To the Editor.
—Spanish-speaking people constitute a large and increasing portion of the US population. Data from 1976 through 1977 show almost 12 million Hispanic people in this country; the number who are fluent only in Spanish is unknown. The pattern of language use among Spanish-speaking immigrants is unique and suggests that Spanish is the most persistent of foreign languages in this country.1 There is evidence that the language barrier is being recognized with increasing frequency by providers of health care. Furthermore, attention is turning away from traditional folk beliefs and toward language and other cultural factors as barriers to medical care access for Hispanic patients.2,3The Bexar County Hospital District and Audie L. Murphy Memorial Veterans Medical Center provide major teaching facilities for the University of Texas Health Science Center at San Antonio, including some 70 residents in the Department of Medicine. The county hospital system provides