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May 2018

Improving Communication With Patients With Limited English Proficiency

Author Affiliations
  • 1Department of Emergency Medicine, Olive View–UCLA Medical Center, Sylmar, California
JAMA Intern Med. 2018;178(5):605-606. doi:10.1001/jamainternmed.2018.0373

It was my first day of clinical rotations as a third-year medical student. We entered a small room in the emergency department to see a frightened woman with acute cholecystitis. One physician asked her how she was feeling, but after another physician said “Spanish-speaking only,” the first physician stopped speaking and instead approached the bedside and began to push on her abdomen. “¿Dolor? ¿Dolor?” he asked. When the patient grimaced, the first physician, apparently satisfied with his evaluation, turned and led the team out of the room. No explanation was offered to the patient. I hesitated, hoping to explain, or perhaps comfort her, but this elicited a stern look. “Hurry up—the OR starts in 20 minutes!” This was my introduction to a medical culture that normalizes undercommunication with patients of limited English proficiency.

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