Although it may be difficult to fit in patient education during initial consults and follow-ups, physicians should not make the mistake of assuming patients understand something just because they say they do, Dr. Cortés says. Aim for clear communication in nontechnical words, and ask patients to teach back to you what they have learned, she recommends. Asking patients how they think they got the disease they have can reveal cultural perceptions and help physicians address any misconceptions, Dr. Robbins says.
Finally, hiring physicians or other staff persons who speak the native language and are familiar with the culture (or cultures) in your patient mix can help. Dr. Ginzler speaks highly of a study coordinator at her hospital who speaks Mandarin Chinese and has a medical background, for instance. Dr. Bello, who is a first-generation son of Colombian-born parents, learned from his physician uncles how to better communicate with his Hispanic patients. “I still use colloquial words and phrases to better communicate,” he says.
Vanessa Caceres is a medical writer and editor in Florida.
References
- Kutner M, Greenberg E, Jin Y, Paulsen C. The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. US Department of Education. National Center for Education Statistics (NCES) Publication No. 2006-483; September 2006.
- Weiss, BD. Health literacy and patient safety: Help patients understand. 2nd ed. American Medical Association Foundation; 2007. Available at www.ama-assn.org/ama1/pub/upload/mm/367/healthlitclinicians.pdf. Accessed December 3, 2009.
Involving LEPs in Clinical Trials
Recruiting LEPs into clinical trials can be difficult, say a number of rheumatologists. First, there’s the trust factor of getting patients to agree to participate. Some minority groups may be very wary about what kind of treatment they will receive and how the results will be used, Dr. Robbins says. Others who are in the United States illegally may worry about revealing personal data in a clinical trial.
Community leaders can help with recruitment and educating LEP patients about clinical trials. At the same time, the organization sponsoring the clinical trial and the hospitals involved should show how the trial will benefit the community, Dr. Robbins adds.
At some hospitals, it is not common to have LEP patients participate in clinical trials. “We have 300 patients in clinical trials, and 290 of them speak English,” says Daniel J. Wallace MD, clinical professor of medicine at Cedars-Sinai/David Geffen School of Medicine at the University of California Los Angeles. “These situations arise when a patient is ill and requires a treatment and is not a citizen and has no insurance.”