HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yoon, J. Articles by Bindman, A. B. Search for Related Content PubMed PubMed Citation Articles by Yoon, J. Articles by Bindman, A. B.

Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

University of California at Los Angeles (JY), San Francisco General Hospital, University of California at San Francisco
Division of General Internal Medicine (ABB), San Francisco General Hospital, University of California at San Francisco
Department of Family and Community Medicine (KG), San Francisco General Hospital, University of California at San Francisco
Primary Care Research Center and the UCSF Center for California Health Workforce Studies (ABB, KG)

Correspondence: Address correspondence to Andrew B. Bindman, UCSF Department of Medicine, Box 1364, San Francisco, CA 94143-1364 (e-mail: bindman{at}itsa.ucsf.edu)

Background: National studies report patients with limited English proficiency (LEP) have difficulty finding bilingual physicians; however, it is unclear whether this situation is primarily a result of an inadequate supply of bilingual physicians or a lack of the insurance coverage necessary to gain access to bilingual physicians. In California, 12% of urban residents are Spanish-speaking with some limited proficiency in English. The majority of these residents (67%) are uninsured or on Medicaid.

Methods: In 2001, we performed a mailed survey of a probability sample of primary care and specialist physicians practicing in California. We received 1364 completed questionnaires from 2240 eligible physicians (61%). Physicians were asked about their demographics, practice characteristics, whether they were fluent in Spanish, and whether they had Medicaid or uninsured patients in their practice.

Results: Twenty-six percent of primary care and 22% of specialist physicians in the 13 urban study counties reported that they were fluent in Spanish. This represented 146 primary care and 66 specialist physicians who spoke Spanish for every 100,000 Spanish-speaking LEP residents. In contrast to the general population, there were only 48 Spanish-speaking primary care and 29 specialist physician equivalents available for every 100,000 Spanish-speaking LEP patients on Medicaid and even fewer (34 primary care and 4 specialist) Spanish-speaking physician equivalents for every 100,000 Spanish-speaking physician equivalents for uninsured Spanish-speaking LEP patients.

Conclusion: Although the supply of Spanish-speaking physicians in California is relatively high, the insurance status of LEP Spanish-speaking patients limits their access to the physicians. Addressing health insurance-related barriers to care for those on Medicaid and the uninsured is critical to improving health care for Spanish-speaking LEP patients.