Culture, Medicine and Psychiatry

, Volume 15, Issue 1, pp 91–110 | Cite as

Communication between Spanish-speaking patients and their doctors in medical encounters

  • Sharry Erzinger


Little research in patient-doctor communication addresses the profound difficulties that emerge as Spanish-speaking patients seek medical services in the U.S. This study examines the interaction of language and culture in medical encounters between Spanish-speaking Latino patients and their doctors who have a range of Spanish language ability and a variety of cultural backgrounds. Initial ethnographic fieldwork investigated Spanish-speaking patients' perceptions of doctors' Spanish language skill as it relates to their medical service. To elaborate on these fieldwork findings, medical encounters were audiotaped for detailed conversational analysis. Data from the two methods illustrate how language and culture interact in accomplishing communicative tasks as doctors attend Spanish-speaking patients.


Medical Service Cultural Background Language Skill Language Ability Spanish Language 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Cafferty, P. and W.C. McCready (eds.) 1985 Hispanics in the United States. New Brunswick, N.J.: Transaction Books.Google Scholar
  2. Chavez, N. 1979 Mexican American's Expectations of Treatment, Role of Self and of Therapists: Effects on Utilization of Mental Health Services. In Martin, P.P. (ed.). La Frontera Perspective: Providing Mental Health Services to Mexican Americans. Tuscon, AZ: Old Pueblo Printers.Google Scholar
  3. Cicourel, A.V. 1983 Hearing is not Believing; Language and the Structure of Belief in Medical Communication. In Fisher, S. and Todd, A.D. (eds.), The Social Organization of Doctor-Patient Communication. Washington, DC: Center for Applied Linguistics.Google Scholar
  4. Edgerton, R.B. and Karno, M. 1971 Mexican American Bilingualism and Perceptions of Mental Illness. Archives of General Psychiatry 24: 286–290.Google Scholar
  5. Erzinger, S.L. 1989 Consultas Medicas: A Study of Communication Between Spanish-speaking Patients and their Doctors. Doctoral Dissertation. Berkeley, CA: University of California.Google Scholar
  6. Flaskerud, J.H. 1986 The Effects of Culture-Compatible Intervention on the Utilization of Mental Health Services by Minority Clients. Community Mental Health Journal 22(2):127–141.Google Scholar
  7. Frankel, R.M. 1990 Talking in Interviews: A Dispreference for Patient-Initiated Questions in Physician-Patient Encounters. In Psathas, G. (ed.). Studies in Ethnomethodology and Conversation Analysis, No 1. Washington D.C.: International Institute for Ethnomethodology and Conversation Analysis and University Press of America.Google Scholar
  8. Gomez, R., Ruiz, P. and Rumbaut, R.D. 1985 Hispanic Patients: A Linguo-Cultural Minority. Hispanic Journal of Behavioral Sciences 7(2):177–186.Google Scholar
  9. Gonzalez-Lee, T. and Simon. H.J. 1987 Teaching Spanish and Cross-Cultural Sensitivity to Medical Students. Western Journal of Medicine 146(4):502–504.Google Scholar
  10. Gumperz, J.J. (ed.) 1982 Language and Social Identity. New York: Cambridge University Press.Google Scholar
  11. Gumperz, J.J. and J. Cook-Gumperz 1981 Ethnic Differences in Communicative Style. In Ferguson, C. and S. Brice (eds.). Language in the USA. New York: Cambridge University Press.Google Scholar
  12. Kline F., F.X. Acosta et al. 1980 The Misunderstood Spanish-speaking Patient. American Journal of Psychiatry 137(2):1530–1533.Google Scholar
  13. Malgady, R., Rogler, L. and Costantino, G. 1987 Ethnocultural and Linguistic Bias in Mental Health Evaluation of Hispanics. American Psychologist 42(3):228–234.Google Scholar
  14. Marshall R. 1988 Interpretation in Doctor-Patient Interviews: A Sociolinguistic Analysis. Culture, Medicine and Psychiatry 12(2):201–218.Google Scholar
  15. Mishler, E. 1984 The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex Publishing Co.Google Scholar
  16. Mishler, E. and Clark, J.A. et al. 1989 The Language of Attentive Patient Care: A Comparison of Two Medical Interviews. Journal of General Internal Medicine 4:325–335.Google Scholar
  17. Padilla, A., Ruiz, R. and Alvarez, R. 1976 Delivery of Community Mental Health Services to the Spanish-speaking/surnamed population. In Alvarez, R. (ed.). Delivery of Services for Latino Community Mental Health. Monograph No. 2, University of California, Los Angeles, CA: Spanish-Speaking Mental Health Research and Development Program.Google Scholar
  18. Pendleton, D.A. and Bochner, S. 1980 The Communication of Medical information in General Practice Consultations as a Function of Patients' Social Class. Social Science and Medicine 14A:669–673.Google Scholar
  19. Perez-Stable, E. 1987 Issues in Latino Health Care. Western Journal of Medicine 146:213–218.Google Scholar
  20. Quesada, G. 1976 Language and Communication Barriers for Health Delivery to a Minority Group. Social Science and Medicine 10:323–327.Google Scholar
  21. Rogler, L.H. Malgady, R.G. et al. 1987 What Do Culturally Sensitive Mental Health Services Mean? American Psychologist 42(6):565–570.Google Scholar
  22. Saville-Troike, M. 1985 The Place of Silence in an Integrated Theory of Communication. In Tannen, D. and Saville-Troike, M. Perspectives on Silence. Norwood, N.J.: Ablex.Google Scholar
  23. Schreiber, J.M. and J.P. Homiak 1981 Mexican Americans. In A. Harwood (ed.). Ethnicity and Medical Care. Cambridge, MA: Harvard University Press.Google Scholar
  24. Schur, C., Bernstein A. and Berk, M. 1987 The Importance of Distinguishing Hispanic Subpopulations in the Use of Medical Care. Medical Care 25(7):627–641.Google Scholar
  25. Shuy, R. 1983 Three Types of Interference to an Effective Exchange of Information in the Medical Interview. In Fisher, S. and Todd, A.S. (eds.). The Social Organization of Doctor-Patient Communication. Norwood, N.J.: Ablex Publishing.Google Scholar
  26. Tannen, D. 1984 Conversational Style: Analysing Talk Among Friends. Norwood, N.J.: Ablex Publishing.Google Scholar
  27. Triandis, H.D., Marin, G., Lisansky, J., Betancourt, H. 1984 Simpatía as a Cultural Script of Hispanics. Journal of Personality and Social Psychology 47(6):1363–1375.Google Scholar
  28. West, C. 1984 Routine Complications: Troubles with Talk Between Doctors and Patients. Bloomington, Ind.: Indiana University Press.Google Scholar
  29. West, C. and Zimmerman, D. 1977 Women's Place in Everyday Talk. Social Problems 24:521–529.Google Scholar
  30. Young, L. 1982 Inscrutability Revisited. In Gumperz, J.J. (ed.). Language and Social Identity. New York: Cambridge University Press.Google Scholar

Copyright information

© Kluwer Academic Publishers 1991

Authors and Affiliations

  • Sharry Erzinger
    • 1
  1. 1.c/o US Embassy San Jose APOMiamiU.S.A.

Personalised recommendations