Language barriers and patient-centered breast cancer care

Abstract

Objective Provision of high quality patient-centered care is fundamental to eliminating healthcare disparities in breast cancer. We investigated physicians’ experiences communicating with limited English proficient (LEP) breast cancer patients. Methods Survey of a random sample of California oncologists and surgeons. Results Of 301 respondents who reported treating LEP patients, 46% were oncologists, 75% male, 68% in private practice, and on average 33% of their patients had breast cancer. Only 40% reported at least sometimes using professional interpretation services. Although 75% felt they were usually able to communicate effectively with LEP patients, more than half reported difficulty discussing treatment options and prognosis, and 56% acknowledged having less-patient-centered treatment discussions with LEP breast cancer patients. In multivariate analysis, use of professional interpreters was associated with 53% lower odds of reporting less-patient-centered treatment discussions (OR 0.47; 95% CI 0.26–0.85). Conclusion California surgeons and oncologists caring for breast cancer patients report substantial communication challenges when faced with a language barrier. Although use of professional interpreters is associated with more patient-centered communication, there is a low rate of professional interpreter utilization. Practice implications Future research and policy should focus on increasing access to and reimbursement for professional interpreter services.