156203 Physicians' perspectives on treating patients with limited English proficiency: A survey of one New York City teaching hospital

Monday, November 5, 2007

Nisha S. Agarwal, JD , New York Lawyers for the Public Interest, New York, NY
Jamie B. Rosenberg, MD , Department of Ophthalmology, Montefiore Medical Center, Bronx, NY
John J. Kim, MD , Department of Ophthalmology, Montefiore Medical Center, Bronx, NY
An extensive medical literature has developed over the last fifteen years documenting the importance of language assistance services for patients with Limited English Proficiency (LEP). Researchers have found that the lack of competent language assistance services can result in the following: substantial risk of misdiagnosis, higher likelihood of adverse drug events or serious medical events, lower patient satisfaction, and difficulty obtaining patient compliance with treatment regimens. While the impact of inadequate language assistance on patients has been well documented, comparatively little research has been conducted on the concerns of providers with regard to linguistic competency. The lack of attention on providers in the language access literature is particularly surprising since providers are the ones who face the clinical and legal obligation to ensure the adequacy of language assistance services, and they frequently struggle to meet these obligations. This study shifts the focus to provider-side issues in language access through a survey of physicians' experiences treating LEP patients in a large teaching hospital in the Bronx, New York City. In particular, we investigate: (1) whether physicians, as opposed to the administrators of the institution in which they work, understand their obligations to provide language assistance services and, if not, why not and (2) the impact that this knowledge (or lack thereof) has on physicians' perceptions of LEP patients and their own professional satisfaction. The study also explores whether language barriers influence physicians' attitudes toward LEP patients to such a degree that negative or discriminatory attitudes develop toward this patient population.

Learning Objectives:
1) Identify specific challenges that hospital-based physicians face in treating patients with Limited English Proficiency (LEP). 2) Evaluate quality, appropriateness and accessibility of hospital-provided language assistance services from physician's perspective. 3) Discuss impact of language barriers on physicians' attitude toward and treatment of LEP patients.

Keywords: Cultural Competency, Physicians

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.