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19 August 2008 | Volume 149 Issue 4 | Pages 264-269
The proportion of the U.S. population with limited English proficiency is growing. Physicians often find themselves caring for patients with limited English proficiency in settings with limited language services. There has been little exploration of the decisions physicians face when providing care across language barriers. The authors offer a conceptual framework to aid physicians in thinking through difficult choices about language services and provide responses to common questions encountered in the care of patients with limited English proficiency. Specifically, they describe 4 factors that should inform the decision to call an interpreter (the clinical situation, degree of language gap, available resources, and patient preference), discuss who may be an appropriate interpreter, and offer strategies for when a professional interpreter is not available. The authors use a hypothetical case to illustrate how decisions about language services may evolve over the course of an interaction. This conceptual and practical approach can help clinicians to improve the quality of care provided to patients with limited English proficiency.
Author and Article Information
From the University of California, San Francisco, and California Pacific Medical Center, San Francisco, California.
Acknowledgment: The authors thank Leila Alpers, Robert Brody, Leah Karliner, and Jeff Kohlwes for their comments on an earlier draft of this manuscript.
Grant Support: By the National Institutes of Health (NIH) Career Development Award K23-RR018324-01 (Dr. Fernandez) and NIH Center Grant MH062246 (Dr. Lo), NIH Roadmap Clinical and Translational Sciences Award U01 AI46749 (Dr. Lo), and the Greenwall Foundation (Dr. Lo).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Alicia Fernandez, MD, University of California, San Francisco, Box 1364, San Francisco, CA 94143; e-mail, afernandez{at}medsfgh.ucsf.edu.
Current Author Addresses: Drs. Schenker, Lo, and Fernandez: University of California, San Francisco, Box 1364, San Francisco, CA 94143.
Dr. Ettinger: California Pacific Medical Center, 2395 Sacramento Street, San Francisco, CA 94115. ACADEMIA AND CLINIC
Navigating Language Barriers under Difficult Circumstances
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