American College of Physicians: Internal Medicine — Doctors for Adults ®

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Physicians struggle with language barriers

By Jessica Berthold

Nearly two-thirds of internists have patients with Limited English Proficiency (LEP), yet physicians are rarely reimbursed for the extra time and expense of treating these patients, a new survey of College members found.

“On average, patients with LEP comprise 12% of active patients in the practices of ACP member internists,” said College President Lynne M. Kirk, MACP, in a press briefing Friday announcing the survey results. “Physicians encounter such patients on a fairly frequent basis.”

The College's Board of Regents voted this week to ask Medicare to reimburse doctors for the extra expense and time it takes to treat LEP patients, and to advocate for a national clearinghouse of translated documents and patient education materials.

Because patients with limited English have more difficulty understanding basic health information, they usually require more time during office visits, the survey found. Roughly half of survey respondents said they spend an extra five to 15 minutes with LEP patients versus those who are proficient in English; another quarter reported spending an extra 16 to 30 minutes; while 15% said they spent no additional time with LEP patients.

“The extra time comes with patients taking a longer time to explain symptoms, ask questions and understand health information and treatment,” said Board of Regents Chair William E. Golden, MACP.

The College's survey, conducted in late 2006, found that internists see patients who speak nearly 80 languages, with Spanish being the most common. A paper summarizing the survey findings can be found online at www.healthlaw.org.

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