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J Immigr Minor Health. 2009 Dec;11(6):494-8. doi: 10.1007/s10903-008-9222-7. Epub 2009 Jan 19.

Patient-physician language concordance and lifestyle counseling among Spanish-speaking patients.

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Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline, Boston, MA 02446, USA.



Patient-physician language discordance is associated with worse quality of healthcare for patients with limited English proficiency. Patients with language-discordant physicians have more problems understanding medical situations. The impact of patient-physician language concordance on lifestyle counseling among Spanish-speaking patients is not known.


We performed a retrospective medical record review and identified 306 Spanish-speaking patients who used interpreter services between June 2001 and June 2006 in two Boston-based primary care practices. Our primary outcome was counseling on exercise, diet, and smoking. Our main predictor of interest was patient-physician language concordance.


Patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients with language-discordant physicians. After adjustment for age, sex, insurance status, number of primary care visits, and comorbidity score, these differences in counseling persisted for diet [odds ratio (OR) = 2.2, CI 1.3-3.7] and physical activity (OR = 2.3, CI 1.4-3.8). There was no significant difference with regard to discussion of smoking (OR = 1.3, CI 0.8-2.1).


Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician compared to those having a non-Spanish-speaking physician. Further research is needed to explore whether matching Spanish-speaking patients with Spanish-speaking providers may improve lifestyle counseling.

[Indexed for MEDLINE]

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