"Does this Doctor Speak My Language?"

Improving the Characterization of Physician Non-English Language Skills

Having doctors rerate their non-English language skills on a descriptive, 5-level scale, from an initial, non-descriptive 3-level scale, resulted in physicians more modestly assessing their fluency. This seems to improve the accuracy of self-reported proficiency.

There is little guidance on how to assess physician foreign language capability, despite compliance requirements and an understanding of the importance of doctor-patient communication to quality of care. This study arose from a large (950+ physician), Southern California medical group’s dissatisfaction with its own method of assessing the language capability of its doctors. Previously, physicians were asked to assess their language skills on a 3-tier scale (basic, medical/conversational, fluent), developed by the group’s marketing department for the website. This study examined the impact of implementing a well-tested and validated 5-tier scale, with descriptors (poor, fair, good, very good, excellent.)

Key Findings:

  • Within six months of implementation, nearly three-quarters of doctors who spoke a language in addition to English had rerated their foreign language skills, suggesting they found the new scale “plausible, convincing and easy to use.”
  • There was substantial variation in how doctors who had previously rated their skills as “medical/conversational” characterized their fluency within the new scale, with 11 percent rating their capabilities as “excellent,” 17 percent as “very good,” 34 percent as “good,” and 38 percent as “fair.”
  • There was some tendency for doctors to downgrade their assessment of their language skills on the new scale, especially doctors who were multilingual (as opposed to bilingual.)

This study should be followed with research to measure, through independent testing, the accuracy of doctors’ self-assessments on the new scale and whether patient outcomes and quality of care correlate to doctors’ fluency as indicated on the new scale. But the new scale did seem to improve accuracy.