As the daughter of an immigrant, I witnessed the many hardships that occur when you are not a native English speaker. I watched my mother and grandmother struggle with disadvantage in not only the job and education market, but also when seeking the equivalent healthcare they were entitled to. Despite paying the same premium for their health insurance that many native English speakers paid, the quality of treatment and service they received was different. I learned growing up, that there are two healthcare systems in the United States, and that despite no official language - quality care was only delivered in English.
Throughout my childhood I remember watching my grandmother, who moved to the US and learned English at the age of 31, battle breast cancer, twice. During the course of treatment she had questions and concerns, but never had the tools available to actually connect with her doctor. The language barrier between herself and her Doctor left her scared and confused, yet she had no other option but to continue seeking less informed care. Carrying these experiences with me into adulthood, I was inspired to go into healthcare and be a part of the solution. I desired to help create a world where equitable healthcare was practiced and not just discussed - where people were understood. I envisioned a system where non-English speakers thrived instead of just survived - A system where providers and patients talked.
When I look back on my ten years in practice as a Doctor, first-hand experiences have helped me to realize that the divide in the healthcare space is greater than ever before. The problem of non-equitable care is not just a reality for my grandmother, but for the 55 million Limited English Proficiency (LEP) patients in America today. My time in practice has been riddled with communication issues that have no great solution for non-English encounters, and the most accessible options offer marginal results at best. Providers have been indoctrinated to become comfortable with inefficient or inaccurate translation solutions, leading patients to be forced into accepting a lessened experience/service.
What would truly ensure an LEP patient’s best interest? What would give providers confidence that communication on both sides is accurate? What kind of solution would build trust?
The healthcare space was built on the foundational pillars of non-discrimination, yet has it evolved into a system that readily accepts inequity? How, as a worldwide institution, have we become okay with violating the oath that we took to do no harm, while not doing our part to protect those who can’t protect themselves. We must do better by providing a base level of communication throughout the patient experience. People deserve to be understood and healthcare deserves to be equitable. We need trust and we need understanding. At a minimum, we have to deliver quality conversations about health, starting with the simplest of concepts...We should talk.