Language-Concordant Care: a Qualitative Study Examining Implementation of Physician Non-English Language Proficiency...

Area of Science:

• Health Services Research
• Medical Education
• Linguistics in Medicine

Background:

• Language concordance improves patient access and health outcomes.
• Systematic assessment of physician non-English language skills is infrequent in health systems.
• This gap represents a missed opportunity to optimize language-concordant care.

Purpose of the Study:

• To identify barriers and facilitators influencing primary care physicians' participation in non-English language proficiency assessments.

Main Methods:

• Qualitative study employing semi-structured interviews.
• Participants included eleven fully and partially bilingual primary care physicians.
• Thematic analysis with constant comparison was used to code interview transcripts.

Main Results:

• Barriers included fear of negative test consequences, time constraints, and difficult test formats.
• Facilitators comprised messaging aligned with professional values, incentivizing organizational culture, personal empowerment, and champion advocacy.
• Physician language proficiency varied, with fully bilingual physicians passing the assessment more consistently.

Conclusions:

• Health systems should address physician-identified barriers and leverage facilitators to boost language assessment participation.
• Interventions can standardize processes, enhance transparency, offer preparation resources, and incentivize participation for improved patient care quality and safety.