Rural Kansas Family Physician Satisfaction with Caring for Spanish-Speaking Only Patients

BACKGROUND: Patient satisfaction with the care they receive can be influenced negatively by a language barrier between the physician and patient. However, there is a paucity of information regarding the consequences of a language barrier on physician satisfaction, although this barrier has the potential to decrease physician wellness. This study sought to determine if a language barrier is a source of professional dissatisfaction in family medicine physicians in rural Kansas. METHODS: In a cross-sectional study, members of the Kansas Academy of Family Physicians who practiced in the rural Kansas counties with the highest percentage of Hispanic residents were surveyed. A questionnaire was developed to determine the demographics of the physician, details regarding his or her practice, and percentage of Hispanic and Spanish-speaking only (SSO) patients in their practice. Physicians also were queried as to their level of Spanish-speaking ability, availability of certified interpreters, and their satisfaction with caring for their SSO patients. RESULTS: Fifty-two physicians were identified and sent questionnaires by mail. Eighteen questionnaires were completed and returned, resulting in a 34% response rate. Respondents remained anonymous. In the practices surveyed, 61% of practice settings had a Hispanic-patient population greater than 25%. Only one of the eighteen respondents had greater than 25% of SSO patients in his or her practice. A certified interpreter was used less than 25% of the time in over 75% of the clinical encounters with SSO patients. Seventy-five percent of physicians reported no difficulty establishing trust and rapport with their SSO patients. Eighty-nine percent of respondents rated their relationship with SSO patients as good to excellent, and 83% were satisfied with the care they were able to provide this group. Seventy-eight percent of respondents reported that their ability to care for SSO patients decreased or had no effect on their professional satisfaction. Seventy-eight percent of physicians also rated their overall professional satisfaction in regards to their physician/patient relationship as good to excellent. However, language barriers affected physician-patient relationships, physician satisfaction with care, and professional satisfaction. CONCLUSION: Language barrier affected physician's relationships with SSO patients, led to decreased physician satisfaction with the care they provided and to decreased professional satisfaction.