Exploring the lived experiences of family physician-patient language discordance and perceptions of associated impacts on end-of-life care across Ontario

Language and cultural discordance means that a physician and patient do not speak the same language or are not from the same cultural background. This study looks at why this matters in care provided to patients and their families the end of life. We interviewed 16 palliative care doctors across Ontario to ask about their experience providing language and/or culturally discordant care. We found that there are: 1) Communication challenges when mediated by professional and family interpreters; 2) Care challenges related to developing patient-centered goals of care and providing access to timely EoL care; 3) Cultural navigation especially during difficult conversations around death and understanding patient preferences; and 4) Ways to cope through physician interpersonal skills and suggestions for systemic resources in language/culture. Our findings will help improve care for people from minority groups.