"Does this doctor speak my language?" Improving the characterization of physician non-English language skills

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.

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.