Patient-physician language concordance and lifestyle counseling among Spanish-speaking patients.
OBJECTIVE
Patient-physician language discordance is associated with worse quality of healthcare for patients with limited English proficiency. Patients with language-discordant physicians have more problems understanding medical situations. The impact of patient-physician language concordance on lifestyle counseling among Spanish-speaking patients is not known.


METHODS
We performed a retrospective medical record review and identified 306 Spanish-speaking patients who used interpreter services between June 2001 and June 2006 in two Boston-based primary care practices. Our primary outcome was counseling on exercise, diet, and smoking. Our main predictor of interest was patient-physician language concordance.


RESULTS
Patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients with language-discordant physicians. After adjustment for age, sex, insurance status, number of primary care visits, and comorbidity score, these differences in counseling persisted for diet [odds ratio (OR) = 2.2, CI 1.3-3.7] and physical activity (OR = 2.3, CI 1.4-3.8). There was no significant difference with regard to discussion of smoking (OR = 1.3, CI 0.8-2.1).


CONCLUSIONS
Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician compared to those having a non-Spanish-speaking physician. Further research is needed to explore whether matching Spanish-speaking patients with Spanish-speaking providers may improve lifestyle counseling.
Eamranond
Pracha P
PP
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, Boston, MA 02446, USA. peamrano@bidmc.harvard.edu
Davis
Roger B
RB
Phillips
Russell S
RS
Wee
Christina C
CC
D000328:Adult; D000368:Aged; D003144:Communication Barriers; D003376:Counseling; D004032:Diet; D015444:Exercise; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D012907:Smoking; D012959:Socioeconomic Factors