Partial language concordance in primary care communication: What is lost, what is gained, and how to optimize

Abstract

Objective

In healthcare encounters, partial language concordance occurs when clinicians have some linguistic ability in the patient’s preferred non-English language or patients have some linguistic ability in English or another language (e.g., Mandarin when their preferred language is Cantonese). While the best practice is to work with qualified professional interpreters in these cases, oftentimes visits occur without qualified interpretation. This paper seeks to understand how these partially concordant visits are conducted and how they may be optimized to meet legal standards of non-discrimination.

Methods

19 partially concordant primary care visits with Chinese speaking patients were analyzed using discourse analysis.

Results

Findings illustrate expected communication challenges and unexpected benefits of partial language concordance. While partial language concordance can facilitate rapport building, vocabulary and fluency limitations can also open the door to miscommunication. We also observed how implicit and explicit request of a qualified interpreter to be on standby during the visit can be utilized by the physician to facilitate communication.

Conclusions

Communication might be optimized by the inclusion of a qualified interpreter with an explicit discussion at the beginning defining interpreter roles.

Practice Implications

Discussions with interpreters and how they can best engage throughout could retain the rapport created by a shared language, while minimizing miscommunication and errors.