The Health Care of Hispanics

Abstract

To the Editor. — In one of the editorials of the January 9, 1991, issue, Drs Furino and Munoz 1 state that there are many hypotheses but little consensus as to whether increasing the number of Hispanic physicians will improve health care access and utilization for Spanish-speaking patients. We studied the effect of a language barrier on health care utilization by Hispanic patients. 2 We found that, compared with monolingual Spanish-speaking patients with bilingual physicians (language concordant patients), monolingual Spanish-speaking patients with monolingual English-speaking physicians (language discordant patients) were three times more likely to omit medications, three times more likely to miss office appointments, and twice as likely to make emergency department visits. All but one of the bilingual physicians were Hispanic. Moreover, we surveyed 43 university hospitals in the United States and found that over half had no bilingual physicians on staff. The dimensions of this problem are suggested