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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 encounters.⁷

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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