A few years before Avantpage was founded, our CEO Luis Miguel’s friend had a bit of a health scare. 

This friend, a native Spanish speaker with limited English proficiency (LEP), went to the doctor one day to check up on a health concern he’d had. Though he often brought his daughter to doctor’s appointments to interpret for him, he decided not to this time around, in case it was something serious. But when he left the doctor’s office, he wasn’t sure what to make of the experience — he knew he had a growth in his chest, but he had no idea if it was malignant or not.

So he asked Luis Miguel to help him out. Luckily, it was just a cyst, and not a tumor, as he had feared. It was this experience, among others, that inspired Luis Miguel to found Avantpage nearly three decades ago.

Luis’s friend’s experience was lucky, but not entirely unique — millions of patients across the United States have LEP, making a routine trip to the doctor’s office a fairly complicated excursion. As we celebrate Avantpage’s 27th birthday on Oct. 31, we think it’s worthwhile to understand what it means to be an LEP patient navigating the all-too-complex healthcare system in the United States.

In this blog post, we’ll explore the experience of LEP patients, while also providing a few key tips for healthcare providers to keep in mind as they attempt to support individuals with LEP.

What it Means to Be an LEP Patient

 As defined by the United States government, an individual with LEP “does not speak English as their primary language and has a limited ability to read, speak, write, or understand English.” Nearly 10% of the country’s population fits into this category — as of 2021, there were 25.7 million residents of the US above the age of five years old with LEP.

Having LEP can be a major obstacle for individuals seeking out healthcare, whether that’s navigating the complex health insurance market or calling an ambulance during an emergency. Individuals with LEP struggle to comprehend complex medical terminology and effectively communicate their healthcare needs with providers.

Healthcare is complex enough as it is. Most of the documents and information you’ll encounter in a healthcare setting — things like the instructions on your prescriptions, or informational pamphlets you receive at the doctor’s office — require a 7th- or 8th-grade reading level to fully understand. 88% of adults (English speakers included) in this country have inadequate health literacy levels.

So if it’s hard for English speakers, it’s even harder for LEP patients. It’s important for healthcare providers to be thoughtful in their approach to language access, so that patients who don’t speak English are able to understand their health and take an active role in their care.

How to Support LEP Patients

Misunderstandings in healthcare settings can have dire consequences. A misdiagnosis due to language barriers, a failure to follow prescribed treatments, or misunderstanding post-treatment instructions can all lead to compromised health outcomes. It’s important to provide a little extra support to LEP patients to lower the chances of such misunderstandings taking place.

The first step toward fully supporting and caring for LEP patients is to devise a language access plan and put it into action. Working with interpreters, translators, and language service providers is a good way to ensure that your patient-facing communications are accessible in languages other than English.

It’s also important for healthcare organizations to invest in training their front-line staff so that they’re prepared to work with LEP patients and have adequate cross-cultural communication skills. Here’s a checklist of things front-line staff need to keep in mind when working with LEP patients:

  • Understanding the meaning of LEP: Staff should be able to identify patients with LEP quickly and act accordingly by contacting an interpreter or colleague who speaks the patient’s language.
  • Identifying language needs: Front-line staff should also be able to identify the language an LEP patient speaks — tools like “I Speak” cards and language identification documents are particularly useful and allow you to know what language to request when seeking out an interpreter.
  • Effective communication skills: Train your staff to find alternative ways to get a patient’s phone number or tell them to hold while on the phone.
  • Documenting language preferences: Staff should learn to document patient language preferences and follow up with communications in the preferred language.
  • Encouraging interpreting services: Even if a patient brings someone for interpretation, staff should encourage the use of professional interpreting services. LEP patients often bring bilingual family members or friends to interpret for them, but interpreting is a tough job and requires a trained professional to ensure accuracy.
  • Patient’s right to choose: Staff should understand that patients have the right to choose between on-site and remote interpreters, and staff should respect their preferences. Additionally, individuals who are proficient in English but prefer to receive interpreting services also have a right to interpreting services.
  • Consistency with interpreters: Whenever possible, try to use the same interpreter for consecutive appointments to foster continuity of care.
  • Gender considerations: Some patients might have a gender preference when working with an interpreter — front-line staff should be able to gather this information from patients to ensure a comfortable interaction with the interpreter.


A patient’s English skills should never be a barrier to quality healthcare. At Avantpage, we believe it’s absolutely critical to provide an extra layer of support for LEP patients — here’s how you can train your front-line staff to work with individuals with LEP and ease their journey in navigating the healthcare system:

  • Know what it means to have LEP: It’s important to understand the unique challenges that LEP patients face when navigating the healthcare system. By understanding these challenges, you can come up with solutions to ease the burden your patients might face.
  • Implement a language access plan: Devise a language access plan that your organization can enact to make sure that your services are offered in languages that are in particularly high demand among LEP patients in your locale. For more information on developing a language access plan, read our blog on how to get started.
  • Train your front-line staff to communicate with LEP patients: Your front-line staff should know how to recognize a patient with LEP and how to get them the care they need in an efficient and effective manner.

At Avantpage, we’re proud to have spent the last 27 years helping LEP patients navigate the healthcare system. If you’re looking to improve the health outcomes of LEP patients in your organization, Avantpage is here to help with translation, interpreting, localization services and more. Contact us today at [email protected] or (530) 750-2040 for more details.