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Wm. MacMillan Rodney, MD
San Bernardino County Medical Center San Bernardino, Calif

JAMA. 1986;255(19):2601.

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

To the Editor.—

Since I have taught and practiced in cross-cultural environments over the past ten years, the recent article by Dr Putsch¹ had special significance for me. My colleagues and I are family physicians and our experiences have been similar to those described.^2,3

There are special issues regarding the care of Spanish-speaking patients that remain unaddressed. We have previously documented the underdiagnosis of psychosocial issues in a family medicine setting.⁴ An interesting finding was the large percentage of patients who spoke Spanish only. We applied multivariate techniques to discern possible etiologies for "noshow" behavior by family medicine patients.⁵ This analysis selected language barrier as an important issue.

These experiences and studies led us to slightly different conclusions regarding general guidelines for monolingual providers. First of all, we borrowed from Osler's dictum that "who the patient is is more important than what disease the patient has." Therefore, . . . [Full Text PDF of this Article]

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