These Days It’s Not Just What You Know—It’s How You Say It

Updated on January 1, 2016

nicole-200x300By Nicole Martino-Murray

“My doot id duk!!  My doot id duk!!

As my 2-year old daughter yells from the backseat, I immediately go into interpretation mode.

“What is she saying?” 

“Did she see a duck?”

I can’t see her, so I am left only with my trained ear.  After a few seconds, I figure it out…

“My foot is stuck!!”

For parents of toddlers, this is a guessing game we play multiple times a day.  We even think it’s cute to hear to the ways children mispronounce everyday words and phrases. 

But what happens when this guessing game occurs in the healthcare industry? 

As the number of foreign-born healthcare professionals in the United States continues to rise, so do derivatives of Standard American English pronunciation.  This results in a unique, but sometimes challenging communication dynamic in the workplace.

While foreign accents are an inevitable occurrence in individuals who speak English as a second language, the degree to which the accent affects his or her intelligibility becomes a key factor.  Some accents are considered mild and easy to understand, while others are stronger and more difficult for a listener.

Many foreign-born healthcare professionals complete rigorous English training and have a strong grasp of the language, yet their accent can still negatively affect their communicative effectiveness, as a majority of ESL programs do not place great emphasis on the actual pronunciation of English.

With patient experience continuing to play a key role in healthcare quality measurement, patient-provider communication remains a critical service delivery component.  Patients and their families often correlate a positive experience with their overall comfort and how they are treated on a personal level.  Few patients completely comprehend complex medical information they receive, and can become confused during provider-patient interactions.  When this is compounded with the presence of a strong foreign accent, effort becomes devoted to “figuring out” what the provider is saying rather than actually understanding it.  These struggles lead to frustration for both the patient and the provider.

When communicative effectiveness is compromised by a foreign accent, more and more healthcare professionals are turning to accent modification training as a viable solution.  Medical students, nurses, physicians etc. take advantage of these services when patients, caregivers and colleagues continuously misunderstand them. 

The overall goal of accent modification training is to help individuals speak English that is easier to understand by others, while still maintaining their distinctive cultural identity.  In essence, he or she is learning a Standard American English accent that can be utilized at their discretion.  This is achieved through a structured, individualized training program based on his or her unique speech patterns.

Clients complete an assessment to determine how their accent differs from a Standard American English accent.  After the primary sound differences are identified, a 12-13 week program is designed which helps the client practice target sounds in words, phrases, sentences and conversation. 

At the conclusion of the training program, a post-assessment is completed and results are compared to the initial assessment.  Clients who follow the program closely can expect to be 50%-70% easier to understand.  They experience increased confidence when providing critical medical information and feel less frustrated during interactions with patients, families and colleagues. 

Nicole Martino-Murray is a certified accent modification trainer, licensed speech-language pathologist and owner of Accent Navigator. She can be reached at [email protected] or by visiting her website

Throughout the year, our writers feature fresh, in-depth, and relevant information for our audience of 40,000+ healthcare leaders and professionals. As a healthcare business publication, we cover and cherish our relationship with the entire health care industry including administrators, nurses, physicians, physical therapists, pharmacists, and more. We cover a broad spectrum from hospitals to medical offices to outpatient services to eye surgery centers to university settings. We focus on rehabilitation, nursing homes, home care, hospice as well as men’s health, women’s heath, and pediatrics.