Introduction
Effective communications are essential for the provision of quality healthcare services. Efficient communication allows patients to describe symptoms and give feedback regarding medical interventions. For healthcare providers, efficient exchange of information with clients facilitates accurate diagnosis, planning on a management plan, and assessing the efficacy of medical interventions. Any barrier or breakdown in communication puts the patient’s life at high risk. Language is the tool for the exchange of information to achieve efficient communication. Language can be verbal or nonverbal in gestures, facial expressions, and writing (Partida, 2012). For efficient communication and provision of healthcare services, providers and patients must have a common language. This article explores how language affects access and provision of healthcare and why it is important for healthcare workers to understand this connection.
The Connection
Efficient communication through language proficiency facilitates access to high-quality healthcare services. There is an established relationship between the proficiency to speak the English language and access to healthcare services (Partida, 2012). Patients competent in English access higher quality services and achieve better health outcomes than patients with limited English proficiency (LEP). The common language between providers and patients allows effective communication, which facilitates the process of diagnosis and patient management. Language barriers result in misdiagnosis, poor medication adherence and significantly increase the risk of medical errors. Patient-centered care is affected when interpreters are used to overcoming the barrier effects as patients’ concerns are lost in translation (Karliner, 2018). The patients’ ability to input their care plan or object to it is greatly affected.
Language affects the equality with which healthcare services are provided. Persons from linguistic minorities, such as immigrants and asylum seekers, face discrimination as they seek healthcare services. The discrimination manifests in healthcare centers where the focus shifts to their immigration status instead of their illness. Sadly, medical practitioners are often biased in their approach to patients from minority groups. A negative attitude from practitioners is revealed when some ignore patients or make inappropriate comments about them. Bias from practitioners is unacceptable as it violates their oath of service that demands service to all human beings regardless of their differences. Politically, immigrants are viewed as a burden and ineligible to benefit from the precious healthcare resources (Piacentini et al., 2018). Inequalities should not exist in healthcare as every human being has a right to the best healthcare standards possible.
The language barrier limits access to healthcare, especially for linguistic minority groups. In the study by de Moissac and Bowen (2018), patient-reported difficulty booking appointments with healthcare providers. Patients struggled to find words to describe their symptoms, they had to repeat their complaints more, and providers struggled to understand them. The assessment process was prolonged, and some patients had to make additional visits to clarify providers’ instructions. After such difficult experiences, patients were reluctant to contact healthcare providers in future engagements. In addition to reduced patient satisfaction, provider satisfaction is also reduced: difficulty comprehending patients contributes to work-related stress.
Language and culture are intertwined; language facilitates culture, which influences people’s perspectives on health. Language facilitates social interactions that shape the identity, practices, customs, and beliefs of a people that become their cultural identity. Their culture largely influences people’s understanding of health or defining illness. Different cultures have different explanations for the causes of diseases and their treatment. Consequently, culture influences health-seeking behavior and whether the individuals will accept medical treatment. Patients from paternalistic societies are likely to have a doctor-patient relationship where they expect the doctor’s opinion is the law and the patient is unlikely to question their care. Religious persons are more likely to attribute diseases to a divine cause and will often seek divine intervention first before seeking medical attention (Andrulis and Brach. 2007). Such cultural factors affect healthcare quality for persons from groups with extreme cultural practices.
Language affects the efficiency and cost of running a healthcare system. The language barrier reduces the effectiveness of the healthcare system and increases the running costs. Inability to access medical care by linguistic minority groups may undermine disease eradication campaigns that require outreach to a majority of the population. Outbreaks of diseases previously eradicated, such as polio, are not uncommon among minority groups. Training and employment of interpreters to accommodate minority groups increase the running costs. Miscommunication results in malpractices and errors, such as misdiagnosis, wrong medication, or delayed treatment (de Moissac and Bowen, 2018). Lawsuits from malpractices result in additional costs that burden the system.
An example of the costly nature of lawsuits is the case of Willie Ramirez, an 18-year old boy who had limited proficiency in English. He developed a headache and was rushed to the hospital. He tried to communicate his symptoms to his friends and paramedics in Spanish. The medics misunderstood his word to mean drug intoxication while Willie was describing the symptoms of an aneurysm. Willie had severe intracranial hemorrhage, which left him quadriplegic (Jacobs et al., 2018). The miscommunication and misdiagnosis resulted in a lawsuit with a $71 million award to the plaintiff.
Lessons for Healthcare Workers
Healthcare providers need to stay true to their oath of service by providing the best healthcare services to all patients without discrimination, including those from minority linguistic groups. Effective communication requires more than just having a common language with the patient. Practitioners need to employ skill and tact when delivering the information to patients, especially from minority linguistic groups. Practitioners should acknowledge patients’ cultures and the role they play in healthcare. For example, they can ask about the cause of their patient’s illness from their perspective. Communication strategies can incorporate patients’ native language to improve their effectiveness (Partida, 2012). To minimize miscommunication, practitioners can ask patients to state information given in their own words and clarify where necessary.
Healthcare providers should assess their patients judiciously to identify those who may not be proficient in the official language and adjust their communication approach accordingly. In writing information for patients, such as prescriptions, the writing should be clear and easy to understand. Audiovisual materials can help deliver information more easily in a manner that is easy to understand (Andrulis and Brach, 2007). The training of healthcare professionals should include courses on communication skills.
Conclusion
Conclusively, language is important in healthcare; it facilitates effective communication. Effective communication ensures the provision of high-quality services and reduces incidences of malpractice. For healthcare providers, language and effective communication make their work easier, minimize errors and ensure high standards of patient care. For patients, effective communication translates into quality care and overall satisfaction. It is important for healthcare policymakers, administrators, and practitioners to recognize the important role of language in healthcare. Practitioners should continually sharpen their communication skills, and provisions should be implemented to overcome language barriers.
References
Andrulis, D. P., & Brach, C. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American journal of health behavior, 31(1), 122–133. Web.
de Moissac, D., & Bowen, S. (2018). Impact of language barriers on quality of care and patient safety for official language minority francophones in Canada. Journal of patient experience, 6(1), 24–32. Web.
Jacobs, B., Ryan, A. M., Henrichs, K. S., & Weiss, B. D. (2018). Medical interpreters in outpatient practice. The annals of family medicine, 16(1), 70–76. Web.
Karliner, L. S. (2018). When patients and providers speak different languages | psnet. Web.
Partida, Y. (2012). Language and health care. Diabetes spectrum, 25(1), 19–22. Web.
Piacentini, T., O’Donnell, C., Phipps, A., Jackson, I., & Stack, N. (2018). Moving beyond the “language problem”: Developing an understanding of the intersections of health, language and immigration status in interpreter-mediated health encounters. Language and intercultural communication, 19(3), 256–271. Web.