title: Caring for patients with limited English proficiency: the perspectives of small group practitioners.
abstract: BACKGROUND
  Language barriers in medical care are a large and growing problem in the United States. Most research has focused on how language barriers affect patients. Less is known of the physician perspective and the efforts they are making to overcome these barriers.
  
  
  OBJECTIVE
  To learn about current approaches to communicating with limited English-proficient (LEP) patients and the associated financial and nonfinancial constraints that private practice physicians and managers perceive in providing these services.
  
  
  METHODS
  Computer-assisted telephone focus groups with open-ended discussion guide.
  
  
  METHODS
  Small private practices in geographic areas that have experienced recent dramatic increases in LEP populations.
  
  
  METHODS
  Primary care physicians, specialists, and practice managers.
  
  
  METHODS
  Focus group transcripts were systematically coded using grounded theory analysis. The research team then identified common themes that arose across the groups.
  
  
  RESULTS
  Citing the cost, inaccessibility, and inconvenience of using professional interpreters, physicians commonly used family and friends as interpreters. Few recalled any actual experience with professional interpreters or were well-informed about the cost of their services. Physicians and office managers voiced uniform concern about how language barriers impede quality and safety of patient care and increased malpractice risk.
  
  
  CONCLUSIONS
  Health care providers in private practice recognize the importance of overcoming language barriers. However, perceived barriers to implementing cost-effective strategies to these barriers are high. Physicians in private practice would benefit from information about how to best overcome language barriers in their practices efficiently and affordably.
authors.affiliation: American Medical Association, 515 N. State Street, Chicago, IL 60610, USA. margaret.gadon@ama-assn.org
authors.forename: Margaret
authors.initials: M
authors.lastname: Gadon
authors.forename: George I
authors.initials: GI
authors.lastname: Balch
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
mesh_terms: D001291:Attitude of Health Personnel / Q000208:ethnology*; D003144:Communication Barriers; D054521:Cultural Competency; D005260:Female; D017144:Focus Groups; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D007802:Language; D016365:Liability, Legal; D008297:Male; D009042:Motivation; D009817:Office Management / Q000191:economics; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000191:economics; D011331:Private Practice / Q000191:economics; D036301:Qualitative Research; D012938:Social Perception; D014481:United States