Greater language education as well as the placement of language assistance services in clinical practice may help physicians overcome language barriers and improve symptom control among non-native English-speaking patients, according to a paper published in JAMA Internal Medicine.1

Findings from a survey conducted in 2011 demonstrated that more than 60 million people spoke a language other than English while at home, with 42% of these people reporting that their English was poor or intermediate.2 Physicians and healthcare practitioners who do not understand a patient’s language are less likely to identify the patient’s symptoms in a timely manner, resulting in delayed care. Currently, undercommunication with non-English-speaking patients seems to be an accepted norm in clinical practice.

Even physicians with limited capabilities in their patient’s primary language may not decrease the likelihood of patient dissatisfaction or inadequate treatment. Although limited communication may still result in appropriate diagnosis of symptoms, it may also result in the misidentification of the issue’s root cause. For instance, a Spanish-speaking patient who receives diagnosis and treatment from an English-speaking physician for an injury resulting from domestic violence may receive appropriate treatment for the injury but remain at risk for future domestic violence issues.

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Language assistance from a medical translator is often available; however, this is heavily underused in the clinical setting. In some cases, enforcing this assistance can take a considerable amount of time, and ineffective communication may be considered a tradeoff for the sake of efficiency. Instead of a transcriber, healthcare practitioners may simply rely on nonverbal communication skills to communicate, which ultimately results in greater time spent caring for the patient, higher healthcare costs, and potentially worse overall patient care.

“Standards, training, and credentialing for the use of languages other than English by clinicians…should be implemented to assure competence, just as they are for physicians who perform invasive procedures,” the author concluded.


  1. Taira BR. Improving communication with patients with limited English proficiency [published online March 19, 2018]. JAMA Intern Med. doi: 10.1001/jamainternmed.2018.0373.
  2. Ryan C. Language use in the United States: 2011. Washington, DC: US Department of Commerce. Published August 2013. Accessed January 24, 2018.