Barriers to offering French language physician services in rural and northern Ontario.
BACKGROUND
Rural and Northern Ontario francophones face many health-related challenges including poor health status, a poor supply of French-speaking physicians, and the potential for an inability or reduced ability to effectively communicate with anglophone healthcare providers. As such, it can reasonably be expected that rural and Northern Ontario francophones experience barriers when receiving care. However, the experience of physicians working in areas densely populated by francophones is largely unexplored. This paper identifies barriers experienced by French-speaking and Non-French-speaking rural and Northern Ontario physicians when serving francophone patients.


METHODS
A series of key informant interviews were conducted with 18 family physicians practicing in rural and urban francophone communities of Northeastern Ontario. Interviews were analyzed using a thematic analysis process.


RESULTS
Five categories of barrier were identified: (1) language discordance, (2) characteristics of francophone patients, (3) dominance of English in the medical profession, (4) lack of French-speaking medical personnel, and (5) physicians' linguistic (in)sensitivity. Some barriers identified were unique to Non-French-speaking physicians (eg language discordance, use of interpreters, feelings of inadequacy), some were unique to French-speaking physicians (eg limited French education and resources), and some were common to both groups (eg lack of French-speaking colleagues/staff, added time commitments, and the particularities of Franco-Ontarian preferences and culture).


CONCLUSIONS
Healthcare providers and decision makers may take interest in these results. Although physicians were the focus of the present article, the barriers expressed are likely experienced by other healthcare providers, and thus the lessons learned from this article extend beyond the physician workforce. Efforts must be made to offer educational opportunities for physicians and other healthcare providers working in areas densely populated by francophones; these include linguistic and cultural sensitivity training, in addition to teaching strategies for the practice of 'active offer' of French-language services. In sum, the present study outlines the importance of linguistic concordant communication in healthcare delivery, and describes some of the challenges faced when providing French-language services in rural and Northern Ontario.
Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada. pe_timony@laurentian.ca.
Patrick E
PE
Timony
Laurentian University, School of Human Kinetics, Sudbury, Ontario, Canada. agauthier@laurentian.ca.
Alain P
AP
Gauthier
Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada. suzanneserresse@gmail.com.
Suzanne
S
Serresse
City of Lakes Family Health Team, Sudbury, Ontario, Canada. nataliegoodale@yourfamilyhealthteam.com.
Natalie
N
Goodale
Health Sciences North/Horizon Santé-Nord , Sudbury, Ontario, Canada. jprpic@hsnsudbury.ca.
Jason
J
Prpic
D003142:Communication; D003144:Communication Barriers; D054521:Cultural Competency; D003469:Culture; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008297:Male; D009864:Ontario; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000458:organization & administration*; D012111:Residence Characteristics; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D000078329:Workforce
General/Family Practice; Medical; North America; Practice Tips; Professional conduct; Qualitative Research