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

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.