Speaking Spanish as a healthcare provider isn’t just a communication skill. It is an act of reassurance at a time when millions of immigrants across the U.S. are afraid of Immigration and Customs Enforcement (ICE).
This well-founded fear is leading many immigrant patients to feel unsafe seeking medical care. That is why Spanish-speaking physicians, in addition to nurses, physician assistants, administrators, and other clinicians, matter more than ever.
Spanish is the most spoken non‑English language in the U.S., spoken by approximately 43 million people. Nearly 28 million people in the U.S. do not speak English or have limited English proficiency. Among immigrants with limited English proficiency, nearly three in ten report that difficulty speaking or understanding English has made it hard to obtain healthcare services.
Yet, our healthcare physician workforce has not kept pace with that need.
A study of more than 107,000 first‑year resident physicians found that 43.2 % reported speaking Spanish at some level. But only 22.7 % of those Spanish‑speaking residents described their proficiency as advanced or native, the levels most consistent with providing truly language‑concordant care.
Today, I am a medical student training at a large public academic medical center, where I see firsthand how language can shape a patient’s experience of care. But I learned about this gap long before medical school. My mother speaks only Spanish and has limited health literacy. As a bilingual child, I sat beside her during doctor’s appointments, struggling to find an interpreter and helping to relay descriptions of her seizures, medication side effects, and questions she was sometimes afraid to ask in English. I watched her struggle to explain what she was experiencing and wondered how many details were being lost between what she felt, what she said, and what her physician understood.
My mom’s experience is not unique.
Being able to greet a patient or give basic instructions in Spanish is not the same as being able to take a detailed medical history, explain a new diagnosis, discuss medication risks, or ask about a sensitive symptom. Medical language requires more than conversational fluency. It requires the ability to communicate precisely when the stakes are high.
That distinction matters, and research suggests patients notice the difference.
In a randomized clinical trial involving Spanish‑speaking patients with cancer, those who received care directly in Spanish from bilingual physicians reported greater satisfaction with communication and empathy, more confidence in their physicians, and better overall quality of care than patients who received care from the same physicians through professional interpreters. Patients who received direct Spanish‑language care also asked more questions and volunteered more information.
My mom has now seen how much better her care can be when it’s in her language. Today, she prefers doctors who speak Spanish because she feels more comfortable asking questions and explaining her symptoms without worrying something will be lost in interpretation. For her, being able to speak Spanish with her doctor lifts a burden and makes healthcare feel safer.
Professionally trained medical interpreters remain essential to safe and equitable care, particularly when a physician does not speak the patient’s preferred language. But interpreters alone cannot solve a workforce gap in language‑concordant care. And that gap matters even more when patients are afraid to seek care in the first place.
A 2025 KFF/New York Times survey found that 41 % of immigrants worried that they or a family member could be detained or deported. Four in ten immigrant adults reported experiencing negative health impacts related to immigration concerns. Meanwhile, the share of immigrant adults who reported skipping or postponing healthcare in the previous 12 months increased from 22 % in 2023 to 29 % in 2025. Among immigrants who went without care, nearly one in five said immigration‑related concerns were the reason.
A patient who is already worried about encountering ICE should not also have to worry about whether they will be understood once they reach the doctor’s office. This is why administrators, faculty, physicians, policymakers, and funders in the healthcare system must think beyond translating information into Spanish or having a sign or waiver form printed in Spanish. It is urgent to invest in the people delivering that information.
Medical schools can help prepare the next generation of physicians by expanding medical Spanish education and giving students meaningful opportunities to develop and demonstrate clinical language proficiency. Healthcare institutions can recognize bilingualism as a clinical competency, one that strengthens communication, trust, and patient care.
Residency programs are well‑positioned to build on that training, giving bilingual physicians opportunities to use and further develop their language skills in clinical practice. Medical educators can help advance this work by expanding bilingual clinical training and developing consistent ways to assess clinical language proficiency. Together, these efforts can make language‑concordant care a more intentional part of how we prepare and support physicians.
Professional interpreters must remain available for patients whose physicians do not speak their preferred language. The goal is not to replace interpreters. It is to build a healthcare workforce in which language‑concordant care is more readily available.
It is not possible to assuage every fear a patient brings with them into a healthcare setting. But it is necessary to prevent the healthcare system from giving them another reason to feel unheard.
My mother taught me that language can determine whether a patient is heard and whether she understands. For patients today navigating both language barriers and fear of ICE, being heard and understood can be the first step toward building enough trust to seek care in the first place. That trust may begin with something simple: a doctor who speaks their language.
