This patient is not happy with Indian physicians. This is a pretty controversial letter to the editor in a Tennessee newspaper. I bought the article, so it can be discussed here:

Doctors need to be able to understand English

According to the American Association of Physicians of Indian Origin, 38 percent of physicians now practicing in the United States are Indians. I have no objection to the racial background of these physicians. I do question their motivation – surely doctors are needed in their native country where many of them were fortunate enough to receive their medical training. Physicians are almost worshiped by many in India, so while prestige there might be greater, the financial return here must be overwhelmingly larger.

There is a general disregard for women in India that may be problematical for American women under the care of male Indian physicians who grew up in that culture. Our native-born doctors are guilty enough of slighting their women patients in many ways, but they were at least reared in an atmosphere where equal treatment and respect were given lip service.

There is the language barrier. Although reaping financial benefits, which would provide a private language tutor, many foreign-born physicians still speak heavily accented English. If they speak so poorly, is their understanding adequate?

Do they understand the nuance of the language well enough to catch that important clue to a patient’s condition? Can medical care be adequate when the doctor cannot understand the patient’s speech, and vice versa?

Anyone who wishes to practice medicine in the United States should understand and abide by the cultural standards of the United States – at least in dealing with patients. He/she should be able to think clearly in the English language, and speak clearly enough to be understood easily. Foreign physicians reap a rich reward here; the least they can do in return is respect patients by following these standards.

Comments are moderated before they are published. Please read the comment policy.

  • beajerry

    Good and bad points there. I would think a good physician would be interested in learning nuances of working in a second-language, and a bad physician wouldn’t care.

    As for the patient, is it their responsiblity to adjust themselves to communicate better with the physician?

  • Anonymous

    “As for the patient, is it their responsiblity to adjust themselves to communicate better with the physician?”

    Ah, the unfathomable arrogance of doctors. Yes–and should I “adjust myself” so that I can communicate better with my Mexican-immigrant house maid or my Honduran gardener? Of course not. I’m the paying customer.

    It seems obvious that if there are credentialing requirements for doctors at all, such requirements should include a mastery of American English. If that requires a month with a speech coach, so be it–much as I like/admire the contributions of Indian Americans.

  • Anonymous

    Whoever wrote it clearly doesn’t speak any foreign language well and doesn’t have much experience with dealing with people from other countries. Otherwise the author would understand that having a heavy accent doesn’t preclude one from being fluent in the language. One can have a very limited vocabulary and very limited grammar, but be able to pronounce every sound perfectly (e.g. a 5-year old who spent a few months in the US or a musician with perfect pitch and an innate ability to reproduce sounds perfectly). One can have a very heavy accent but know a language fluently.

    It is impossible to get rid of an accent unless you’ve lived in a country since a very young age. The older you are when you come to the US the heavier your accent will be. Yes, if you work harder on it and have better ear for languages, you may reduce your accent, but you will never eliminate it.

    Most educated people in India grew up speaking English. So, most of them do understand all nuances of a language. Also, in order to get a medical license in the US, a foreign doctor needs to pass an English test.

  • Anonymous

    Not true–accents can be diminished with hard work and training. The question is whether the cost is too hight for foreign doctors/society to bear.

  • Anonymous

    As a physician of east asian background (Vietnamese) I grew up in the U.S. and don’t have an accent…yet I am still looked upon as a foreigner by patients and non-patients…let’s call this what it is…racism.

  • small squirrel

    People are astoundingly ignorant. First of all, any foreign physician’s understanding of English must be good enough to let them pass the USMLEs. Second, in India a good many medical schools conduct all their classes in English. Third, depending on what state in India the doctor comes from, English was probably his/her first or second language.

    Many Indians do have an accent when they speak English. As do Brittons or Australians. It can become a barrier to communication if the accent is so thick that the patient is unable to understand the physician’s instructions. THis would be my only concern.

    What a racist article. This patient questioning the motivation of doctors who immigrate to the US? Utter BS…. we are a free country with amazing benefits of citizenship…and we ask people to admire that. Should we really be surprised when people then want to move here?

    And there is NOT a general disregard for women in India. There are cultural difference. And come on, if we want to overgeneralize then, what with the high rate of violence against women in this country, should we REALLY be throwing that particular stone?

    The author of that article is a bigot and should hold him or herself to the same standards he/she is espousing.

  • Anonymous

    “Ah, the unfathomable arrogance of doctors. Yes–and should I “adjust myself” so that I can communicate better with my Mexican-immigrant house maid or my Honduran gardener? Of course not. I’m the paying customer”

    Are you Sandra Bullock in “Crash”? Why are you so angry at the races? I really liked you in “speed” though. Keanu Reeves is one hunk. I hate to tell you this, but as the sodomites break us, you’ll see more and more foreigners being your doctor, especially in the high risk, easier specialties like OB-GYN. The funny thing is the Asian patient is less likely to sue so they can keep getting service in english. Get used to your doc saying: ” CongratulatioNS its a roy”

  • Anonymous

    “The unfathomable . . . blah blah blah”

    Go find yourself a doctor of the race, sex, national origin and language you prefer. It’s your money (if in fact it really is your money and not the taxpayer’s you are spending)here. The unfathomable stupidity of whiny self-important blog lurkers more likely. Always someone else’s arrogance, always someone else’s fault. You have the problem. Shut up and own it.

  • Anonymous

    Dear Doctor:

    In case you’re not aware, many patients complain about not being able to understand you, whether you speak the King’s English but use “doctor-speak” or speak with a heavy accent. It is your responsibility to communicate ably enough with your patients so they comply with the treatment plan. I work for a large HMO with so many different foreign-born doctors I refer to it as “the United Nations.” There are some doctors who should have a standby translator so that the patient can understand what you are saying.

  • TXMed

    “What a racist article. This patient questioning the motivation of doctors who immigrate to the US? Utter BS…. we are a free country with amazing benefits of citizenship…and we ask people to admire that. Should we really be surprised when people then want to move here?”

    Small Squirrel, are you arguing that the forces driving physicians from India are issues of human rights? We are talking about the world’s largest democracy here, not North Korea.

    Foreign born physicians jump through hoops to practice here, and they are indispensable, filling what I imagine is a large percentage of rural practices and other practice oppurtunities currently unpopular with American graduates, but to act like questions concerning their motivation are bigoted or not legitimate topics of discussion is a little short sighted, in my own opinion.

    I don’t want to generalize, as I’m sure the motivations behind immigration are incredibly diverse, however, it looks like India’s doctor shortage is currently at least as bad as the United States’ and it is naive to think that quality of life issues tied to income don’t play a major role in many’s decisions to immigrate.

    I encourage a read of this BMJ article, from 2003, looking at one specific British program and more broadly addressing the “brain drain” created by the western world’s recruitment of physicians from developing nations:

    http://bmj.bmjjournals.com/cgi/content/full/327/7420/926

  • Anonymous

    Doctors in the U.S.A., aside from being fluent in English, should be blue eyed, blond, at least 6 ft. tall, male and must belong to the Aryan race.

  • Anonymous

    Racism? This is not racism! Sorry, but I speak English,I don’t understand people from other countries or one that come here and have a heavy accent for that matter. On the other hand I have a specialist from india who has made himself speak English very well and with very little accent. I have seen him for over 8 years now, we have a good realtionship.

    I was sent to a differnt Dr. that I could not understand one word he said. If I can’t understand my Dr. then we aren’t making any progress.

    That is not racism…If I go to other countries I either have to learn their language or I have to expect them to not understand mine. Why is it that you come here and think we should take up your language?

  • John J. Coupal

    I agree about the HMO thing. Many newly (or oldly) immigrant doctors may find the HMO world the easiest to enter. Patients are assigned a doc and when the patients says to her family that “I can’t understand what he is saying”, the HMO says: “I’m sorry. He’s your doc.”

    When the patient (or close family) can’t understand his doc, it is the responsibilty of the doc to remedy the situation. Or, allow the patient to go elsewher for medical care.

    Patients don’t have to hire a Berlitz teacher.

  • Anonymous

    “When the patient (or close family) can’t understand his doc, it is the responsibilty of the doc to remedy the situation. Or, allow the patient to go elsewher for medical care.”

    Go elsewhere yourself if you aren’t satisfied with the communication. Sorry, but it isn’t the doctor’s responsibility to speak to you in unaccented English. In the situations where there is a lack of clear understanding in communication in the same language, the person with the deficiency is usually the patient, and it is usually a deficiency in the ability to speak and understand their native language, in their education and in their breadth of experience of others outside of their particular community. There are consequences and inconveniences to being poorly read and educated.

  • Anonymous

    Not true–accents can be diminished with hard work and training.
    Here is what I said – it is very similar:
    Yes, if you work harder on it and have better ear for languages, you may reduce your accent, but you will never eliminate it.
    Yes, you can reduce your accent. But it is a function of not only hard work, but also your innate abilities and the age at which you started. At the age of 15, it is very easy, at the age of 19 – you can reduce your accent with hard work but not eliminate it; at the age of 40 – it is difficult to even reduce it noticeably.
    I am curious how many languages you speak, how well and at what age you started.

    Also, what one American considers a “heavy accent” another American considers a “very light accent”. We don’t know how heavy an accent of this particular doctor was. The author of the article didn’t appear to have much experience with foreigners which means the accent he/she complained about could’ve been very light. Besides, all foreign doctors have to pass USMLEs (as it was mentioned); from what I heard from foreign doctors they need to pass an English test as well.

    At any rate, my main problem with the article was that the author assumed that heavy accent implied lack of understanding. This is rubbish as these two are unrelated. Especially for Indians who grew up speaking English.

  • Moof

    That article really stirred up a hornet’s nest …

    Personally,I have no problem with “accents,” as long as there is good communication. I’m fluently bilingual, and was raised in Maine speaking a foreign language, although I’ve been told that the only accent I have now is “Down East.”

    It’s not racism to want to be able to communicate with your physician. It’s common sense! It’s necessary for the patient to understand the physician’s questions, instructions, etc. … and likewise, it’s necessary for the physician to understand the patient’s complaints and explanations.

    I didn’t think the article was racist, because all she’s calling for is foreign doctors to be able to communicate well in our language, and to treat both sexes equally. We expect the same of our home-grown physicians!

    I did, however, think she was a bit down on men … with this little slap: “native-born doctors are guilty enough of slighting their women patients in many ways, but they were at least reared in an atmosphere where equal treatment and respect were given lip service.

    * ouch! *

    Those in this thread who are continually substituting the word “accent” for “understandability” are showing their own prejudices. Most people don’t mind accents – but they do, and should mind not being able to communicate.

  • Gasman

    Damn.
    People from Tennessee sure talk funny. I especially don’t like it when one of them is my physician, all heavily accented, with the ‘yall-come-back-now’ superficial southern charm.

    Why can’t docs from Tennessee just stay where they are. I’m certain that there are pleanty of underprivlaged local citizens for them to treat that they don’t have to invade my state.

    There are nuances to standard english (defined as how network new anchors speak) that southerners just don’t get; how do I know that they will
    understand me?

    Anyone who wants to practice medicine in a free state needs to abide by cultural norms; if they can’t master the language they should just stay home.
    [n.b. satire for those who didn't get it]

  • SarahW

    Gasman, that reminds me of my last trip to Tennessee. We were expecting guests in our hotel room and made a quick run to a nearby Wal-mart for some cheap glasses, and snacks and a much needed umbrella. I got a cart to collect my purchases and made my way down the aisles.

    As I was deep in thought, browsing the fine selection of coffee mugs and wondering why hotel rooms in knoxville had no corkscrews, a quiet nearby voice declaimed:
    “Kin yew mewve yer buggy”.
    A buggy? Cool, who’s got a buggy, I thought.I looked around to try and spot the a quaint “tinnisee” carriage in the wall mart.

    “EXKEWSE ME!” I felt a tap on the shoulder. “Kin Yew please mewve yer buggy?”

    Was my face red. And I quickly rolled my shopping cart aside.

    Seriously, I just recently decided against a dentist because, though he is a good dentist from all reports, he has a thick accent, I had to repeat things to him several times and figured nitrous oxide and/or novocain would not improve the situation.

    It’s silly to ask the patient to accomodate any language barrier. Physicians with thick accents or who are not fluent in the mother tongue of the people he generally treats may not be as effective as a doctor who does. That’s simply common sense.

    FWIW, Indians do have weird ideas about the ladies, and this cultural difference is not something I would put up with if I were to detect
    a hint of mysogyny. I don’t put up with it in articulate doctors born and bred in the states, and I’m not going to put up with it because you come from a place with a “cultural difference”.

    If I have to choose, and go elsewhere, and pay more, it’s 500 rupees now, vs 50,000 rupees later. To quote a certain notorious Indian billboard.

  • Cathy

    Why don’t we all just give Physicians their own way about everything? It doesn’t matter if we can understand them nor them us. As long as we can’t understand them, then we don’t know what they are advising us to do. Not much chance they can get sued for malpractice if we’re not sure what the hell they told us from the beginning..

    I imagine all Drs. (even homegrown ones)now will be learning a new language as part of their defensive medicine practice.

    Sounds like a really good idea. Their defense can be….”That is not what I advised this patient to do, but, because we have this hugh gap in communication, it is not my fault she didn’t follow directions.” “Therefore I’am not to blame because she/he is to ignorant to understand the language I speak.” You should all immediately enroll in foreign languages!

    (satire for those who didn’t get it)

  • Anonymous

    I do have an accent (very “soft”, I was told), and despite trying very hard, there is no way I can get rid of it. If you come to the US at the age of 14 or older, you will keep a foreign accent, your accent will not change completely, even with training. And I speak german since I was three and french since I was six. The interesting thing is that my mother complained when I visited her recently that I am speaking my own language with an accent :)
    The problem is that american medicine lacks true competition and there is little motivation for a physician to polish his patient skills, whether it is his accent or his Speedy Gonzalez- type hospital rounds. Reinstate true competition and the accent will soften or the doctor will go bankrupt.

  • Anonymous

    Whoever said that Drs. have to speak good english to get medical physicians rights in the USA, can’t be right..

    I was sent to an ENT (new guy in town) several months ago. When I arrived there were 3 other pts. in his office. He (the Doc. himself) came into the waiting room to ask for his next patient to come back. He said a name that not one of the 4 of us recognized as being ours. We just kind of all looked at him and each other. He repeated this 4 times and finally we decided to repeat our last names to him in the hope that would help…

    the last name that he so terribly pronounced was “Miller”…When it was my turn I didn’t understand one word that came from his mouth. His wife was his receptionist and same thing..It was a completely wasted appt.

  • Anonymous

    Maybe I’m missing something here, but it’s not as if a patient has to see a certain physician. Go somewhere else. I wouldn’t choose a GP if I couldn’t understand what he/she was saying, no need to hang around and whine about it. Go somewhere else and quit your whining.

  • Anonymous

    Anon 6:52 I think thats what most people do once they realize they can’t understand them. But, that first visit you don’t know until you get there. Some foreign Drs. speak good english, atleast well enough to be understood, I don’t have a problem with them at all.

    I should have realized whining is reserved for Drs. only. Sorry for trespassing on your territory.

  • Anonymous

    The thing I’ll never understand is why can all these foreign docs claw there way to the top to be included in the top 1% of income earners in the United States, and yet you lazy Americans just sit on your ass and are satisfied with the mediocrity of your lives till your dying days…

  • Anonymous

    Several points:

    1. At the mid-tier university program where I did my residency the strongest resident was Indian (second generation). What you people don’t realize is something the biologists call the bottle neck effect. The type of person who is smart enough to learn a second language and move to an entirely foreign country has superior genes to the people who could not pull that off. We as a country have reaped the benefit of this effect for hundreds of years. If you don’t like how someone speaks of looks or smells, go somewhere else. But remember, that person is probably smarter than you, how many languages do you speak? Could you pass a difficult exam in that language?

    2. The reason that foreign born doctors (bless them all) live and work in rural settings is that most other doctors don’t want to. If you run out all the “foreigners” you will be left with no access. Remember, you can’t have everything. Which would you like–a cultural barrier or poor access to care. (“No, I want both, it is my right as a citizen and taxpayer!!”)

    3. What is infinitely more common in practice is for the patient to walk in the room and have no clue about communication. I practice the “wait 60 seconds for the point” rule that we all learned in medical school, but what usually comes out is verbal diarrhea. If you have to work with a doctor who can’t communicate very well, perhaps you should use some economy of speech, or write down what your complaints are. Why is it that everyone has to cater to you? I did an experiment in my office where I had a large basket of drug rep pens and paper pads for the patients to use to make notes of what I said. Out of hundreds of people those few months maybe one made use of the pads. Most all would like for me to write down their diagnosis, their prognosis, their treatment, etc. but a scant few are willing to do it themselves. The foreign doctos learn your language, pass your exams, conform to your culture, hire your race to work in their office, and then have to write down for you what to do. You are the lazy american that is dragging down the average.

    p.s.-I am a white american born male.
    b

  • Anonymous

    First off, I cnat believe that initial statistic.

    38% of all american doctors are indians? I find that unbelievable. If thats true, that means that indians outnumber ALL FEMALE doctors in the USA.

    Indians do make up a good chunk of doctors, but there’s no way its 38%. I would guess something more like 20% maybe.

    38% is probably the number for all foreign born doctors in the USA.

    Second, you DO NOT need to speak good english to get an american medical license. You dont even have to take the TOEFL anymore. You have to be able to read english good enough to pass the USMLE exams. But reading a language and speaking it are 2 VERY DIFFERNET THINGS. I can read French fine, but my speaking skills are very subpar.

    So as long as you can read english enough to take USMLE, then you dont need to speak a lick of it in order to get licensed.

    Thirdly, foreign doctors only practice in rural areas long enough to establish their visa protections and get green cards. After they get permanent residency status, they go to the big cities just like everywhere else. Then new foreigners come into the rural areas where the older foreigners vacated. Using foreign docs to plug rural areas is NOT a good long term solution, its a temporary stop gap measure

    Fourthly, the USA takes in more foreign doctors than ALL OTHER NATIONS COMBINED. The percentage of foreign doctors in the USA is higher than in any other country. They are lucky we open our doors to them. Lets get real, they come here because doctors get paid a lot more in the states than elsewhere. Maybe 1% come because of persecution, but they are rare animals. The vast majority just want the money. I dont fault them for that, but lets call it what it is. They dont have a desire to help out poor rural country folk more than any of hte native born doctors.

  • Anonymous

    Well who put them in the top 1% of all income earners (if thats even correct)?

    Oh, I know, it’s all those lazy Americans, sitting on their asses, that go to them and make that possible!

  • Anonymous

    I’d rather see an Indian Doctor who cares about me as a patient and is able to figure out what’s wrong then a doctor like me who’s so worry about getting sued all I can do is order tests to cover my Ass. Don’t you people all your doctors are doing is passing you off from consultant to consultant to cover their butts? English is not a prerequisite to that.

  • Anonymous

    What makes you think Indian doctors aren’t doing the same…they know defensive medicine too!

  • Anonymous

    whether it’s working at a 7-11, or doing cardiac catheterizations, those indians work hard…all you americans do is sit on your asses and get diabetes and coronary disease and give us more business…

  • John J. Coupal

    It would be scary here if “anonymous” is really only one person!

  • Neerav Singh

    I think we need to do a good rigid rectoscope exam on the original authour to get to the bottom of his matter. I wonder if this talented doctor has ever seen a rigid rectoscope, else he won’t be have been so rude.

  • Cathy

    John Coupal, I’ve said that before about this site. I think there are a couple people here with big MPD problems. I understand why people don’t want to use their real names. But, if they adopted ANY name, for the purpose of posting, atleast one could keep them straight.

  • DrPak

    I think the letter is not, in itself, racist. It is entirely concievable that the writer of this letter to the editor is genuinely concerned about accents being a problem with communication.

    However, given the terrible track record that the Southern States have with regards to different races, its no surprise that the initial preception (amongst many commentators) is one of racism. If a Tenessee newspaper carries an issue about “foriegn” doctors, its not surprising that racism is the first thing that comes to mind.

    I’m sure if the letter was published in a New York newspaper, and written by a New Yorker, preceptions would have been different. There would be little, if any talk of racism then.

    The preception (at least to us IMGs) is that the Southern states are not very open to “outsiders”. I don’t work in the US (yet), but when I do apply to residencies, I’m going to follow the advice of friends and steer clear of the Southern states for this very reason. After working my heart out to get a chance to train in the US, I shouldn’t have to put up with racism whether its veiled behind ridiculous concerns about accents or not veiled at all.

  • Anonymous

    Dr. Pak: If you can come to Boston. This city is (now) multicultural and you will be judged on our skills as a doctor, not on what country you come from. Diversity is not only accepted here, it is appreciated.

  • beajerry

    As a nurse, whenever I have a patient who can’t speak english I feel truly inadequate and want to learn as much of their language as feasable in the short amount of time they’re there so that we don’t have to talk through the annoying interpreter phone. I probably butcher their language something awful.
    The point is: it bothers me and I try to adjust the best I can to help them.
    It’s not their problem. It’s mine.
    That’s how I look at it.

  • Aya

    “Second, you DO NOT need to speak good english to get an american medical license. You dont even have to take the TOEFL anymore. You have to be able to read english good enough to pass the USMLE exams.”

    Not true…USMLE step 2 CS involves encounters with trained simulated patients.A subcomponent of this exam is communication and interpersonal skills which is assessed by these patients.

  • Anonymous

    It is important to have instructions understood by the patient. However it doesnt take much intelligence to ask your doctor to repeat what they said/ write it down / or even have a second person explain it. If I had to choose between a doc with excellent english but lacking in manners/intellect and a foreign doctor who was brilliant but had poor english – its obvious who I would feel comfortable with. Anything which is unclear can be resaid/ written down. Dont forget these foreign doctors are on top of their class – if not they would be thrown out of the US.
    The orignal article had an element of racism ( the woman comment)and xenophobia which is unfortunate but is common post 9/11.

  • Anonymous

    What are you talking about. You pay a 10-20 copay and the insurance pays the rest. Or if you are medicaid you don’t pay anything.

  • Anonymous

    Anon 11:22, Yes I pay my co-pay and my out of pocket, and my deductable and my contributions to our group policy that happens to be part of my salary, as it was a negotiated aspect of excepting employment. Is there some problem with me needing to understand my physician? Do I need your approval to decide I don’t want to continue seeing Dr. X,Y or Z?

    Your a Dr. but guess what, you don’t rule the world, and you sure as hell don’t make my decisions!

  • Anonymous

    “Do I need your approval to decide I don’t want to continue seeing Dr. X,Y or Z?”

    You can see whoever the hell you want. Let us just remember that there is a HUGE difference between paying a 10-20 dollar copay with your monthly deductions and actually paying a significant portion of the medical care you recieve. Like most Americans you have little clue as to how expensive medical care really is.

    “Your a Dr. but guess what, you don’t rule the world, and you sure as hell don’t make my decisions!”

    Correct and let me thank my lucky stars you aren’t in my patient panel.

  • Anonymous

    “to repeat each sentence 3-4 times”

    when you get a little older and are hard of hearing or demented maybe we should discharge you from our practices because you waste so much of out time…

  • Anonymous

    “Like most Americans you have little clue as to how expensive medical care really is”

    What is your problem? You whine and moan over the patients who are on medicare or medicaid, you b**** about the ones who have private ins., you admit to over testing,(which absolutely has to be fraud), you drive the cost of medical care up by ordering all these tests, you think we should be overjoyed to communicate with a physician who doesn’t even speak our language, you don’t allow any conversation because of your arrogance, abusive and know-it-all attitude, then you think we should be thrilled to pay out-of-pocket for all of your “save my own ass” defensive medicine..

    On top of that you have the nerve to say to me that “I want my cake and eat it too”

    Talk about the pot calling the kettle black!

  • Employmentforphysicians

    Yes, I agree with your article: Doctors need to be able to understand English

  • Anonymous

    Out of hundreds of people those few months maybe one made use of the pads. Most all would like for me to write down their diagnosis, their prognosis, their treatment, etc. but a scant few are willing to do it themselves.

    If you tell them something simple, like “Take this pill twice a day with food,” they don’t write it down because it’s so simple they’re sure they’ll remember it.

    If you tell them something more complicated, like the specific name of their condition, they don’t write it down because they have no idea how to spell it. They haven’t been to med school.

  • Anonymous

    This could only have been written by a monolingual American.
    India is a former British colony. Most educated Indians have a better grasp of the English language than comparably educated Americans.
    Speaking with an accent is not the same thing as not understanding standard English.
    The patient’s understanding of the doctor is another matter, but there is absolutely no reason to question a doctor’s understanding of the patient based on the doctor’s accent.
    I see that someone has posted similar points, and more eloquently, but I’m posting this anyway to add my voice to those taking exception to this sort of ignorance.

  • Anonymous

    Sorry, but I speak English,I don’t understand people from other countries or one that come here and have a heavy accent for that matter.

    Sorry, but you don’t.

  • Matt

    I’m amazed that this issue as perceived as being purely a linguistic problem by many while you clearly are playing on the stereotypes that have been created about foreign doctors. The writer has a non-linguistic related problem with foreign doctors.

    The question of adequate testing doesnot hold water as another author pointed out the simulated clinical part of the exam which will surely weed out clinicians without adequate language skills.

    Accents are exactly what they are. Move a hundred miles and it changes. I have seen patients and physicians (AMerican born and bred) struggle with the accents in the top hospital that I work in, a place that draws patients from all around the US. What makes this hospital really great is their policy of hiring the best, irrespective where they are from. This has contributed to the breakthroughs that we see here. This to me is only a small model of what the ideal academic, cutting edge hospital should be. Isn’t this what America is about?

    As much as we may bemoan midicine in this country, it still is the best in the world, and with no small contribution from “foreign doctors” who can “speak little english”.
    Drive out all the foreign MD’s and see what happens to the health care access. It’s ridiculous to also assume that these doctors find work only with HMO’s. Take a look at any of the premier hospitals, if you haven’t been to one.
    Those who complain about defensive medicine pushing up health care costs should not forget that the doctors are defending themselves from the lawsuits, warranted or frivolous, by the patients, and hence, patients too have to take the blame for it. This is not how medicine was 30 yrs ago.

    What exactly do you mean by good english? I would challenge the writer to understand in the first try, what anyone from London says (forget liverpool or newcastle). Does that mean that the British can’t speak english?

    Rather than make excuses, why not try “can you speak a little slower doc, I can’t understand you”.
    If the writer is so concerned, she should be prepared to pay higher taxes, so more American students may go to medical school, funded by the state, without the fear of a $300000 debt at the end of it. Also, more americans should be willing to dedicate 7-12 years after graduation from college, working 70-80 hours a week for minimum wage or less and studying the rest of the time. If you call that purely financial motivation, then I feel sorry for you.

    Can you all honestly say that you understand every person, irrespective of their colour and origin, as long as they are american? If not, take off the mask and acknowledge your real feelings.

  • Anonymous

    It’s interesting how endangered the locals/Americans feel by hard-working, talented immigrants in selective, high-ranking professions in the U.S. Have you run out of other aspects of their work to criticize, in order to deplete their market? Although I agree there often is a language barrier, and that it should be overcome in professions where communication-skills are pivotal, I disagree that the blame lies squarely on the medic’s shoulders. Personally, I would prefer hearing correct English with a heavy Indian/foreign accent than hearing incorrect English with an American/local accent. The former would speak volumes about competency, rather than style.

  • no english

    Dear Western Doctors,
    English is the only language
    that has stolen words from numerous other languages . (pantaloon became
    pants,Threys became 3,hastband became husband ,,,,,,,, soon soforth.
    )
    Moreover all the medical words are nothing but greek and latin.
    and not English ,
    You can be an american idol but
    not understand Simon accent,
    What is simon doing in an american Idol anyway?
    Look at your back yard First.
    Go get a life.

  • Anonymous

    In each country, there are always the intolerant and the tolerant people. The intolerant think that everybody should speak their language fluently with a standardized accent; the other ones reflect.
    Tell me who speak the better English: the Americans, the British? They do not have the same accent. Would you rebuke a British physician the same way you did for the Indian one?
    The US was build on immigration. The American people should not forget that…

    A French physician in the US

  • speech coach

    What an interesting series of comments! I definitely agree that clear communication between any health care professional and a patient or patient’s family is essential, especially in an emergency or on the telephone. As a corporate speech pathologist in Tennessee who provides foreign accent modification in an intensive 3 day course, I see many foreign-born physicians and others who are highly motivated to pronounce English more clearly. However, often hospitals and other employers are not willing to pay for this training of their employees because they do not feel it is essential.
    If you have a physician whom you cannot understand, you need to tell the hospital administrator, personnel director or chief of staff about this, so they know of the need for more training. Patients vote by their feet. If you still get care from that doctor, tell the doctor what you cannot understand, and ask him to speak slower or write the information down. Communication is everyone’s responsibility.

  • Anonymous

    Don’t say anything if you don’t have a clue of what you are talking about. First of all, the younger you are introduced to a foreign language the better to learn it without an accent. I can tell you for my own experience, The older you are the heavier the accent. Don’t tell me that I should try to loose the accent because I CAN’T. I worked with an expert for about 2 years and was unable to do it(It helped a lot with my pronunciation though). Do you think that we want to have an accent?? OF Course NOT–Especially the way we are treated by some people. Unfortunately we have to live with it. Let me tell you something PRONUNCIATION is the most difficult part of the English Language. I’m fluent and can read and write in English probably better that many native speakers. I Attended an American University and graduated with honors, so LET’S MAKE IT CLEAR “A FOREIGN ACCENT DOESN’T MEAN THAT THAT PERSON IS NOT FLUENT IN THE ENGLISH LANGUAGE. Give people some credit for speaking 2 languages, at least we try.