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Evaluation of Language Diversity Among Orthopaedic Surgeons
Vienna Liu1, Emma Tapp, Rafat H Solaiman
1From the University of Michigan, Ann Arbor, MI (Liu), the University of California San Francisco School of Medicine, San Francisco, CA (Tapp), the Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI (Solaiman), the Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Ortega), the Occidental College, Los Angeles, CA (Atkin), and the Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA (Shapiro).
Introduction:
The United States is a diverse nation, with over 22% of the population speaking a language other than English at home. Barriers and care disparities persist for orthopaedic patients with a non-English preferred language, particularly for those treated in language-discordant settings. The purpose of this study was to assess the linguistic diversity of orthopaedic surgeons and evaluate this relative to census-level linguistic diversity.
Methods:
This cross-sectional observational study analyzed the American Academy of Orthopaedic Surgeons database to assess surgeon language diversity. Data on state, subspecialty, and language(s) spoken were extracted for all surgeons listed. Descriptive statistics were used to evaluate linguistic diversity among surgeons. Differences between surgeon-level and population-level linguistic diversity were quantified using residuals from an expected 1:1 representation, reflecting ideal language concordance.
Results:
Among the 19,505 orthopaedic surgeons registered in the database, 1,615 (8.28%) spoke at least one language aside from English, with 172 (0.88%) speaking three or more languages. Spanish (61.55%), French (20.87%), and German (12.07%) were the most common second languages. Pediatrics (7.77%) and spine (5.67%) had the highest percentage of multilingual surgeons, while trauma (3.70%) and musculoskeletal oncology (3.19%) had the lowest. Utah (16.59%), New Mexico (13.91%), Florida (12.46%), and Arizona (12.11%) had the highest proportions of multilingual surgeons. In 39 of 50 states, the proportion of Spanish-speaking surgeons is lower than that of Spanish speakers in the population, with the greatest discrepancies in California, Texas, and New Mexico.
Conclusion:
This study highlights linguistic disparities between patients and orthopaedic surgeons, indicating gaps that may contribute to language-discordant care and reliance on interpreters. Additional assessment of opportunities to increase multilingual representation and care capabilities across health systems is essential to ensure patient-centered and equitable care.
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