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In 2000, nearly one in five people in the United States spoke a language other than English at home, an increase of 15 million people since 1990, according to the U.S. Census Bureau. Of those who primarily speak a language other than English, only 55% reported speaking English very well. That translates into a need for bilingual physicians who can communicate with limited English proficiency (LEP) patients. Title VI of the Civil Rights Act of 1964 and Executive Order 13166 both entitle LEP patients to an interpreter and make it illegal to deny services to a patient because of his or her national origin.