Breakthrough Patient Recruitment

: Getting the “Gist” of a Medical Conversation is NOT Enough!

Getting the “Gist” of a Medical Conversation is NOT Enough!

Global Content Strategist

Through the fault of none-or perhaps the fault of many- non-English speakers in the United States often experience miscommunication regarding their health care. To improve services to these patients, it's important to engage in a deeper discussion to understand each patient and to address their health from a linguistic and cultural point of view.

 

Linguistics

 

For the purposes of this post, let's focus on Spanish-speaking patients. According to 2011 estimates from the American Community Survey of the U.S. Census Bureau, almost 43.7% of Americans who speak Spanish at home, speak English less than "very well." In the absence of readily available qualified medical interpreters, health care providers often turn to people without sufficient skills to interpret for them.

 

Individuals, such as family members, friends, or untrained staff are substantially more likely to make mistakes and to neglect valuable information when interpreting. It is only natural to skip or misinterpret a word or sentence that one does not understand and to simply convince oneself that the few missing words probably weren't important anyway.

 

Let's take a look at a few examples of miscommunication …

 

False cognates are particularly dangerous when interpreting information. These are words that sound the same in both English and Spanish, but mean something different.

 

Intoxicated vs. intoxicado/a

 

"Intoxicado" in Spanish is an all-encompassing word that means there's something wrong with you because of something you ate or drank. It is not alcohol related. The danger of this false cognate is demonstrated in the particularly sad case of Willie Ramirez.

 

Embarassed vs. embarazada

 

Another false cognate that causes problems in the medical community if misunderstood is "embarazada." In Spanish, this word does not mean embarrassed; it means pregnant. Imagine, for instance, a woman with rudimentary knowledge of English, trying to explain to medical staff that "I am embaras." If medical staff misinterprets the word, they may conduct procedures harmful to a fetus.

 

Culture

 

Cultural differences further complicate the language issue. As health providers communicate with Spanish-speakers, they need to tend to cultural differences as well. While they may believe they are communicating adequately and effectively, their own beliefs and strategies for handling situations will affect patient care issues. Understanding and respecting such differences is essential to proper treatment.

 

Let's consider the below …

 

Authority figure

 

In the Spanish-speaking community, health care providers (particularly doctors) are often viewed as authority figures who are not to be contradicted. In an effort to ensure they show no disrespect, patients may be hesitant to ask questions, which could ultimately affect their care. Thus, health care providers need to consider who their patient is and what their background and beliefs system is. They need to ask questions, listen to the answers, be sensitive, show respect, and build trust.


Sharing negative information

 

Cultural differences affect how people react to ailment, respond to symptoms, look for medical care, and perceive health care providers. All this, ultimately, impacts how they will react to and respond to treatment. It is the provider's responsibility to the patient and the family to communicate negative information in a caring, kind, and respectful manner. Taking time to be with patients and discussing information in a deliberate, unhurried manner is particularly important when discussing serious topics.

What we say, how we say it, when we say it, and to whom we say it is critically important. Miscommunication-and health care concerns stemming from it-is not unique to Spanish speakers. Similar issues affect other linguistic minorities in this country. For more information on how language and cultural nuances affect patient care, refer to this blog post written by my colleague Veronica Badillo.

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