Mai Pham, MD, who works in Bread for the City, a Washington, DC-based clinic, says many physicians and patients face difficulties in overcoming language and cultural barriers, but often these problems aren't articulated—or can't be properly communicated. "Many patients are already feeling vulnerable because they have less information, less expertise, and less control. People can become afraid and insecure, " says Pham, who is also a senior health researcher at the Center for Studying Health Systems Change.
Healthcare providers have legal obligations to provide needed interpreter services, at least for patients with public insurance. However, physicians in solo and group practices were less likely to adopt measures to address disparities than those in institutional practices, such as hospitals, health insurers, and medical schools, according to the study.