A Heavy Foreign Accent, a Liability?
by Rebecca Shafir
If foreign-born med professionals (FBMPs) have a heavy accent or speak English as a 2nd language, communication problems can arise with their patients and colleagues:
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Patients may misinterpret non-verbal differences, which are for the most part are culturally determined, like the use of eye contact, voice tone and inflection or a lack of physical contact
Not only can a heavy accent or non-verbal differences, rendering speech unintelligible at times, create confusion, but it can create tensions that can have legal ramifications and affect employee/patient retention, says Rebecca Shafir, speech/language pathologist with the Hallowell Center in Sudbury, Mass.
A thick foreign accent can mask superior clinical skills and good command of English. And sometimes a FBMP may be unaware that his/her accent is a problem. Patients are often reluctant to ask questions or ask for a repetition of a key word to avoid appearing “difficult” or “rude.” Instead, they may nod incessantly giving the FBMP the sense that they are understanding what their doctor said.
Other times FBMPs will become annoyed having to repeat instructions or explanations and this takes up valuable time. So, despite a comparable level of medical expertise, the careers of FBMPs may lag behind their native-born counterparts purely because of their communication differences.
Accent modification taught by a speech/language pathologist with specialized training in this aspect of communication can help root out some of the most common patterns associated with a heavy accent. Rebecca’s clients, mostly of Asian or Spanish descent, are hindered by too rapid speech rates, incorrect syllable stress or sound substitutions like /v/ for /w/, or difficulty producing /r/ or /l/ sounds. Sometimes the omission of articles like “a,” “an,” and “the” or a lack of subject-verb agreement like “she take” vs. “she takes”, can disrupt the melody and interpretation of the spoken message.
Rebecca, also a voice coach for professional speakers, must help prepare
foreign-born researchers for large group presentations. When nervousness is added to the mix, the accent is exacerbated by even a faster rate, mumbling or insufficient breath support.
One client, Dr. Avinash Patel, expressed his relief after only eight sessions with Rebecca.
“My patients appear to be more comfortable with me. I’m not having to repeat myself as much. There is a lot less confusion in my office and between me and my patients. I’ve been asked to present more at seminars, and I think people are more enthusiastic about my work…now that they can understand what I’m saying,” he chuckles.
Accent reduction does not happen overnight. It requires consistent practice.
The first step is analysis of a speech sample and list of single words and phrases.
The goals are prioritized and 60 minute sessions are held once to three times a week depending on the student’s availability. Practice schedules are set and personalized practice tapes are created for the student to practice in the car on the way to work.
In addition to face-to-face sessions, Rebecca offers phone sessions for her clients that live
far away. “Phone coaching has become very popular in the last year or so, as schedules are so irregular for the busy physicians. Yet being able to communicate clearly is a priority for them and working over the phone saves time.”
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