QUESTION: I work for two different dentists who have something in common that drives me crazy. We have many Spanish-speaking patients, most of who are completely bilingual and easy to understand. Occasionally we have patients who have excellent English vocabulary and grammar skills but heavy accents. It is obvious to me that they comprehend everything I say, but occasionally I must ask them to repeat themselves because of their thick accents.
Whenever the dentists speak to these patients, they will slip in the few simple words they remember from their high school Spanish classes. I think this is embarrassing at best and insulting at worst. They speak in English of all the complex details of the patients' dental treatment, and then will say something like, "Now rinse with the agua," or "Abre la boca," or "You had a root canal on the second bicuspid and there is periodontal involvement and the possibility of future fracture of the tooth, and if the tooth breaks we may not be able save it and you will have to get an implant so I am recommending a corona." Worse still, one of these dentists will frequently ask in a very loud voice, "Comprender?"
I cringe every time this happens. Should I say something?
ANSWER FROM SUSAN KULAKOWSKI, Owner of DDS Consulting, LLC:
Yes, I believe this situation should be addressed since this team member feels strongly that the interaction with Spanish-speaking patients is offensive or demeaning, even though the dentists are likely attempting to reach out and relate personally to their patients through their limited communication skills. While their intentions are good, these doctors probably do not realize how it is perceived by their patients and team members, and the awkward communication that is the result. As such, it is not doing justice to the doctors not to make them aware that this is a concern and to give them an opportunity to address the issue.
As with any issue, sweeping it under the rug does not accomplish anything except greater sensitivity, reaction, and resentment potential. It is best to have a meeting with each to respectfully address the situation and agree on a resolution. If other members of the team are also concerned, it should be addressed in a staff meeting. Since there are many Spanish-speaking patients in practices today, there should be an established patient communication protocol. Hispanics comprise 16.9% of the country's population and their numbers continue to grow. Due to this rapid growth, this may become an even greater issue to be addressed in practices. More than 50% of Florida, California, and Texas populations are Hispanic. In these states particularly it can be a communication advantage to have a bilingual doctor or team member(s) in the dental practice.
ANSWER FROM SHELLEY RENEE, Owner of Shelley Renee Consulting, LLC:
Volumes of books have been written on the subject of communication. English to English is complex enough without diversity. What you describe is not simply a language issue; this involves cultural and personality differences between doctor, patient, and team. We all have different approaches to the same situation based on how we were raised. The question is: what is proper? Is there only one right way to communicate? No, every person is unique. The overall goal in a difficult conversation is to convey care and respect. Facial expressions and body language should exude a spirit of care. This attitude will come across all language, cultural, and personality barriers. Patients will see, hear, and feel that they matter, even if they miss a word or two.
Of course a respectful chuckle or two is not out of line. Face it, all of us tend to raise our voice or instantly feel like we’ve developed an accent when we’re with someone who speaks another language. I’m sorry this annoys you. Please speak to the doctors respectfully and light heartedly. The one doctor may not be aware of his volume. It doesn’t sound like he is consciously trying to be disrespectful. I can guarantee the few foreign words that they sprinkle into the conversation come from good hearts trying to help.
Perhaps more visual aids and an awareness of the behavior is all that is needed. Set up a system for the team specifically for these occasions. Have some internal team signs to signal each other when help is needed or the volume of speech goes up. Care, respect, and humor are the best medicine. Enjoy the differences; this is what makes life so colorful and fun.
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