It was a typical medical visit—until it wasn’t. The patient nodded politely as the doctor reviewed his medications. It wasn’t until later, when a multilingual staff member followed up, that they realized he had misunderstood key instructions about his insulin dosing. The consequences could have been serious.
Stories like this one are all too common in the United States, where millions of people prefer to communicate about their health in languages other than English – most commonly, Spanish. For a growing number of patients, not being able to communicate directly in Spanish with healthcare staff can lead to missed diagnoses, medication errors, and a diminished sense of trust in the healthcare system. At the National Association of Medical Spanish (NAMS), we believe it does not have to be this way.
Founded to advance high-quality multilingual healthcare, NAMS is a multidisciplinary, collaborative organization that supports clinicians, educators, students, and institutions in their efforts to promote effective Spanish-language communication in healthcare settings. Our mission is to build infrastructure for medical Spanish education, assessment, and certification—ensuring that clinicians are prepared not only to speak Spanish but also to do so with cultural and clinical competence.
What makes NAMS unique is not just our mission but how we carry it out. Our members and leaders include professionals from many different fields spanning healthcare and language disciplines who are deeply passionate about improving the health of Spanish-speaking populations. We count on the collaboration of experts in language education, linguistics, curriculum design, public health, medical interpretation, pharmacy, and multiple physician specialties. We work alongside undergraduate and graduate students, medical trainees, community advocates, and patients themselves. Our strength lies in this rich diversity of perspectives: physicians learn from language educators, interpreters exchange strategies with curriculum developers, and students bring fresh insights to every conversation. This cross-pollination has become one of our greatest assets!
One of NAMS’ most impactful contributions is the development of the POLOM Certification Exam—the Physician Oral Language Observation Matrix—a publicly available rating instrument designed to formally evaluate a clinician’s readiness to communicate directly with patients in Spanish without the use of a medical interpreter. NAMS leaders affiliated with the University of Illinois College of medicine and Memorial Sloan Kettering Cancer Center, and in collaboration with faculty members from the University of California, San Francisco, developed and tested the rating instrument thanks to grant support from the National Board of Medical Examiners. Unlike general language rating rubrics, the POLOM is specifically designed for clinical use. It does not just assess whether a clinician knows Spanish—it evaluates whether they can effectively communicate with patients during a medical encounter. NAMS researchers believe in the importance of transparency in the research process and have published their findings to enable health systems and medical schools to evaluate whether an exam based on the POLOM instrument is right for their clinicians and trainees. The validated exam is available through institutional partnerships with the Center for Clinician Multilingualism, a teaching and testing company recently co-founded by NAMS leaders Drs. Pilar Ortega and Lisa Diamond.
Our work could not be more urgent. According to the U.S. Census Bureau, more than 41 million people in the U.S. speak Spanish at home. Despite Joint Commission regulations and legal requirements for language assistance, many Spanish speakers encounter barriers when accessing healthcare, from a lack of multilingual clinicians to the inconsistent availability of professional medical interpreters. Patients sometimes delay accessing needed healthcare services for other reasons, such as fear related to their immigration status. Even when patients are able to make an appointment, inappropriate language services can compromise safety and quality. Research shows that language-discordant care is linked to lower patient satisfaction, worse health outcomes, and avoidable medical errors.
At NAMS, we see these challenges not just as problems to be solved but as opportunities to build a better healthcare system for everyone—one that values the richness of linguistic diversity. We advocate for high-quality medical Spanish education in health professions training programs and the recognition of communication in the languages relevant to the patient population as a core clinical skill. We support learners and faculty through research, mentorship, and networking opportunities, such as our annual conference, and curriculum design resources.
But we cannot do it alone.
We invite educators, students, clinicians, advocates, and institutional leaders to join us in recognizing the value of multilingualism in healthcare. That means investing in language education, supporting faculty who teach and assess it, and ensuring that clinicians have the opportunity to certify their skills. It means reimagining what quality care looks like—and who can benefit.
Language access is not just a compliance issue. It is a matter of safety, dignity, well-being, and health outcomes. And with the right tools and collective commitment, we can ensure that all patients—regardless of the language they speak—receive the care they deserve.
To learn more about NAMS, visit www.NAMSpanish.org.
About the author
Dr. Pilar Ortega is President/Chief Executive Officer and Founder of the National Association of Medical Spanish, Chief Executive Officer of the Center for Clinician Multilingualism, and Clinical Associate Professor of Medical Education and Emergency Medicine at the University of Illinois at Chicago College of Medicine. She enjoys traveling with her family, painting, and hanging out with her chihuahua.