Bridging the Gap Between Research and Health Policy – Insights From Robert Wood Johnson Foundation Clinical Scholars
“Does This Doctor Speak My Language?” Improving the Characterization of Physician Non-English Language Skills
Article first published online: 27 OCT 2011
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 1pt2, pages 556–569, February 2012
How to Cite
Diamond, L. C., Luft, H. S., Chung, S. and Jacobs, E. A. (2012), “Does This Doctor Speak My Language?” Improving the Characterization of Physician Non-English Language Skills. Health Services Research, 47: 556–569. doi: 10.1111/j.1475-6773.2011.01338.x
- Issue published online: 12 JAN 2012
- Article first published online: 27 OCT 2011
- The California Endowment. Grant Number: #20082043
- Palo Alto Medical Foundation Research Institute
- Physician–patient communication;
- language barriers;
- organizational policy
To describe the initial impact of an organizational policy change on measurement of physician non-English language proficiency.
Multispecialty health care organization in the San Francisco Bay Area.
Study Design/Data Collection
In response to preliminary findings suggesting that the organization's nonvalidated and undefined three-category tool for physician self-report of non-English language proficiency levels was likely inadequate, the organization asked physicians to rate their non-English language proficiency levels using an adapted Interagency Language Roundtable (ILR) scale, a validated measure with five rating levels and descriptors. We then compared the self-reported language proficiency on the original scale and the ILR for those physicians who completed both and used regression analysis to investigate physician characteristics potentially associated with a change in score on the old versus ILR scales.
Six months after the ILR scale was implemented throughout the organization, 75 percent (258/342) of physicians had updated their language proficiency ratings. Among clinicians who had previously rated themselves in the “Medical/Conversational” category, there were substantial variations in scores using the ILR scale. Physicians who spoke two or more non-English languages were significantly more likely to lower their self-reported proficiency when updating from the old scale to the ILR scale.
The organization was willing to adopt a relatively straightforward change in how data were collected and presented to patients based on the face validity of initial findings. This organizational policy change appeared to improve how self-reported physician language proficiency was characterized.