Health Professionals and Patients in California: Speaking the Same Language


Diane Rittenhouse, Alicia Fernandez, Alexandra Ament, and Janet Coffman

Jun 2021

California is facing a shortage of health professionals to meet the needs of its large, diverse, and aging population, and the situation is worsening. Shortages exist across professions and geographies, with sizeable urban and rural underserved populations. Despite increasing population diversity, California’s health professionals don’t reflect the increasing diversity of the state’s population. For example, in 2019, 39% of Californians identified as Latinx, but only 14% of medical school matriculants and 6% of active patient care physicians in California were Latinx.

Over the past two decades, studies have shown the importance of racial and social concordance between physicians and their patients as well as the need for intercultural competencies, which lead to increased trust and greater patient satisfaction. Particularly important, however, is the ability to speak the same language, which not only increases trust and patient satisfaction but simultaneously decreases poor clinical outcomes due to miscommunication. According to the US Census Bureau, almost 44% of California households speak a language other than English, and nearly seven million Californians (19%) report speaking English “less than very well.” Although there are many languages spoken in California, the most prevalent after English are Spanish, Tagalog, Cantonese, Mandarin, and Vietnamese.4 It is essential to increase the number of health professionals in California who can effectively deliver health care services in a language other than English.

Currently, there are no data available on language proficiency among California’s health professionals. Physicians self-report to the Medical Board of California the languages they speak, but proficiency is not measured. Furthermore, the Medical Board data do not indicate whether a physician has sufficient knowledge of health care terminology to converse with patients in their own languages about health care needs.

This brief builds on a recent review of the evidence to identify long-term and near-term policy strategies to increase language concordance for health professionals and patients in California.