title: Language barriers and patient-centered breast cancer care.
abstract: OBJECTIVE
  Provision of high quality patient-centered care is fundamental to eliminating healthcare disparities in breast cancer. We investigated physicians' experiences communicating with limited English proficient (LEP) breast cancer patients.
  
  
  METHODS
  Survey of a random sample of California oncologists and surgeons.
  
  
  RESULTS
  Of 301 respondents who reported treating LEP patients, 46% were oncologists, 75% male, 68% in private practice, and on average 33% of their patients had breast cancer. Only 40% reported at least sometimes using professional interpretation services. Although 75% felt they were usually able to communicate effectively with LEP patients, more than half reported difficulty discussing treatment options and prognosis, and 56% acknowledged having less-patient-centered treatment discussions with LEP breast cancer patients. In multivariate analysis, use of professional interpreters was associated with 53% lower odds of reporting less-patient-centered treatment discussions (OR 0.47; 95% CI 0.26-0.85).
  
  
  CONCLUSIONS
  California surgeons and oncologists caring for breast cancer patients report substantial communication challenges when faced with a language barrier. Although use of professional interpreters is associated with more patient-centered communication, there is a low rate of professional interpreter utilization.
  
  
  CONCLUSIONS
  Future research and policy should focus on increasing access to and reimbursement for professional interpreter services.
authors.affiliation: Department of Medicine, University of California at San Francisco, SanFrancisco, CA 94143-1732, USA. leah.karliner@ucsf.edu
authors.forename: Leah S
authors.initials: LS
authors.lastname: Karliner
authors.forename: E Shelley
authors.initials: ES
authors.lastname: Hwang
authors.forename: Dana
authors.initials: D
authors.lastname: Nickleach
authors.forename: Celia P
authors.initials: CP
authors.lastname: Kaplan
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy; D002140:California; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011331:Private Practice