Your doctor’s office is really a beehive of data. Your patient data requires effective communication between you (the patient) and the doctor. Then communication happens between the doctors, nurses, and the administrative staff in the clinic. Then, your data is often transmitted to other doctors in other clinics and out to laboratories and back again.
A miscommunication or misunderstanding among any of these partners results in lower quality healthcare for the patient. At worst, it can result in malpractice and translate into actual physical harm to the patient.
Clear, effective, and consistent communication pathways are essential to a good health care system.
I learned all of this while sitting in my master’s program in public health back in 2005-2006. Our main mission as students in public health was to understand the health disparities between the underserved minority non-native English speaking people in our communities.
We had to learn the cultural and lingual barriers to providing adequate education and outreach so that the underserved population could have better access to the often complex web of US-healthcare insurance.
Non-Native Speakers Delay Health Care Access
Studies have shown that both language and cultural barriers prevent people from seeking medical treatment in all countries, not just the US.
In Australia, there was a comparative study between Arabic-only speaking and English-speaking patients with type 2 diabetes. Only the Arabic-speaking migrants intentionally delayed access to healthcare services.
Compared with Arabic-speaking migrants, English-speaking participants had no reluctance to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviors were straightforward.
You can read the full study here: http://bmjopen.bmj.com/content/5/11/e008687
Sweden vs. US Health Care
The US health care system is a mess, but at least it was all in English. I knew the behind-the-scenes processes well enough to know what to expect as a patient.
Sweden’s health care system, on the other hand, is quite simple. If you have a personnumer, you’re in the system and are treated anywhere at any time.
Well, not really, but you know what I mean. Access isn’t the problem but knowing what to expect when you are culturally unaware and limited by language is a real problem.
Finding myself with the shoe on the other foot, I am now the non-native speaking foreigner who is not entering the healthcare system as often as I should due to a language barrier.
Adrenaline-Fueled Fluency is a Temporary Solution
We’ve had numerous encounters with the Swedish healthcare system mostly due to our young children’s mysterious rashes, fevers, bumps, and scrapes.
One evening, our 10-month-old daughter had an upper respiratory infection and she was struggling to breathe. I took a video of her laboring to breathe and sent it to my girlfriends in the US (typical, right?) They all told me to head to a clinic.
But before I could be directed to the nearest open clinic at 11 pm, I had to call the number for after-hours care—1177.
The operator spoke only Swedish and couldn’t understand my English whatsoever. In a flood of panic-driven adrenaline, my Swedish became angry.
A string of mostly-understandable Swedish came out of my mouth that successfully conveyed the fact that, “My baby has a high fever, is struggling to breathe, and needs a doctor right away so please tell me where we should go.”
I’ve never lifted a car off of my child before, but I had become instant-fluent in Swedish when it was necessary. Adrenaline can do amazing things.
The operator understood the situation, and we had directions to a clinic and an appointment time within 35 minutes.
I can’t always rely on adrenaline-rushed Swedish fluency to get me through my doctor’s appointments. I can’t conjure up an emergency and Hulk smash my way through the doctor’s office.
My Attempts to Seek Treatment in Swedish Actually Harms the Process
The fact that I can speak conversationally in Swedish means that I’m giving the doctor the impression that I understand more than I am. I’m sure (not certain, but pretty sure) that my original doctor refused to speak English with me because his English proficiency was poor.
We were a bad match for one another and finding a new doctor was in all of our best interests.
“Both the patient and the clinician can underestimate the language barrier between them.”
No matter how much Google Translation preparation I do before my doctor’s appointment, I’m consistently frustrated when seeking out health care in Swedish.
And despite loads of research backing up the fact that non-native speakers need a translator or a doctor who speaks their language to receive proper healthcare, our Swedish general practitioner in our small suburb outside of Stockholm refused to speak English with us.
The peer-reviewed literature says the same—communication is essential to quality health care:
“Effective communication is communication that is comprehended by both participants; it is usually bidirectional between participants, and enables both participants to clarify the intended message. In the absence of comprehension, effective communication does not occur; when effective communication is absent, the provision of health care ends—or proceeds only with errors, poor quality, and risks to patient safety.”
Something’s gotta give—find a doctor who speaks your language
After years of struggling and outright avoiding our local doctor who refused to speak English with us or find a translator, I finally decided to call another doctor within the same practice.
I spoke to her briefly on the phone and explained why I wanted an appointment and asked if we could speak English so I could understand her.
“Sure, no problem,” and she booked my appointment without any fuss.
Upon arriving at my appointment, she greeted me in Swedish, and I again repeated my request for English that was met with a smile and a nod.
“Of course, let’s take a look.”
Advocate for yourself
Why hadn’t I advocated for myself sooner? I am well-versed in the adverse effects that non-native speakers face when entering the healthcare system and I know firsthand how frustrating it is to have a doctor who refuses to speak your language with you. What a relief it was not to have to fight that fight.
I also recognize how fortunate I am to live in a country where my native language, English, is spoken by so many people.
I know that is not always the same scenario for all minority languages and it means that you’ll need to be an even bigger advocate for yourself than you are used to.
So, if you have a doctor who refuses to treat you in your native language, then I urge you to find a new doctor who will speak to you or someone who will provide a translator to your appointments.
Keep in mind that when seeking emergency or urgent care at a hospital, you are often stuck with whoever you have at the moment.
Your Language = Better Care
Receiving medical care in your preferred language is essential not only for your comfort level with your healthcare provider but also to the quality of care you will receive. If you cannot adequately communicate how you are feeling or your medical history, then your doctor won’t understand and cannot properly treat you.
If you are also like me and you’ve been avoiding the doctor specifically due to the language or cultural barriers, then know that you are doing yourself a disservice. The medical issues for which we’d seek treatment often do not resolve on their own, and if you allow too much time to elapse before seeking treatment, you can create a larger issue than if you had simply sought out a new doctor from the beginning.
A huge reason why I practiced self-hypnosis during my second pregnancy was due to the language and cultural barriers in the Swedish midwifery clinics. I knew that so much of my health care would be conducted in another language that I wanted to be in control of my own breathing and movement as much as possible.
The known language barrier for pregnant women is also why Bellies Abroad’s mission is to connect pregnant women with English-speaking doctors in non-English speaking countries so that they can receive medical care in their own language.
It’s also why I love The Virtual Midwife and the services she provides to pregnant women who may not have access to English-speaking medical professionals in their countries.
So, learn a lesson from me or from countless articles in public health journals that encourage doctors to provide health care to patients in their native languages.
Don’t compromise on your health or put off seeking medical care due to a language or cultural barrier.
Your health is worth taking the time to find a doctor or a practice that provides a translator at your appointments.
It’s taken me YEARS to take my own advice and in the video below, I explain some of my avoidance of the healthcare system because my doctor refused to speak to me in English and why me trying to accommodate his needs wasn’t beneficial for me.