See the Full Issue
June 2024
Language Is Power
Connecting with clients for whom spoken English isn’t their primary language is difficult—sometimes even perilous—due to miscommunication over diagnoses, treatment options, risks, and costs. But, taking even small steps to bridge the language gap can make a big difference.
Making Stronger Connections Through Clients’ Primary Language
Client communication already poses plenty of challenges between people who share a common language. Connecting with clients for whom spoken English isn’t their primary language is difficult—sometimes even perilous—owing to miscommunication over diagnoses, treatment options, risks, and costs.
In addition to affecting patient care and outcomes, language barriers also limit access to veterinary care. The 2018 Access to Veterinary Care Coalition’s report surveyed pet owners and found that one of several reasons people failed to get veterinary care was “could not find provider who spoke my language.”
Veterinary equity includes both access to care and equality in lived experiences.
“Language isn’t just about talking. Language is also social and cultural interactions,” said Kyra Munz, MSW, HAEI, at Foothills Animal Shelter in Golden, Colorado. “It’s also crucial that our patrons get a full understanding of the services that we’re trying to provide for their animals. Also, just in a customer service level, making sure everyone can have that same level of experience and feel seen and heard in that interaction.”
In making recommendations to improve access to veterinary care, the coalition included offering services in the pet owner’s native or primary language. The report’s authors added, “Being able to communicate effectively is essential for sharing complex information about pet health issues. Having a veterinarian or veterinary technician who is fluent in at least Spanish is optimal. However, it is important to know the community because there are more languages out there than just Spanish.”
Language isn’t just about talking. Language is also social and cultural interactions.Kyra Munz, MSW, HAEI
For example, in Florida, where Donita McCants, DVM, practices, there’s a sizeable Brazilian population that speaks Portuguese. For a while, McCants worked with a Spanish-speaking veterinary assistant. Even then she says, “We just had to make sure we’re not overwhelming the people who are Spanish speakers because they sometimes get overwhelmed when they have everyone kind of coming at them.”
McCants knows her Spanish-speaking skills atrophied from lack of use after high school and college graduation. “I can kind of pull out enough of the conversation to figure out what they’re asking, but communicating back would be probably really hard for me,” she says.
Growing Demand for Spanish
US Census data projections estimate Hispanic populations (of which not all—but many—members speak Spanish) to continue to grow over the next few decades. The projections say growth will reach:
- 21% (74.8 million) by 2030
- 24% (87.8 million) by 2040
- 26% (99.8 million) by 2050
- 28% (111.2 million) by 2060
Yet a 2015 survey of veterinary professionals in 10 states with large, established or fast-growing Spanish-speaking populations, found just 9.6% of veterinarians, 12.1% of credentialed veterinary technicians, and 6.9% of veterinary assistants spoke Spanish.
There’s still time to prepare or catch up.
Client Communication in Spanish
Right before pandemic lockdowns, Mandala Hunter-Ishikawa, DVM, moved to Colombia. Japanese is her first language, but she grew up speaking English too. Throughout her veterinary career with small animals, large animals, and wildlife around the world, Hunter-Ishikawa learned Chinese, Vietnamese, Amharic (Ethiopia), and a little bit of Malagasy while in Africa as well. Colombia, though, is her first Spanish-speaking locale.
In addition to her work with an NGO called Animals Asia, Hunter-Ishikawa cocreated a RACE-certified language course called “Spanish for Veterinary Professionals” with her husband, Peter Devia, a career languages educator who speaks at least six languages fluently. He grew up bilingual in Spanish and English.
Hunter-Ishikawa’s quest to learn Spanish as quickly as possible taking online classes and using language acquisition apps uncovered the gaps in language learning. “My motivation was high, and yet the programs I’d signed up for were subpar to me as a professional, as a veterinarian, but even as a higher-level learner,” she says. “That’s when my husband said, ‘Let me make a program for you—for somebody else to teach because we all know that spouses shouldn’t teach each other.’”
Creating Spanish courses for veterinary professionals became their pandemic project. She provided the veterinary content. He structured the courses taught by native Spanish speakers. Each 10-hour module focuses on targeted veterinary vocabulary such as first consultation, diagnostic/treatment conversations, prescriptions and home care instructions, and wrapping things up, including financial conversations.
Students can work with remote instructors either one-on-one, or with team members or friends.“We usually say that twice weekly is the best for language retention,” Hunter-Ishikawa says, “but if you can’t make it twice a week, that’s fine. We’ll work with you.”
The Spanish for Veterinary Professionals team also offers classes with specialized vocabulary for spay/neuter clinics and emergency care as well as some equine and exotic bird courses.
In her work in China, Hunter-Ishikawa remembers the frustration in clinical settings, even with onsite translators. “You really don’t know if the person receiving the information, even through translators, is getting what you’re trying to give them—with the compassion and tone that I want to share,” she says.
It’s a challenge, for sure. Tyler Primavera, DVM, once spent three to five minutes explaining neutering a puppy to a 12-year-old who translated for his dad. That translation consisted of what sounded like one sentence, and the dad declined. “Who knows what he said, right?” Primavera asks. “Probably like it costs $300, so the dad said no.” In addition, the stress and potentially mature topics and emotional burden makes relying on kids as translators not ideal.
That situation, among other things, led to Primavera cofounding Vetspacito. The company started with a subscription model of language support resources, including videos done in Spanish to explain common veterinary scenarios. Now, however, Vetspacito makes that content available free on YouTube. Look for a fresh iteration of the company’s training programs in the future.
Emily Singler, VMD, AAHA’s veterinary content specialist, speaks fluent Spanish, but she pursued total immersion via travel and international living on top of Spanish courses in high school and college. “At first, I felt like I couldn’t speak fast enough. I couldn’t string sentences together. I couldn’t understand everything they were saying because they were speaking too quickly,” she says.
Joking that she’s from the compact disc music generation, Singler credits listening to Spanish-language music over and over while reading the printed lyrics from the CD inserts to start speaking faster and sounding more natural. “My first husband, when he was trying to learn English,” she says, “used to listen to National Public Radio a lot because he said they spoke slowly enough and clearly enough that he could understand what they were saying, but for me it was a lot of music. I listened to a lot of Marc Anthony and salsa music.”
Singler also watched some telenovelas and took a few veterinary volunteer service trips while in veterinary school, where she helped translate for veterinarians. “I was still pretty early on in vet school, so I didn’t get to do surgery or anything,” she recalls. “ . . . I got to be the one to do [translations between veterinarians and pet owners], and that was just so reinforcing for me that someone benefited from that skill that I had, even though I felt like I was still very much working on it.”
Best Practices for Adding Language Support
Start with a question
Rather than make assumptions based on someone’s looks or name, ask if the client wants you to use another language you can speak.
Allow extra time
Tyler Primavera, DVM, cofounder of Vetspacito, says, “I’m the type of person who doesn’t mind being late to my next appointment, if it means explaining things better to my previous appointment. The best practice is that once the vet leaves the exam room, they should feel confident that they did their best job, whatever that means.”
Provide signage / printed materials
Post signage and use forms and other printed materials in predominant languages in your community.
Hire & compensate for language skills
In your hiring efforts, find, compensate, and schedule for better language coverage with your team. Often, team members with second language skills carry the translation burden during work hours and even when at home without extra payment, which isn’t fair.
Pay for on-demand translation
Human medicine also struggles with language challenges, so there are companies that specialize in providing phone or video on-demand translation for medical situations in more than 240 languages and more than 20,000 on-demand interpreters. In addition to subscription-type pricing, LanguageLine Solutions even offers no-contract, pay-per-minute services ($3.95 via phone, $4.95 via video) through its app.
Not Just Spoken Languages
In Colorado, Munz says, “I would say the second most common language we see is American Sign Language (ASL), and I think that’s a language that gets overlooked because it’s not a verbal language.”
Many deaf/hard of hearing adults appreciate any efforts to communicate—including writing things down, using an app like Large Text, or even gestures—rather than the burden of lip reading or voicing be placed on them.Maggie Marton
author
Maggie Marton, author of the forthcoming book For the Love of Dog (February 2025) and a hearing person who parents a deaf/hard of hearing (D/HH) child and now also a bilaterally deaf and unilaterally blind dog, learned a lot from deaf community mentors and teachers. She says, “Many D/HH adults appreciate any efforts to communicate—including writing things down, using an app like Large Text, or even gestures—rather than the burden of lip reading or voicing be placed on them.”
Dayna Balinski, CVT (IL), RVT (IN), works for Emergency Veterinary Care Centers in Highland, Illinois. She is deaf and explains that coworkers get her attention by waiving their hands and switching the lights on/off. “Sometimes they throw things at me,” she laughs via emoji. Her advice for communicating with D/HH clients includes using gestures and making sure you look at them and that they are looking at you when you speak. Also, she says, “Talk slowly if possible, but don’t exaggerate your words.”
Gamification for the Win?
Many online and app learning platforms tout gamification as a fast-track to learning. This quote from renowned developmental psychologist Karen Purvis often gets cited: “Scientists have determined that it takes approximately 400 repetitions to create a new synapse in the brain—unless it is done with play, in which case, it takes between 10 and 20 repetitions.”
A systematic review of gamification language learning published in 2021 concluded with the following: “Vocabulary and grammar were the most important basic language skills that reported in the reviewed articles. However, such studies in the literature, especially on pronunciation skills, are still scarce … Even though different game elements have been used for LFL, there was no clear trend as to which types of game elements might be more appropriate for which aspects of learning processes and basic language skills and advantages.”
Streaming Content and Subtitles
When Reddit users debate the best language learning apps, commenters often tout YouTube as a free way to work on new language skills by watching videos with subtitles. Others watch foreign language content from other paid streaming services also with subtitles. It helps to see the language while hearing it.
A for Effort
Whether you trot out Google Translate, compete with colleagues and friends using popular language learning apps, actively hire multilingual team members, or prioritize language education in your staff development plans, simply trying to improve your communication in other languages makes an impact that people appreciate. Veterinary teams might even consider asking multilingual clients to help role play common scenarios.
Whether you trot out Google Translate, compete with colleagues and friends using popular language learning apps, actively hire multilingual team members, or prioritize language education in your staff development plans, simply trying to improve your communication in other languages makes an impact that people appreciate.
Fluency absolutely elevates client service and veterinary care for pets. Singler says, “All of a sudden, you can see their shoulders drop and the look on their faces changes because they realize they don’t have to keep struggling and working so hard to get their point across. Suddenly, they can be comfortable and just talk. That can change the whole mood of the appointment.”
Just One Caution
Considerable research into additional language acquisition describes something called a “moral foreign language effect.” Basically, this means that making difficult decisions in another language blunts emotions and increases focus on outcomes. It’s important for veterinary teams to recognize this in themselves and in clients. Know that you may sound less compassionate, and don’t assume a flatter emotional response indicates a client’s lack of feeling or connection to the veterinary patient.
Illustration credits: ©AAHA/Alison Silverman, frikota/iStock via Getty Images Plus, Dmitrii_Guzhanin/iStock via Getty Images Plus