An estimated 25 million US residents have limited English proficiency (LEP)1 and in a 2006 national survey of 2022 internists, 54% reported encountering patients with LEP at least weekly, with many seeing LEP patients every day.2 Legal guidance related to Title VI of the Civil Rights Act requires that physicians and hospitals take reasonable steps to ensure effective communication with these patients. Hence, when a patient with LEP presents for care, the encounter must either be conducted with a clinician who speaks the patient's language or indirectly through a trained interpreter. Untrained interpreters, such as patients' friends or family members, are sometimes used, although this practice is risky for reasons of competence and confidentiality.
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