When the patient and physician don’t speak the same language

Most health care providers agree that when the patient and the physician speak different languages (officially called “patient-physician language discordance”), a language interpreter is needed to diagnose and treat with informed consent.

We also know exercise, diet, and smoking play a large role in health outcomes.  Lifestyle is important for both preventing and treating many chronic conditions.  Lifestyle counseling is, consequently, a valuable intervention.  One recent study looked at impact of patient-physician language concordance on lifestyle counseling among 306 Spanish-speaking patients who used interpreter services.

Eamranond, P. P., Davis, R. B., Phillips, R. S., & Wee, C. C. (2009). Patient-physician language concordance and lifestyle counseling among Spanish-speaking patients. J Immigr Minor Health, 11(6), 494-498.

The study found, “patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients with language-discordant physicians” and “Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician compared to those having a non-Spanish-speaking physician.”

Interesting.  Does this study reflect your experience?  Why would this be?  Why would not needing an interpreter make it more likely for health care providers to talk about diet, exercise, and smoking?  Why would patients be more likely to bring up these issues when they speak the same language as their health care providers?  Is this due to the perceived time it takes to speak through an interpreter?  Or is this due to the sense that communications are more comfortable when an interpreter isn’t needed?  Is it about relationships?  Is it easier to talk about these personal things when you feel a connection to the health care provider, and it’s harder to feel a connection to someone who doesn’t speak your language?  What could this mean in our efforts to reduce health disparities?

What do you think?