was amazed at the small number of physicians who could truly communicate with their patients.

I started rotations throughout different hospitals in the Bronx in my third year of medical school. Immediately, attendings and residents were requesting my help with their Spanish-speaking patients. The frequency of their requests quickly became overwhelming: “Can you please explain this procedure?” “Can you tell him he is going home?” “Can you tell her she has CANCER…?” As my years of medical school came to an end, my concern about language barriers grew stronger. How will physicians know what is wrong with their patients? How will physicians understand them? Their language? Their culture?

As a resident, I witness more and more of my colleagues struggling to convey important information to their patients, sometimes even wondering why their patients do not follow up as advised. Facing this situation on a daily basis, I was inspired to start a medical Spanish class for my colleagues. My primary goal was to teach them how to ask for common complaints and understand key words during their interviews. To my surprise,residents, fellows, and even attendings began participating in the class.

To date, we have carried out almost two years of classes. Considering the improvements I see every day in my “students,” I believe there should be some formal training for physicians and health-related professionals in cultural competency. New York City is called “the melting pot of cultures,” but we as physicians are sorely lagging behind. Let’s get educated on more than just blood pressure management or the newest chemotherapy available. Let’s train ourselves to communicate with our patients and fulfill our mission to serve them.

I know that new policy proposals or regulations to reduce language barriers will lead to some resistance. And we as physicians are often the most rigid participants when asked to adopt new changes. It seems that unless the government is strongly behind these new policies, and there are changes in the system to ease the transition, the vast majority of physicians will not adopt them. To encourage healthcare professionals to learn other languages, we first need to address those predictable causes of resistance, such as:

  • Lack of available time. Use simple lesson plans that can be practiced in short periods of free time.
  • Cost. Courses are expensive. Government should offer some type of reimbursement or incentive.
  • A steep learning curve. Make available lessons designed by experts on teaching Spanish for medical professionals.

We must take a step back and ask ourselves, “How many Spanish-speaking residents and fellows practice medicine in the Bronx and in other heavily Latino or Hispanic communities? Why do we not include more doctors-in-training who speak the predominant and diverse languages of these underserved areas?”

These are just some of the ideas that we can propose to our colleagues and to the legislators to help healthcare professionals overcome language barriers with their patients. The non-English-speaking community continues to grow, and we will need more physicians that can serve them and serve them well.

In an effort to help residents learn the languages of their patients, CIR has negotiated a significant discount on Rosetta Stone for all CIR members. Learn more about the discount.

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