Linguistic services in ambulatory clinics.

A review of the literature reveals few studies that focus on the challenge of language barriers in primary care settings. Recognizing the need for a national consensus on cultural and linguistic standards for health care in the United States, the Office of Minority Health recently released a set of standards for culturally and linguistically appropriate services (CLAS). These standards were utilized to examine the linguistic services available at eight ambulatory care centers in a small New England state in an effort to determine compliance with recommended national standards. Although myriad studies have focused on provision of linguistically appropriate care in emergency rooms (ERs), few studies have specifically examined ambulatory care settings. Numerous strategies have been adopted by individual clinics in an attempt to deal effectively with linguistic barriers. Yet without clear national regulations and dedicated funding for interpreter services, a large spectrum of services exists. Survey data were obtained from on-site visits at select community health clinics to ascertain availability, need, and utilization of linguistic services for patients with limited English proficiency. The majority of patients served by the clinics surveyed were predominantly Spanish-speaking. Results reveal that although most of the clinics provided informal mechanisms of interpreter services, few directly addressed linguistic services as a component of culturally competent care.