SVG must say no to doctors who cannot communicate in English

A glaring elephant in our healthcare system is the fact that many doctors who are plying their trade in SVG are incapable of satisfactorily communicating with Vincentians – patients, nurses, other doctors, pharmacists, radiographers, lab technicians, and others.

Patients regularly report, “I couldn’t understand he (the doctor) and he couldn’t understand me.”

At this point, I’ll emphatically state that I have nothing against Cuba, the Cuban revolution, the Cuban Government, the Cuban people, or Cuban doctors. My personal Facebook Group, Surviving Our Harsh Economic Environment (21,000 members), by way of many of my posts over the last 17 years, unequivocally substantiates this claim.

Immediately after returning to SVG four years ago to contribute to my dear homeland and serve my beloved people, initially as District Medical Officer in Union Island, I became acutely aware of the doctor-patient/ doctor-doctor communication conundrum in SVG.

The first instance that revealed the existence of this alarming reality involved a pregnant Union Islander. I was assessing her for possible pregnancy complications and referred her to a government facility on the mainland for an ultrasound. A six-year-old could have written a more fathomable report. The report provided zero help regarding the patient’s ongoing management.

Attempting to resolve the matter, I called the facility and asked to speak to the doctor whose signature was attached to the report. I was told this was not possible because the doctor could not speak English and would return my call when the nurse, the doctor’s de facto translator, was available.

I asked the patient if a translator was present when the doctor performed her ultrasound and she responded, “No, it was just me and the doctor”.

Extremely concerned, I contacted someone in the Ministry of Health, Wellness and the Environment to discuss this situation. To be told that what the patient reported was anomalous, for a translator was present whenever a doctor who could not speak English interacted with a patient.

Over the last four years, in the majority of instances, there was no translator present when a doctor who was incapable of conversing in English interacted with my patients.

This is unacceptable, untenable, and downright dangerous!!!

Even when there is no language barrier between the doctor and patient, mistakes are made.

Contemplate for a moment the possible plethora of negative consequences when the doctor and the patient have little to no clue about what the other is saying, asking, feeling, reporting, instructing, or recommending.

Satisfactory communication between a doctor and their patient is critical to optimizing health outcomes. A language barrier between a doctor and their patients can easily lead to:

• Wrong diagnoses, treatments, and procedures.
• Critical delays in diagnoses, investigations, procedures, and treatments.
• Poor patient compliance.
• Overutilization and wastage of scarce healthcare resources.
• The patient being subjected to increased pain and suffering.
• Negative patient outcomes.
• Patient death.
• Inadequate patient education.
• Malpractice lawsuits brought against the employers (e.g. government) of non-English speaking doctors.
• Loss of trust in the healthcare system.

Apparently, the proposed solution to the communication challenges posed by non-English speaking doctors is to “send someone to Cuba to interview doctors” before commencing work in SVG.

Questions:

• Is the person assigned to this task capable of comprehensively and accurately assessing the doctor’s grasp of “medical English”?
• How does such a person address the current on-the-ground situation in SVG regarding the doctors who don’t speak English?

Barbados and Trinidad &Tobago have mandated that ALL non-English speaking doctors have their proficiency in English certified via the Professional and Linguistic Assessment Board (PLAB) test before they can practice in these respective jurisdictions.

What is stopping SVG from implementing a similar requirement?

I strongly encourage the SVG (health) authorities, in the interest of the health, safety, and lives of Vincentians, to:

• Require non-English speaking doctors currently practicing in SVG for less than six years to show evidence that they have passed the PLAB exam by January 1, 2025.
• Make it mandatory that ALL non-English speaking doctors currently looking after Vincentians have a translator at all times at every doctor-patient encounter.
• Allow those who pass the PLAB exam to continue practicing. Those who fail must immediately stop practicing in SVG.
• Decree that all doctors wishing to practice medicine in SVG in the future whose primary language is not English present evidence showing that they have passed PLAB before being allowed to practice in SVG.

Let us embrace ALL Cuban health professionals who can communicate with Vincys.

This article will ruffle a few feathers. However, I’m unapologetically 100% patient-centric. I have no intention of ignoring my conscience. I shall continue to highlight issues, without malice or malevolence, that needlessly and harmfully impact the health and well being of my country and my people.

 Author: Dr. C. Malcolm Grant – Family Physician, Family Care Clinic, Arnos Vale. Former tutor in the Faculty of Medical Sciences, University of the West Indies, Cave Hill, Barbados. Host of the radio programme Physician On Call. For appointments: clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp).

Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.