Physician practices are making some strides in reducing the cultural and linguistic barriers facing patients whose English proficiency is limited, but those efforts are "modest and uneven," according to a report released in February. Of practices that have non-English speaking patients, 55.8% provide interpreter services, said the report, based on a survey of 4,700 physicians nationwide and issued by the nonprofit Center for Studying Health System Change ( Forty percent of practices provide patient-education materials in languages other than English, and four in 10 doctors have received cultural competency training aimed at helping them better serve minority populations. Less than a quarter of physicians receive reports about the demographic characteristics of their patients, and 7% routinely access electronic information about their patients' preferred language. More than 20 million patients speak limited English, according to a 2006 American Medical Association report. These patients have greater trouble following doctors' orders, make less use of preventive services and have worse health outcomes than do English-speaking patients. Practices' ability to implement interpreter and other services varied by their size, the Center for Studying Health System Change study said. About a third of solo and two-physician groups offered interpreters, compared with three-quarters of physician groups of 51 doctors or more. Doctors who accept patients covered by Medicaid, Medicare or the Children's Health Insurance Program must offer interpreter services, though there are exceptions for smaller practices and those with few non-English-speaking patients. "The law is very uneven and muddied in terms of the [interpreter] requirements of providers," said James D. Reschovsky, PhD, lead author of the report and a senior health researcher at the center. "So the bottom line is that this is not going to happen until somebody puts up the resources to support this." The AMA repeatedly has called on Congress to reimburse physicians for providing interpreter services. The full and original article can be found here: