Promoting Appropriate Use of Physicians' Non-English Language Skills in Clinical Care: Recommendations for policymakers, organizations and clinicians

Produced by the Commission to End Health Care Disparities, an umbrella group consisting of more than 70 state and specialty medical societies, Promoting Appropriate Use of Physicians' Non-English Language Skills in Clinical Care seeks to improve the quality of communication and care given by bilingual physicians, who may have varying levels of ability in one or more non-English languages. While nearly nine out of 10 hospitals report using bilingual providers to treat limited English proficient (LEP) patients, very few evaluate their competence in non-English languages in any careful and systematic way. As there are a number of groups in the process of development assessment tools for this purpose, the Commission seeks to encourage these efforts and to capture the consensus of stakeholders on effective strategies for reducing disparities in treatment and health outcome due to language barriers.

The report provides separate recommendations for clinicians, healthcare organizations, and policy makers. Among the recommendations for policy makers are: creating tools to assess and improve use of clinicians' non-English language skills, developing payment models to cover the cost of interpreter services, and collecting and recording patients' language needs at initial point of service.  Health care organizations are urged to provide training to staff on how to work with interpreters and to bring interpreters into clinical care teams. Finally, the Commission encourages physicians to use their bilingual skills with patients "whenever doing so is safe and effective."  In order to make this determination, physicians may wish to ask a trained interpreter "to audit a handful of patient encounters and provide feedback on the quality of the communication." Finally, the Commission proposes a research agenda to clarify outstanding issues, including developing and testing "affordable and accessible (language) assessment tools for bilingual physicians and other health professionals providing care to patients with LEP." (Abstract courtesy Nicholas Montalto, PhD.)

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