We serve a multicultural population, and for many of our patients, English is not their first language. We understand that it may be inconvenient to ask a family member or friend to come with you to your appointment, but clear communication is essential to the care we provide you.

More than many other areas of medicine, the details of your symptoms, and exactly when, and in what circumstances, they occurred are critical. For example, not understanding the words “since” of “after” could lead to disastrous results. If I ask “Have you eaten peanuts since you had that severe allergic reaction?”, and you understand only “Have you eaten peanuts”, you may answer “Yes”, because you have eaten peanuts, but that was before you became allergic. I will then conclude you are not allergic to peanuts, and don’t need testing or protection, when you really are allergic. Many patients believe that their referring health care provider sent me all the information I would need to make a diagnosis, and recommend tests and treatment, but this is almost never the case. I will need to know much more about what is going on before I can figure things out. I always tell my patients “your doctor cannot connect the dots, unless they know all the dots”.

Depending on what your symptoms suggest is going on, various tests, including allergy tests, may be needed. Some of these tests have risks, and many have limitations, which I will need to explain. If there is a significant language barrier, I will not be able to do this, and cannot proceed, as it is necessary for me to have your informed consent before undertaking any procedure or test that involves some risk. Also, if you cannot understand the meaning of those tests, you may misinterpret what they mean and you may misunderstand the nature of your health problem.

Sometimes, patients have problems that are very different from what they or their referring health care provider expect, and I will need to explain why I am doing, or not doing tests, or recommending treatments they did not expect. This can result in frustration for the patient, as they feel they did not get what they came for, and I cannot explain why this is so.

Many of the conditions I treat are complicated, and I need to explain these, using words that are not likely familiar to someone who speaks only a little English. Speaking more slowly will not help.

Lastly, even if I can figure out what your problems or problems are, and can do tests with no risks, I will need to explain what the results are, and what you will need to do to feel better. I cannot do this if you do not understand what I am saying.

For all of the above reasons, if I feel that you and I cannot communicate effectively, then I will stop, and ask you to come back with a translator, so I can do my job, and help you.

While this can be misconstrued as being discriminatory, the opposite is true. All my patients deserve the same level of care, and I need to be able to communicate clearly with my patient in order to deliver that care. Working with a translator takes much more time than dealing with a patient fluent in English, but I am willing to spend the extra time with you and your translator, if that is what it takes to give you the same level of care.