ORIGINAL ARTICLES Access to Spanish-Speaking Physicians in California: Supply, Insurance, or Both

Background: National studies report patients with limited English proficiency (LEP) have difficulty find-ing bilingual physicians; however, it is unclear whether this situation is primarily a result of an inade-quate supply of bilingual physicians or a lack of the insurance coverage necessary to gain access to bi-lingual physicians. In California, 12 % of urban residents are Spanish-speaking with some limited proficiency in English. The majority of these residents (67%) are uninsured or on Medicaid. Methods: In 2001, we performed a mailed survey of a probability sample of primary care and spe-cialist physicians practicing in California. We received 1364 completed questionnaires from 2240 eligi-ble physicians (61%). Physicians were asked about their demographics, practice characteristics, whether they were fluent in Spanish, and whether they had Medicaid or uninsured patients in their practice. Results: Twenty-six percent of primary care and 22 % of specialist physicians in the 13 urban study counties reported that they were fluent in Spanish. This represented 146 primary care and 66 specialist physicians who spoke Spanish for every 100,000 Spanish-speaking LEP residents. In contrast to the general population, there were only 48 Spanish-speaking primary care and 29 specialist physician equivalents available for every 100,000 Spanish-speaking LEP patients on Medicaid and even fewe