Describing Physician Language Fluency: Deconstructing Medical Spanish

Harold Schiffman hfsclpp at
Wed Jan 28 16:24:56 UTC 2009

Describing Physician Language Fluency: Deconstructing Medical Spanish

Lisa C. Diamond, MD, MPH; Daniel S. Reuland, MD, MPH

JAMA. 2009;301(4):426-428.

 Since this article does not have an abstract, we have provided the
first 150 words of the full text and any section headings.

Language barriers are increasingly important in US health care.
Limited English proficiency is associated with poorer health care
processes and outcomes.1 Disparities in care for patients with limited
English proficiency persist even when socioeconomic and insurance
status are considered, suggesting that language and culture also play
an important role.2 Accumulating research shows that having a
language-concordant physician is associated with improved quality and
outcomes.3-5 Using professional interpreters can also lead to better
care for patients with limited English proficiency,6 but physicians
and medical trainees underuse professional interpreters, frequently
substituting their own limited spoken Spanish during clinical

Because many physicians who provide language-concordant care are not
native speakers of Spanish, studies are needed to help understand the
degree of fluency a clinician needs to provide high-quality,
language-concordant communication. In addition, a more basic problem
is the lack of consistency in . . . [Full Text of this Article]

Author Affiliations: Robert Wood Johnson Clinical Scholars Program,
Yale University School of Medicine, New Haven, Connecticut (Dr
Diamond); VA Medical Center, West Haven, Connecticut (Dr Diamond);
Palo Alto Medical Foundation Research Institute, Palo Alto, California
(Dr Diamond); and Division of General Medicine and Clinical
Epidemiology, Department of Medicine, University of North Carolina at
Chapel Hill (Dr Reuland).

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