Page 5 - Kansas Journal of Medicine, Volume 10 Issue 4
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Rural Kansas Family Physician Satisfaction                   KANSAS JOURNAL of  MEDI CIN E
        with Caring for Spanish-Speaking Only
                            Patients
           Theresia Neill, B.S. , Gretchen Irwin, M.D., MBA ,
                                                       2
                            1
         C. Scott Owings, M.D. , William Cathcart-Rake, M.D. 1  INTRODUCTION
                             1
                                                                  With so much emphasis on improving physician wellness and sat-
           1 University of Kansas School of Medicine-Salina
          2 University of Kansas School of Medicine-Wichita,    isfaction, it is important to determine the factors that affect these
                                                                elements. RAND Health identified that an important factor influenc-
           Department of Family and Community Medicine,         ing physician satisfaction is the physician’s perception about quality of
                Family Medicine Residency Program,              care they deliver.  A physician’s ability to deliver high-quality patient
                                                                              1
                       Wesley Medical Center                    care was an important source of his or her professional satisfac-
                                                                tion. There are many factors interfering with a physician’s ability to
     ABSTRACT                                                   deliver quality care, causing frustration for the physician and leading
     Introduction. Patient satisfaction with the care they receive can be   to a decrease in physician professional satisfaction. If this frustration
     influenced negatively by a language barrier between the physician and   stems from poor communication with patients, impediments to care
     patient. However, there is a paucity of information regarding the con-  can be significant and outcomes can suffer. Physicians and patients
     sequences of a language barrier on physician satisfaction, although   both suffer when language barriers exist.
     this barrier has the potential to decrease physician wellness. This   Kansas has seen an increase in the Hispanic population, especially
     study sought to determine if a language barrier is a source of profes-  in rural communities, over recent decades, with a 59.4% increase
     sional dissatisfaction in family medicine physicians in rural Kansas.   overall from 2000 to 2010.  The significant increase in the Hispanic
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     Methods. In a cross-sectional study, members of the Kansas Academy   population has led to many SSO patients seeking medical providers
     of Family Physicians who practiced in the rural Kansas counties   in these rural communities. Often, these communities do not have an
     with the highest percentage of Hispanic residents were surveyed. A   on-site interpreter and may rely on a communication device or other
     questionnaire was developed to determine the demographics of the   resources, such as bilingual staff or family of the patient.
     physician, details regarding his or her practice, and percentage of His-  Cultural, personal beliefs, values, and language differences influence
     panic and Spanish-speaking only (SSO) patients in their practice.   patient satisfaction.  Hispanics are more likely to report dissatisfac-
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     Physicians also were queried as to their level of Spanish-speaking   tion with their physician relationship, have less continuity of care, and
     ability, availability of certified interpreters, and their satisfaction with   perceive poorer quality of care.  Patients who use an interpreter or do
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     caring for their SSO patients.                             not have an interpreter when one is necessary are not as satisfied with
     Results. Fifty-two physicians were identified and sent questionnaires   the patient-provider relationship.  Clinicians reported that commu-
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     by mail. Eighteen questionnaires were completed and returned, result-  nication difficulties affect their ability to treat and connect with their
     ing in a 34% response rate. Respondents remained anonymous. In the   patients and evidence showed that race, ethnicity, and language have a
     practices surveyed, 61% of practice settings had a Hispanic-patient   substantial influence on the quality of the physician-patient relation-
     population greater than 25%. Only one of the eighteen respondents   ship.  Language barriers between physicians and patients also can
                                                                    7,8
     had greater than 25% of SSO patients in his or her practice. A certi-  reduce patient compliance and quality of care. 9
     fied interpreter was used less than 25% of the time in over 75% of   The aim of this study was to determine if a language barrier was a
     the clinical encounters with SSO patients. Seventy-five percent of   source of professional dissatisfaction in family medicine physicians in
     physicians reported no difficulty establishing trust and rapport with   rural Kansas. The authors hypothesized that rural Kansas physicians
     their SSO patients. Eighty-nine percent of respondents rated their   would be less satisfied caring for SSO patients. Recognition of this
     relationship with SSO patients as good to excellent, and 83% were   factor, which could affect physician wellness negatively, could be a first
     satisfied with the care they were able to provide this group. Seventy-  step in seeking resolution to the problem.
     eight percent of respondents reported that their ability to care for   METHODS
     SSO patients decreased or had no effect on their professional satis-  In a cross-sectional study, fifty-two members of the Kansas
     faction. Seventy-eight percent of physicians also rated their overall   Academy of Family Physicians practicing in the fifteen rural Kansas
     professional satisfaction in regards to their physician/patient rela-  counties with the highest percentage of Hispanic residents were
     tionship as good to excellent. However, language barriers affected   invited to complete a seventeen question survey. Counties with the
     physician-patient relationships, physician satisfaction with care, and   highest percentage of Hispanic patients were Seward (59%), Ford
     professional satisfaction.                                 (53%), Finney (48%), Grant (46%), Stanton (36%), Stevens (35%),
     Conclusion. Language barrier affected physician’s relationships with   Hamilton (34%), Kearney (30%), Haskell (29%), Wichita (28%),
     SSO patients, led to decreased physician satisfaction with the care   Lyon (21%), Morton (21%), Edwards (20%), Scott (18%), and Greeley
     they provided and to decreased professional satisfaction.   (18%). 10
     KS J Med 2017;10(4):79-83.


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