Strategies to Overcome Physician-Latino Patient Communication Barriers: Diverse Perspectives

Objective: To develop strategies to overcome language and cultural communication barriers from the perspectives of physicians and patients. Background: With the rapid growth of the Latino population, the American Medical Association developed a Hispanic Health Initiative to assess the magnitude of the problem and to identify strategies to address communication barriers; in 2006 AMA convened a Hispanic/Latino Health Summit of national leaders and experts. Methods: Three focus groups were conducted for the AMA in Chicago, recorded and transcribed with Spanish-speaking Mexican immigrant patients, primarily with diabetes (n=6), experienced Latino physicians (n=6), and culturally diverse non-Latino primary care physicians (n=10). The findings were compared to those generated by the Summit. Our budget limited the number of participants/groups and the representativeness of their perspectives. Results: Focus group and AMA Summit recommendations were similar but the groups allowed more case and systemic analysis. Rapid access to information from physicians, triage, and appointments were a concern for patients. The experienced Latino physicians reported they handled this issue through early intensive patient education. Patient reported satisfaction with services was related to clinic's cultural climate, which is often managed by front-desk staff, on a cold-warmth (calor) dimension. The patient group recommended customer service training for staff. Non-Latino physicians reported cultural training programs tend to ignore intra-group differences among Latinos. We will be summarizing strategies at the physician, patient, and health systems level. Conclusions: Future studies and strategy development should match patients and physicians in different practice settings (solo, group, public) and without or with different health plans.