An Unspoken Inequity: Communication With Patients and Families With Limited English Proficiency.

Abstract

“Dolor?” My ears perked up as I overheard the Spanish word for pain while prerounding on an early weekday morning. I followed the voice of my coresident and quietly observed as she continued to ask “dolor?” while pointing to various body parts on a young child. The patient’s father was communicating back by either nodding or shaking his head. As a Dominican woman fluent in Spanish, I introduced myself and gently offered to interpret. My coresident and the patient’s family offered me grateful smiles. Although I was happy to help my colleague and this patient, I also felt unsettled, likely because of experiences I had growing up. As a child, I went to doctors’ appointments with my grandparents and witnessed interpreter experiences that ranged from outstanding to absent altogether. I watched as they were put in the awkward position of trying to communicate in broken English, while simultaneously feigning understanding of the broken Spanish spoken by health care providers. In thinking about these memories, I became frustrated. Why don’t health care providers request and use an interpreter each time one is needed? However, I cannot deny that I too have taken “shortcuts.” For example, I remember quickly talking to an Arabic-speaking family without an interpreter, using a hand signal to indicate that I would be back later. Yet although providers are certainly part of the problem, the core issue at hand is not with me or my coresident as individuals. The reality is that our health care system and culture remain inadequately prepared to ensure equitable communication with patients and families with limited English proficiency (LEP). The scope …