Physician-patient language concordance and malpractice concerns

OBJECTIVE:: To study the association between physician-patient language concordance and physicians' malpractice concerns. METHOD:: We use a nationally representative physician data set, the 2008 Health Tracking Physician Survey maintained by the Center for Studying Health System Change. The Health Tracking Physician Survey includes 5 assessments of physicians' concerns about malpractice risk. Physicians are also asked the percentage of patients they have difficulty in understanding owing to language barriers. We estimate multivariate logistic regressions to investigate the association between physician-patient language concordance and physicians' malpractice concerns. RESULTS:: Physicians who have difficulty understanding patients owing to language barriers are 27% to 74% more likely to order extra tests or ask for consultant opinions to avoid the risk of malpractice suits. They are also 30% to 90% more likely to worry or feel pressure about malpractice risk, compared with those without difficulty understanding patients owing to language barriers. CONCLUSIONS:: It is important to understand the incentives associated with malpractice concerns to move physicians toward cost-effective healthcare delivery. Our results show that physicians having difficulty understanding patients owing to language barriers are more likely to have malpractice concerns. Understanding this association may have important implications for reducing physicians' malpractice concerns.