Council targets language barriers to health care. (California ACOG Chapter Involved).

Results from a survey of leading physician organizations, medical groups, and other health care associations in California suggest that nearly half (48%) of the 293 respondents knew of an instance in which a patient's limited English proficiency impacted his or her quality of care.

The three biggest complaints were difficulty of history taking, wrong diagnosis, and a general frustration with the lack of nuance in physician-patient communication with patients who have limited English proficiency (LEP).

Written examples from survey respondents included a case of misunderstanding about abruptness of headache, leading to delay of diagnosis of subarachnoid hemorrhage.

Another physician shared the account of a patient with COPD who thought her nasal spray was an inhaler. She was admitted to the hospital because of adverse events.

The survey was conducted as part of the Medical Leadership Council on Language Access, a group that is working to explore barriers to, and potential solutions for, achieving language access for California patients with limited English proficiency. Funded by a $424,700 grant from the California Endowment, a private statewide health foundation, the council includes presidents and executive directors of 24 medical specialty societies and representatives from health plans, hospitals, and consumer advocacy groups. The California Academy of Family Physicians (CAFP) serves as the convening organization for the council, which is believed to be the first of its kind.

"We thought the best thing to do was to convene leaders from organized medicine and educate people on the issue, get their thinking, hear their concerns, and create a venue for that discussion to take place," said Ignatius Bau, J.D., a program officer with the California endowment.

The council is one part of a larger strategy by the foundation to develop the field of health care interpretation and translation. The foundation "does not necessarily expect the council to achieve consensus or produce a 'solution' to the complex issue of language barriers in health care settings, but these early discussions are important first steps," according to a statement from foundation president and CEO Dr. Robert Ross.