Bridging the Opportunity Divide

A Prescription for the Doctor-Patient Language Barrier

April 12, 2018
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A Prescription for the Doctor-Patient Language Barrier
ConsejoSano helps non-native English speakers navigate the healthcare system. Photo by TommL/Getty Images
For non-English speakers, telehealth startup ConsejoSano makes navigating our complicated healthcare system a little bit easier.

Even if you’re a native English speaker who’s lived their whole life in the U.S., the healthcare system can be a nightmare.

Labyrinthine call systems are only the start. You’ve also got to find a doctor you trust; figure out the care you need; decipher what your insurance will cover; learn how and when to take (or refill) prescriptions; and remember to make follow-up appointments. If you’re a parent, you’ll need to repeat the exhausting process for each of your children. And if you’re employed full-time, you’ve also got to find the time to juggle your healthcare before, after or in between work hours.

Now imagine navigating that same confusing terrain without being able to speak fluent English.

For the millions of Americans who don’t, ConsejoSano (translation: “healthy advice”) is here to help. The Southern California-based telehealth startup offers the only health platform tailored to address the needs of multicultural, non-English-speaking patients.  

Most of the clients ConsejoSano works with are health plans, employers, government programs and at-risk providers who are united by a common cause: Motivating the people most likely to fall through the cracks of the U.S. healthcare system learn how to master it — in their own language. Through a suite of technological solutions, including multi-channel messaging and data analytics, along with a cadre of bilingual employees, ConsejoSano helps the marginalized and underserved access the care they need now and improve their overall health literacy.

The company’s initial focus was on helping Hispanic patients. Services are free, around-the-clock and help tackle issues related to costs, language barriers and immigration status.

“In the U.S., nearly 60 million people speak Spanish; 20 million of those only speak Spanish. Another third can only manage basic communication in English, like ordering food at a restaurant,” explains Abner Mason, ConsejoSano’s founder and CEO. “Ask them to explain — in English — that they have a piercing pain in their lower back, and they don’t have the tools. Or if a doctor wants to explain to them, also in English, why their 12-month-old baby needs vaccinations, they won’t get the full understanding.”

Although Hispanics make up over 17 percent of America’s population, “Spanish-speaking doctors represent only 4 percent of our physicians,” notes Amon Anderson, director of Acumen, an investor in ConsejoSano. “In four short years, ConsejoSano has quickly expanded its reach across Southern California … escalating thousands of cases to healthcare providers and ensuring Hispanic patients receive the care they need.”

ConsejoSano healthcare
ConsejoSano founder Abner Mason says it’s his mission to never leave any patient behind.Photo courtesy of ConsejoSano

Today, ConsejoSano also provides services to speakers of Arabic, Farsi, Mandarin, Cantonese, Armenian and Tagalog, among other languages. Currently, the company counts about 300,000 users and hopes to see that number climb to 1 million by the end of 2018.

But ConsejoSano does far more than translating a generic automated call into a different language.

For starters, initial communications from ConsejoSano to patients are likely to happen via text.

“One thing all cultures have in common across the board is text messaging,” says Mason. “Many communities have loved ones and friends in other countries, so they’ve become accustomed to using WhatsApp or other platforms. It’s just how people communicate now.”

The next step: calling a patient and talking to them in their own language, with an emphasis on their cultural background. (ConsejoSano’s multilingual employees follow a script that has been reviewed and approved by the company’s medical director.)

“Say you’re going to convince a mom that her baby needs vaccinations,” says Mason. “If you use the same message in Spanish to communicate with a mom in San Diego as you do with a mom in Miami, you won’t get the same results. One culture comes from Mexico, the other may be someone who comes from Puerto Rico or Cuba. They don’t have the same traditions or culture.”

Patient content is consciously tailored too.

“Often people design materials for English speakers, then translate it into other languages. But because they’re not starting with culture, just hitting Google Translate, the signal it can send to the patient is, ‘Who I am doesn’t really matter. This message isn’t really for me,’” says Mason.

Dr. Alfredo Ratniewski is executive chief medical officer for Borrego Health, a ConsejoSano client whose 23 locations serve Medicaid patients in California’s San Diego, Riverside and San Bernardino counties. He’s seen firsthand how ConsejoSano campaigns have coaxed parents to bring their children in for wellness checkups, encouraged women to have annual mammograms and convinced older adults to agree to colonoscopies so they can be screened for colon cancer.

“That cultural approach makes all the difference in the world,” says Ratniewski.

Before launching ConsejoSano, Mason founded the Workplace Wellness Council of Mexico, which is now the leading corporate wellness company in that country. He also served as a member of the Presidential Advisory Council on HIV/AIDS and was the founder and executive director of the AIDS Responsibility Project.

What causes people to ignore their healthcare is a puzzle he tries to solve every day. And every day, the answer is different.

“If an Arabic woman needs to come in for a pap smear, you need to build a trusted communication channel not just with her, but for [her] family,” Mason says by way of example. “If someone needs a prostate exam, the reasons why need to be explained and in a way that also deals appropriately with their culture.”

Our current political climate can make that tricky. Many people don’t trust “the system.”  They worry loved ones may be taken away by ICE. In other words, says Mason, “they don’t feel equal.”

Because of that, “we’ve got to get the culture right, the language right, the mode of communication right — and all that has to be built on a foundation of trust,” Mason says. “We get responses all the time, from patients who say, ‘This is the first time someone’s treated me like a first-class citizen.’”

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