The concept of “limited ability” is used in LEP terminology to refer to the language limitations of patients but is seldom applied to the language abilities of clinicians. In fact, although a vast majority of U.S. hospitals report regularly providing care to patients who prefer to communicate in languages besides English [18], few hospitals assess the language proficiency of their healthcare staff [19].

he responsibility of language skills assessment and the decision about calling a medical interpreter is placed upon the clinicians themselves without clear guidance or training.

History-taking alone during medical encounters has been demonstrated to lead to a diagnosis 75% of the time [22], demonstrating the power of language as a diagnostic tool. Despite the critical role of language-appropriate communication in diagnoses, ad hoc interpreters remain in widespread use, such as the use of family members and untrained medical staff, even when professional interpreters are available. Researchers have identified obstacles to using professional interpreters including time and lack of accessibility [23] as well as lack of training on interpreter use [24]. A recent analysis of data from the CLAS Physician Survey found that only 30% of physicians report regularly using professional interpreters [13].

As reflected by the challenges of telemedicine care during the COVID-19 pandemic, interpreter services may not be taken into consideration in the development of new technologies or healthcare solutions, such as telehealth [26]. In fact, as health disparities for ethnic, racial, and linguistic minorities are magnified in the context of the pandemic, individuals who previously relied on medical interpreters for health communication are encountering more rather than fewer obstacles to care

Replacing the term LEP with the term “non-English language preference” (NELP) more accurately and effectively describes individuals presenting to the healthcare setting.

“Individuals who prefer a non-English language with respect to a particular type of service, benefit, or encounter.”

Coupled with data regarding the underuse of medical interpreters, the lack of assessment of physician NELS raises concerns about the potential miscommunications and medical errors that may take place in clinical settings due to unchecked use of limited skills

The requirements specified by the Final Rule of 2020 [28], stating that “translators or interpreters provided in order to comply with the law must meet specific minimum qualifications, including ethical principles, confidentiality, proficiency, […] and the ability to use specialized terminology as necessary in the healthcare setting,” should be applied similarly to healthcare providers with NELS.

Health professionals should be trained to appreciate and utilize language resources as an essential medical tool to deliver quality patient care.

Transitioning away from the limitations imposed by the artificial construct of LEP to viewing language preferences (NELP) and skills (NELS) of both patients and clinicians as fluid and dynamic is critical to putting person-centered care in its deserved place, at the forefront of medicine.