The Commission to End Health Care Disparities has released this publication on the appropriateness of physicians using their language skills in languages other than English while providing clinical care to patients with limited English proficiency (LEP).

The Commission comprises more than 70 state and specialty medical societies and aligned organizations and is led by a Secretariat of the American Medical Association, the National Medical Association and the National Hispanic Medical Association. The commission’s primary role is to support health professionals and health professional associations in their efforts to eliminate health care disparities. This is accomplished through: (1) proactively collaborating to increase awareness and education among health professionals about health care disparities; (2) producing clinical tools and resources that promote the use of effective strategies to combat disparities in practice; and (3) coordinating advocacy to support policy and action that will lead to the elimination of disparities in health care and thereby strengthen the health care system and our nation.

This issue of when self-identified multilingual physicians should use their language skills is increasing an issue of quality and liability for health care organizations.  Many health care organizations recognize that trained and qualified health care interpreters are essential to health care safety and quality.  Physicians and other clinicians who use their language skills should be similarly qualified to ensure proficiency in the additional languages, especially knowledge of medical terminology and the ability to hear and communicate effectively with patients with varying levels of literacy, education, and language skills themselves (for example, the language being spoken may also be a second language for the patient).

The paper makes the following recommendations for clinicians:

1. Monitor the quality of communications with LEP patients

2. Receive training to promote effective communication with LEP patients

3. Plan ahead for LEP patient visits

Recommendations are also made for health care delivery organizations:

1. Provide integrated training to staff on how best to work with interpreters in the organization

2. Promote teamwork with trained interpreters recognized as specialists in communicating with LEP patients

3. Help clinicians plan for appropriate communication in encounters with LEP patients

4. Examine and address barriers to using interpreter services

And finally, recommendations are made for policymakers and health system leaders:

1. Create tools to help clinicians appropriately use their non-English language skills

2. Use patient safety and quality improvement systems to address communication risks in the care of patients with LEP

3. Develop payment models that support the provision of quality care to patients with LEP

4. Facilitate collection of language information at health care encounters, to enable more rapid access to language services when needed

5. Create and promote market opportunities to encourage excellent care for LEP patients

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