Breaking down the language barrier

National Report — As the number of foreign-born U.S. residents, specifically those of Hispanic descent, climbs, veterinarians cite a growing need to improve foreign-language skills to meet the need, especially in Oregon, California, Arizona and Texas.

In Oregon alone, 11 percent of its residents are Hispanic, and the number climbed from 8 percent just a decade ago, according to recent media reports.

While the trend is expected to intensify in the coming years, the communication challenges will become ever-present for healthcare especially in terms of communicating a diagnosis, follow-up care, administration of medications and compliance with recommendations.

It's an important issue for veterinarians, says Orlando Garza, DVM, of East El Paso Animal Hospital in Texas. In fact, the veterinary profession will be asked to adapt to language-related challenges by clients as population centers grow. "The reality is that more people are speaking Spanish than in the past," he says. "As the population changes, we have to adapt to it by learning to speak the language or getting trained professional staff to help us communicate better."

Spanish-speaking in action

Garza understands the issue very clearly. In fact, "not a day goes by" he doesn't speak Spanish to clients.

"Being bilingual is a tremendous asset for me and my business, even though not all veterinarians in the city have this background. Often they get around that by having staff that is bilingual," he says.

Garza believes that Spanish-speaking clients are "more comfortable" if the veterinarian is speaking to him or her directly versus communicating through a translator. "It's more of a trust factor — and it works for us. But I realize that for those veterinarians who are not bilingual, they do just fine having someone bilingual on staff."

In his case, Garza, who has been in practice 30 years, grew up being exposed to Spanish because both parents were fluent in the language. "They would speak to us in Spanish, and we would answer in English. So, we learned the language one way or another. Over time, I became a lot more fluent."

Having a Spanish background has definitely helped. "But I'm not saying that the Hispanic clientele go to the Yellow Pages seeking a Hispanic-looking name necessarily. It has just worked out and has helped my business overall to have this background."

Language barrier gap

"Language — and potential language barriers — are huge issues," adds Lisa Greenhill, associate executive director for diversity at the Association of American Veterinary Medical Colleges (AAVMC). "The Hispanic population unquestionably is the fastest-growing population.

"If there's a breakdown because there's not a connection or there's a language barrier, then how do you explain treatment options, how do you get informed consent? How do you confirm that the client understands the therapies selected? How do you ensure compliance of therapies at home, of pill taking and medications?" Greenhill asks.

Yet, according to Dr. Susan Tornquist, associate dean of Oregon State University's College of Veterinary Medicine, the need for veterinary students to have some background in Spanish can range from "extremely important to not important," based on the areas of practice, location and other factors.

"It is a skill that can contribute to the success of students in many settings, especially certain private-practice areas as well as public health, and research and development in international settings," Tornquist says.

According to AAVMC, of the U.S. veterinary class of 2008, 3.3 percent recognized themselves as Hispanic. That percent rises to 3.9 percent for the class expected to finish in 2011.

AAVMC's Greenhill says the big question today is, "How do we meet growing cultural and language needs of the population we're serving?"

She cites a significant project under way through the North American Veterinary Medical Education Consortium that AAVMC has spearheaded to look at future competencies for the new graduate, seeking to answer the question, "What does it mean to be a new graduate?

"My role in that discussion is to talk about diversity (in terms of) representation. What is it we expect students to know or understand, in relationship to the environment they'll be working in?" asks Greenhill.

Tornquist adds that veterinary students, through varying degrees of coursework, will be able to address future cultural differences with clients. For example, at Oregon State's veterinary program, students are required to take courses in veterinary communications, veterinary ethics, veterinary professionalism and veterinary practice management. All of these, in some form or another, would provide skills and knowledge in addressing cultural differences, Tornquist adds.

Despite efforts to remain on top of language-related barriers, Greenhill says that in healthcare in general, there is "clear data" that demonstrates that minorities are historically under served with limited access to healthcare.

"Some of those types of barriers will persist in veterinary medicine as well," she says. "When you add the language barrier, the gap widens and you reduce overall access."