In this episode of the Language on the Move Podcast, Brynn Quick speaks with Dr. Leah Karliner. Dr. Karliner is Professor in Residence in the Division of General Internal Medicine, Department of Medicine at the University of California, San Francisco in the United States. She is Director of the Center for Aging in Diverse Communities and Director of the Multiethnic Health Equity Research Center. She is both a practicing general internist and a health services researcher, with expertise in practice-based and communication research. An important aspect of her scholarly work centres on improving quality of care for patients with limited English proficiency, and the goal of her research agenda is aimed at achieving health equity through improved communication and clinical outcomes.
In this episode, Brynn and Leah discuss a 2024 paper that Leah co-authored entitled “Language Access Systems Improvement initiative: impact on professional interpreter utilisation, a natural experiment”. The paper details a study that investigated two ways of improving the quality of clinical care for limited English proficiency (LEP) patients in English-dominant healthcare contexts, by:
- Certifying bilingual clinicians to use their non-English language skills directly with patients; and
- Simultaneously increasing easy access to professional interpreters by instituting on-demand remote video interpretation.
Brynn and Leah talk about the results of this study and what they mean for improved communication with LEP patients in healthcare.
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The Multiethnic Health Equity Research Center is based at UCSF (Image credit: UCSF)
References
A discussion about the terms “limited English proficiency” (LEP) and “non-English language preference” (NELP) in healthcare, which is also laid out nicely in Ortega et al.’s (2021) Rethinking the Term “Limited English Proficiency” to Improve Language-Appropriate Healthcare for All
Leung et al.’s (2025) paper entitled Partial language concordance in primary care communication: What is lost, what is gained, and how to optimize
And for more Language on the Move resources about the intersection between language and healthcare:
- Reducing Barriers to Language Assistance in Hospital
- Language policy at an abortion clinic
- Mismatched public health communication costs lives in Pakistan
- Why it’s important to use Indigenous languages in health communication
- Linguistic diversity in a time of crisis: Language challenges of the COVID-19 pandemic
This work is licensed under a
I really see this podcast as showing the realities of healthcare practitioners, especially when Leah emphasized how family involvement can be crucial, so I want to highlight what Brynn Quick said about how Leah combines the practical side of primary care with research, since it’s vital for a practitioner to know each patient’s history to shape the right approach. For a healthcare practitioner, that history isn’t just a detail; it’s the foundation for building understanding between doctor and patient. This becomes even more important for patients with less English proficiency in English‑dominated healthcare settings, where language barriers can easily disrupt care. Also, in some cases, a patient may have a family member in healthcare who can easily interpret the terms used in the doctor’s diagnosis. It shows that lean practice is about making healthcare responsive, empathetic, and inclusive.
I’m not fully sold on replacing “limited English proficiency” with “non-English language preference.” The episode itself says this is not just preference in the casual sense. For some patients, another language is necessary for them to understand their care. So while PREFERENCE avoids the deficit framing of LIMITED, I wonder if it also makes a communicative need sound more optional that it actually is. That feels like a strange trade-off.
The episode gives enough room for the terminology to be questioned from inside the conversation itself. The fact that “preference” can sound both more respectful and somehow less urgent is exactly the kind of tension that made me keep thinking after it ended 🙂
This meaningful episode illustrates the real purpose of communication, specifically in healthcare. Language is not used merely to provide necessary treatment; rather, it is used to communicate and to help patients feel emotionally safe and healthy. As featured on the podcast, patients with limited English proficiency illustrate how a language barrier can significantly affect access to quality healthcare. When communication is unclear, crucial medical information may be lost. This podcast enlightens viewers that effective healthcare shall include support heard from providers to lighten the weight of their difficulties.
The talk or conversation between Brynn QUick and Dr. Leah Karliner about the 2024 paper entitled, “Language Access Systems Improvement initiative: impact on professional interpreter utilisation, a natural experiment” was very insightful! It’s refreshing to know that there are two ways of improving the quality of clinical care for limited English proficiency in an English-dominant healthcare context that have been investigated. One thing that made me realize about interpreters in the healthcare setting is that it is not an easy task, as it requires qualifications, a skill set, and the confidentiality of information to serve patients and others through accessible communication and interpretation. Additionally, it amazes me that there are certified bilingual clinicians, and I am sure that direct communication with patients and persons is smooth and reassuring. Access to language proficiency has become the ‘norm’ but it is true that it is not perfect; great podcast!
Thanks for that important insight, Kathleen! Absolutely, being able to interpret in healthcare contexts is a huge skill set that requires a lot of training, and it’s so important that we recognize that skill.
Indeed, listening to this podcast reminded me of the thesis topics I had in mind prior to my senior year as an English Language Studies student. I do believe the healthcare sector is one of the most important yet underexplored areas of linguistics because it not only undermines the quality of care but also hinders effective communication when necessary measures are not taken to accommodate its multilingual landscape. Hence, Dr. Leah Karliner’s discussion on certifying multilingual healthcare professionals and even talking about various interpretation methods made me realize that there is a primary solution, and in that way, we should be able to prioritize them in order to deliver the quality care patients need from all walks of life, and from all types of communities. This bridges the gap between communication and medical literacy since, at the very beginning, healthcare is often communicated at a standardized English-level lexical terms. In the end, this was an insightful podcast that I would like to apply in my local healthcare settings.
Thank you, Shannen! It’s pretty amazing to consider how English-dominant so much of healthcare (worldwide) is, isn’t it?
This was an insightful listen! I personally would like to commend how this podcast highlights family members as “interpreters” as a difficult situation to address. We may have noticed that, in some cases, medical consultations can manifest a heavy atmosphere, especially if the conditions being discussed are quite severe. These could negatively affects family members, too, and their emotional and mental weights may be overbearing that the responsibility to interpret can be challenging to fulfill. The existence of an interpreter, whether in person or not, allows the patient and their family to digest and process the information properly, ensuring that communication from both parties are smooth sailing and clear. This scenario is just one of the many probabilities that truly solidifies how professional interpreters are so significant in the field of healthcare.
Thank you, Marvin! I agree that it’s important to consider the potential burden of family members being asked to interpret in healthcare situations.