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Traduttore, Traditore

Wm. MacMillan Rodney, MD
JAMA. 1986;255(19):2601. doi:10.1001/jama.1986.03370190084018.
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To the Editor.—  Since I have taught and practiced in cross-cultural environments over the past ten years, the recent article by Dr Putsch1 had special significance for me. My colleagues and I are family physicians and our experiences have been similar to those described.2,3There are special issues regarding the care of Spanish-speaking patients that remain unaddressed. We have previously documented the underdiagnosis of psychosocial issues in a family medicine setting.4 An interesting finding was the large percentage of patients who spoke Spanish only. We applied multivariate techniques to discern possible etiologies for "noshow" behavior by family medicine patients.5 This analysis selected language barrier as an important issue.These experiences and studies led us to slightly different conclusions regarding general guidelines for monolingual providers. First of all, we borrowed from Osler's dictum that "who the patient is is more important than what disease the patient has." Therefore,


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