UCLA researchers investigated the consequences of language mismatch that occurs when physicians and patients cannot speak the same language.
Researchers from the UCLA Latino Policy and Politics Initiative analyzed California census data in a study released earlier this month to gather evidence and develop policy solutions to address the shortage of Spanish-speaking physicians in California.
LPPI director Sonja Diaz said in a press release Latinos are going to college at higher rates than ever before, but fewer are graduating from California medical schools than in 1980.
There are 62.1 Spanish-speaking physicians per 100,000 Spanish-speaking Californians, compared to 344.2 physicians for English-speakers, according to the study. Southeast Asian languages, including Tagalog, Thai and Vietnamese are also underrepresented.
David Hayes-Bautista, a professor of health policy and management who authored the study, said Californians with limited English proficiency have worse health outcomes in areas including access to care, health status and patient safety.
He added his work with underserved communities informed his personal understanding of how a common language affects health outcomes.
“I’m a great believer that everyone should have best access to healthcare, and language is part of that access,” Hayes-Bautista said. “It’s a social justice issue, quite frankly.”
Hayes-Bautista is also the director of the Center for the Study of Latino Health and Culture at the UCLA School of Medicine.
Arturo Bustamante, an associate professor of health policy and management affiliated with the study, said a lack of communication between physicians and patients ultimately harms patients because of unconscious biases and a diminished sense of trust.
Bustamante also said physicians are rewarded for being trained in narrow, lucrative specialties, and not for providing more general services to underserved communities. He added he thinks medical schools should consider reforming to increase the number of well-rounded physicians in underserved areas.
“Many of the first-year grads from med school don’t find incentives to pursue a career in underserved areas,” Bustamante said. “We need medical school, training and career tracks that train physicians that have skills to work in other areas.”
The study suggests potentially changing medical school admissions to include underrepresented language skills as part of their criteria.
Hayes-Bautista noted with such large applicant pools, medical schools could afford to add proficiency in underrepresented languages to admissions criteria.
Theodore Hall, associate dean for admissions at the David Geffen School of Medicine, said in an emailed statement the school does not have a language proficiency requirement beyond effective English communication skills, but encourages applicants to consider learning Spanish because of a large Latino patient population they will likely encounter in their careers.
Hall added changes to admissions criteria, such as the inclusion of a language requirement, must be vetted by the Admissions Policy and Oversight Committee and confirmed by the Faculty Executive Committee.
Hayes-Bautista added that learning a language is a decision anyone can make.
“Anybody can learn to speak one of those (underrepresented) languages. I have a four-year-old grandson; he speaks Spanish perfectly well,” Hayes-Bautista said. “It’s not impossible.”