The way people express their symptoms is shaped by their language and culture. Part of my job as a physician is to embrace that.
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The French language is beautiful. Québécois culture is beautiful. They are worth protecting, but not like this — not with new regulations governing the health-care system.
Given the mass exodus of medical professionals to the private sector, we need to give some serious consideration to how we treat our health-care workers. Doctors, nurses and other allied professionals are precious resources. Once they have left or retired, good luck getting them back. With an aging population requiring greater levels of care and services, we must focus on increasing access. Period.
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Studies have shown that language barriers between doctors and patients can increase the risk of adverse health outcomes. Provided patients can get care in a common language and health-care workers can communicate with each other, who cares what language they use?
When I moved to the Laurentians nearly three years ago, I gave myself almost a year to set up my family practice. It was vital to learn the medical acronyms in French and understand the terminology used in radiology and pathology reports to be able to treat patients accordingly. It was also essential to familiarize myself with the regional expressions for pain and various other health concerns so as not to miss important diagnoses. For example, the expression “avoir mal au coeur” translates to nausea, and not chest pain like one might initially think.
The way people express their symptoms is shaped by their language and culture. Part of my job as a physician is to recognize and embrace that as part of providing culturally competent care. Language can be an essential part of building the doctor-patient relationship; only when this is established will people feel safe to disclose more sensitive health issues. This is when that stomach pain a patient has been coming to you about for several months reveals itself as anxiety from a domestic abuse situation. This is when your patient who keeps presenting for depressive symptoms and sleep issues opens up about their substance abuse.
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Any law that threatens a doctor’s ability to connect with their patients is dangerous and may lead to missed opportunities for diagnosis. We should be dismantling barriers to health care, not adding to them.
If the Quebec government wants to protect French language and culture, it should consider focusing on education. Ensure that elementary schools are safe and adequately staffed. Invest in social workers and youth mental health support so that children can finish high school.
There are so many ways to engage with Québécois culture that don’t make people feel as though they are being punished. While I think it is devastating for a native Montrealer to not know enough French to order a pizza, oppressive laws on health care and public services are not going to convince people to learn French. If anything, they will have the opposite effect and will deter some people from engaging in anything in French. Embracing culture and language happens organically through friendships and social activities, not through feeling as if one is under scrutiny in one’s place of work.
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Seeing a doctor is scary enough as it is, and caring for critically ill patients is challenging enough with the limited resources we have. Je vous en prie, please do not use our fragile health-care system as a political platform to push a language agenda.
Family doctors in this province are already subject to significant constraints when it comes to where and how they practise, which is part of the reason many are turning to the private sector. Let’s not give them yet another reason to leave our already drained public system. I don’t know how much more strain our system can handle.
Laura Sang is a family physician who trained at McGill University and is practising in the southern Laurentians.
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