My patient, Alma, came to the emergency room with chest pain radiating to her left breast. She was 55 and had already had a lumpectomy for suspected breast cancer five years ago. She was worried about her heart, but her deeper fear was that her breast cancer somehow was coming back. She was trying to learn English, but the subtleties of language made the conversation with the hospital staff about the different medical possibilities, the required lab tests, and her underlying fears of the unknown much more difficult. Such a conversation -- in which a patient and doctor discuss life-changing diagnoses and decisions -- is difficult enough in a patient’s native language, let alone one which you are trying to learn but have not yet mastered. As I walked in to meet with Alma, she looked up with dread in her eyes, but when I introduced myself in Spanish, she brightened.
Throughout my career as a family physician, I have witnessed again and again the relief of patients who don’t speak English well, when they realize they can communicate with me. As an immigrant myself, who can communicate in six languages, I understand the urgency of good communication for sound health. Better communication leads to better, more accurate diagnoses, less medical harm, less waste of resources to the system, and more compassionate care. If a clinician cannot speak to the patient directly in their preferred language, it is essential that the patient receive information on how to get help in their own language in order for his or her care to be effective.
That is why the Trump Administration’s proposed regulation change is so dangerous. The Health Care Rights Law -- a section of the Affordable Care Act -- assures that patients who are limited English proficient (LEP) receive notices of legal rights to language assistance and guidance on how to access information in their own language. The Trump Administration’s proposal eliminates those taglines that help people find information in their language which enables them to make informed decisions and better communicate with their providers. Alma was lucky -- her provider could speak her language -- but in our diverse country, where millions of immigrants communicate more easily in a language other than English, we need to assure that all patients can fully understand their treatments and their options so they can be empowered to get well.
As a physician, my first motive is to do no harm. When access to communication in the language of the patient is denied, we jeopardize the health of patients. Better communication only serves to improve my effectiveness as a healer. I call on the Administration to protect patients’ health and support me to do my job well: remove the proposed rule to the Health Care Rights Law and reaffirm the language protections that all patients need. Comments are accepted until August 13th [2].
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