Impact of Language Barriers on Breast Imaging Care

More than 25 million Americans are reported to have limited English-language proficiency (LEP), as per the U.S. Census Bureau. Such barriers can lead to difficulties in accessing healthcare services and result in lower rates of preventive measures, including screening mammograms. This issue is outlined in a recent article published in the Journal of Breast Imaging.

The study emphasizes the necessity of employing certified medical interpreter services in scenarios where breast radiologists are unable to communicate effectively with their patients. Lead author Yara Z. Feliciano-Rivera, MD, from the University of Miami Miller School of Medicine, and colleagues discussed the direct relationship between the utilization of medical interpreters and enhancements in clinical care and patient satisfaction for LEP patients.

The research indicates that access to medical interpreters significantly improves adherence to screening mammograms and follow-up care within this demographic. According to Dr. Feliciano-Rivera and her team, breast radiologists can help mitigate disparities in breast cancer screening and treatment by fostering effective communication. They stress that proper training and certification of medical interpreters are crucial to avoid misinterpretations and ensure patient safety.

Additionally, the authors recommend best practices when using interpreter services. These include speaking directly to the patient, maintaining eye contact, seating the interpreter next to or slightly behind the patient, using visual aids whenever available, and having the patient repeat information to ensure understanding.

The authors caution against using untrained personnel or family members as interpreters due to potential medical errors, adverse health outcomes, and breaches of patient confidentiality.

The repercussions of ineffective communication are not limited to patient satisfaction; they also jeopardize the quality and safety of imaging. Daniel B. Chonde, MD, PhD, an assistant professor of radiology at the University of Kentucky College of Medicine, explains that language barriers can lead to confusion regarding follow-up recommendations, complicating access to care. Chonde notes that these barriers can subtly affect diagnostic quality, as highlighted in a study by Taffel et al. in 2020, which found that patients with limited English proficiency undergoing abdominal MRI experienced increased motion artifacts and reduced image quality.

He points out that poor image quality decreases sensitivity in detecting subtle pathology and may necessitate repeat imaging, resulting in higher costs and possible delays in diagnosis and treatment. Dr. Chonde underscores that effective communication is vital throughout the imaging process, especially in settings that require nuanced conversations, such as consent and patient education in breast imaging and interventional procedures.