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November, 2008 - Dallas Morning News
Language pros help foreign doctors speak English more clearly
by Jason Roberson
Karen Yates has a discerning ear.
A language specialist, she hears native Chinese speakers
learning English failing to pronounce the consonants at the end of their syllables,
so they'll say "blah" instead
of "blood."
Indian speakers, she says, often reverse "W" and "V" and,
as a result, "heart valve" becomes "heart wow."
It's precisely these kinds of language issues that convinced Ms. Yates of the
need to teach foreign doctors and medical students in Dallas how to speak English
with less of an accent.
The statistics back her up: Nearly a quarter of the 45,500 licensed physicians
practicing in Texas received their medical degrees overseas and English probably
is their second language, according to Texas Medical Board records.
Considering that the average physician conducts an estimated 25 patient interviews
a day, clear speech is essential.
Some language miscues are more serious than others, of course. Fifteen
milligrams and 50 milligrams sound awfully similar.
So do the words breathing and bleeding.
"And if the doctor speaks too quickly, without American English pausing
and rhythm, the patients may nod as if they understand but they may not know
the specifics of what was said," Ms. Yates said.
'The same language'
Dr. Josie Williams, president of the Texas Medical Association, said patients
often relate better to physicians "who are the same color or speak the
same language."
Specifically, elderly patients tend to trust foreign doctors less because
they often can't understand them, Dr. Williams said
"We would applaud that physician who recognized they had a problem and
sought help to correct it," Dr. Williams said. "This is a communication
issue and a patient safety issue."
Because Texas has a physician shortage, it has made a concerted effort to
simplify the process of getting foreign doctors to practice medicine here.
According to the Texas Medical Association, the growth in the state's physician
workforce is barely keeping pace with increases in the state's population.
In 2007, Texas had 156.7 practicing physicians per 100,000 population – the
same ratio it had in 2000. Though the number of physicians rose 17 percent
during that period, the state's population grew 16.6 percent, according to
a report from the Texas A&M Health Science Center.
And a growing number of the state's new doctors are from foreign medical schools.
From May 1998 to May 2008, the number of international medical school graduates
practicing in Texas increased 61 percent, from 6,128 to 9,857, a faster growth
rate than the 41 percent increase of graduates from U.S. medical schools.
Last year alone, the Texas Medical Board dealt with physicians trained in
83 foreign countries. Almost 30 percent, or 1,032, of the physicians licensed
in Texas last year received their medical education at foreign schools.
The classes
The increasing need to teach foreign doctors to speak with less of an accent
is driving Ms. Yates' 2-year-old Dallas-based business, G.E.T. English Training,
to yearly revenue in excess of $100,000. Her accent reduction course costs
$113 an hour, or $1,465 for hourlong sessions spanning 13 weeks.
Ms. Yates, who has a master's degree in linguistics and previously taught
English in Mexico, takes a 45-minute taped speech sample during the student's
free first session. Later, her staff will listen to it, over and over, for
more than three hours, picking up speech patterns and rhythm.
They then review the results with the individual students in class.
By the end of this year, 65 students will have graduated from her group classes,
most of which are held on the campus of UT Southwestern Medical School in Dallas.
Ms. Yates is not the only provider of accent reduction courses in North Texas.
For the last three years, Texas Health Resources Inc., the largest health
system in North Texas, has offered its staff an accent modification program
at Presbyterian Hospital of Dallas, and it's now in the process of taking it
systemwide.
Hearing results
Mina Kini, who runs THR's language programs, stressed they are "not trying
to make everyone sound like robots." Instead, she said, they focus just
on the sounds most hampering communication.
Ms. Yates says that people learning English as a second language "hear" the
language with their eyes, by reading how a word is spelled instead of listening
with their ears to what is really said. For example, in trying to say eyes,
her students often will say ice because it is spelled with an "s."
Ilse Valencia, 33, a research specialist from Chile, had another complication
with English while reading a sentence aloud for Ms. Yates' class.
"We increase-sed the dose and stopped the other medicine," Dr. Valencia
read slowly, sounding unsure of herself.
She's learning that the pronunciation of increased represents one
of three ways to say past-tense words with -ed endings. The -ed in
this word is actually pronounced with a t – increast.
While working as an administrator handling patient complaints, Mikhail Gorbatenko,
a native of Russia and a former student of Ms. Yates, said he made patients
even angrier because they couldn't understand what he was saying.
His th, w and v all sounded the same. "But by working
with Karen, she showed me how to position the tongue in my mouth," Mr.
Gorbatenko said.
Today his English sounds fairly American.
His only problem: When he goes home to Russia for yearly visits, friends and
family complain that he now speaks Russian with an accent.
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