Getting medical care in a language you don’t feel comfortable speaking is like driving a stick shift when you don’t know how: difficult and likely to result in errors.
Researchers at the UCLA David Geffen School of Medicine found that while the proportion of Latinos in the U.S. population has grown over the past 30 years, the proportion of Latino physicians has decreased. The researchers also predicted that the Latino population will grow about threefold by 2060.
The shortage of Latino Spanish-speaking doctors is a problem because when care is not provided to a patient in the language he or she feels most comfortable with, information is often misunderstood and more medical errors are made. The patient is also less likely to follow up on treatment because of confusion about treatment options, said Dr. Gloria Sánchez, an associate clinical professor at the David Geffen School of Medicine and director of the family medicine assistant residency program at the Harbor-UCLA Medical Center.
The study points out that Latino doctors are more likely to work in and serve Latino populations than non-Hispanic white doctors are. Patients are also more satisfied with their care when they receive it from a doctor who not only speaks their language, but also understands their cultural background. This emphasizes the importance of increasing the number of Latino doctors, not just the number of Spanish-speaking doctors.
And while the study calls for medical schools to admit more Latino students,there are more immediately effective responses to providing quality care for Latino patients who are more comfortable speaking Spanish.
In hospitals, there are resources such as translators that can facilitate communication, but in smaller clinics, services like these can be difficult to implement because of financial restrictions. UCLA, a larger organization that has the financial means to implement such services, needs to ensure that all of its facilities, including small clinics, are sufficiently staffed with translators and support services to provide good care to all of its patients.
This is particularly true because UCLA itself is not exempt from the problem at hand. The Harbor-UCLA and Olive View-UCLA medical centers feel the effects of these shortages of Spanish-speaking and Latino doctors. Both facilities serve populations that are heavily Latino.
The average medical interpreter makes about $40,000 a year. UCLA has 14 medical clinics, and staffing each one with a translator would cost less than $600,000 a year in salaries. In the context of a total budget of $500 million, $600,000 is chump change.
There are also other immediate steps that can be taken to improve the quality of care for Latino patients at California hospitals. For example, UCLA is taking steps to increase the number of Latino Spanish-speaking doctors with its International Medical Graduates Program. The program trains students who are mostly from South America and Mexico to help them pass their medical exams in the U.S. in exchange for committing two to three years to working in underserved medical communities in California.
The IMG program is an excellent proactive step taken by UCLA, and should be an example to other institutions in California that face a similar shortage.
All medical clinics need to ensure that they have competent translators and services for patients for whom English is not their first language. This will mitigate most of the problems of miscommunications and confusion that result from language barriers.
In the long term, more large-scale changes need to be made to incentivize and encourage Latino Spanish-speaking students to apply and enroll in medical school. Changes also should be made to help them gain acceptance to and succeed at medical school by evening the playing field in primary school. But while we’re undertaking those larger efforts, more immediate steps must be taken.
Medical care should never be compromised because of something as fixable as a language barrier.