(Published in LINKS: Minority Research & Training - Spring 2011 )
When award-winning actor and advocate for clear science communication, Alan Alda, talks to young scientists about ways to effectively describe their work to a nonscientist, Alda advises them to make their research personal: How does it relate to their lives and the lives of others? Why should the listener care? For Gerardo Moreno, M.D., M.S.H.S., answering these questions is easy. In fact, personal experience may be the most important driving force for his research.
Growing up in California’s Central Valley, Moreno witnessed the health challenges facing migrant farm workers, including his own parents. In college at San Jose State University, he was struck by the disparities between the largely poor, medically underserved people living in the agricultural valley and the wealth of the people in Silicon Valley. It was around that time that Moreno started thinking maybe there was something he could do to support the medical needs of his community.
“Becoming a doctor seemed almost out of the realm of possibility. My brother and I were the first of our family to ever attend college. But during a summer enrichment program, I had an opportunity to shadow a Latino doctor in my home town. It made me realize that with hard work I could achieve anything,” Moreno recalls.
Moreno received his medical degree from the University of California-Los Angeles (UCLA), did his residency at the University of California-San Francisco, and returned to UCLA for a Robert Wood Johnson Clinical Scholars postdoctoral research fellowship. Today, Moreno is an assistant professor of family medicine at UCLA and a research scientist with the UCLA/Charles R. Drew University Resource Center for Minority Aging Research, funded by the National Institute on Aging (NIA).
In a recent publication in the Journal of General Internal Medicine, Moreno and colleague Leo Morales, M.D., Ph.D., present their findings about how Spanish-language interpreters affect patient satisfaction with their care. “In this study we focused on a national demonstration project to improve doctor-patient communication by increasing access to and quality of interpreter services called Hablamos Juntos – Together We Speak,” explains Moreno. “We surveyed Latinos at clinical sites in eight states to determine if people who used interpreters reported better experience with care than those for whom an interpreter was unavailable.”
As Moreno and Morales suspected, Spanish-speaking Latinos who needed and used an interpreter expressed higher satisfaction with doctor communication than those who did not have an interpreter. They also regarded the office staff as more helpful. People who needed an interpreter but did not have access to one had a much more negative perspective of their health care. The researchers evaluated doctor-patient communication in four areas: listening carefully to patients, explaining things in ways patients understand, showing respect for what patients say, and spending enough time with patients. Office staff communication was analyzed in two areas: (1) being courteous/respectful and (2) being helpful.
The researchers note that their study provides further incentives to comply with laws that require healthcare providers who receive federal funds to offer language interpreting services when needed. “Latinos represent one-half of the population growth in the U.S.,” says Morales, associate investigator at Seattle-based Group Health Research Institute. “In light of this trend, hospitals and clinics should strongly consider investing in a professional interpreter service. It will better position them to provide high-quality care to linguistically diverse audiences and may result in happier, healthier patients.”
Moreno’s personal experiences continue to inform his research directions and clinical choices. Research that supports better health care for traditionally medically underserved populations remains at the heart of his professional interests, “My hope is that we can identify ways of removing barriers to positive health outcomes and minimize—or, even better, eliminate—the health disparities facing our rapidly growing Latino communities.”
Reference: Moreno, G. & Morales, L.S. Hablamos Juntos (Together We Speak): Interpreters, provider communication, and satisfaction with care. J Gen Intern Med. 2010. 25(12):1282-8.