The commitment By Vishal Kumar, MD, FSIR, and Hirschel D. McGinnis, MD, FSIR
The language of bias: Part 2 At the center of it all
t began like any other routine quarterly medical staff meeting that I’d attended: the report from the hospital president, an update from the chief medical offi cer, presentation of new policies, etc. But when the chief nursing offi cer took to the podium, the energy in the room changed. She was an enthusiastic changemaker. That night, she presented the new patient surgical discharge instruction sets. The changes were immediately noticeable—better design and more engaging, with strong branding and clarity of explanation. This advancement was a huge step forward in off ering our patients high-quality information regarding their postoperative care. When the CNO asked if there were any questions, I raised my hand and asked if the new documents would be off ered in the three most common languages spoken in the community we serve. The response? “No. We’ll roll it out in English fi rst and see how it goes from there. We can get it translated later.”
While this happened about 15 years ago, it’s always stuck with me. There was a cognitive clash between the excitement and acceptance of this advancement in care and the indiff erence towards the many patients who would be unable to derive its benefi ts. And at the center of it all was language.
Language is defi ned as the principal method of human communication, consisting of verbal, nonverbal and written expression. We live in a world in which nearly 7,000 languages exist—at least 350 languages are in use within the United States alone.1
The signifi cance of
language in delivering eff ective medical care cannot be overstated.
Read “The language of bias: Part 1” now.
14 IRQ | WINTER 2024
Language barriers between healthcare providers and patients who do not share a common language can drastically impact the cost and quality of care. These barriers constitute a safety risk and contribute to reducing both patient and provider satisfaction and bar eff ective communication between involved parties. Patients facing language barriers are more likely to consume more healthcare services and experience more adverse events.2,3
Consider the word “once.” In English, this communicates “one time and no more.” However, in Spanish, “once” connotes the number 11. Imagine what could happen if a patient who exclusively speaks Spanish was told in English to change their dressing “once a week” or take a medication “once a day” without the support of an interpreter. There could be a serious negative outcome.
Bias—the conscious (explicit) and/or unconscious (implicit) tendencies of individuals or groups to favor certain beliefs or attitudes over others—can lead to inequitable treatment or clinical decision-making and may be expressed in language usage. Communication barriers or unconsidered word choices may negatively reinforce stereotypes or assumptions about a patient’s race, ethnicity, gender or sexual orientation.
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