Do you speak French?

How research helps improve the delivery of health services in French in minority Francophone communities

November 6, 2015

Dr. Denis Prud’homme is the Scientific Director of the Institut de recherche de l’Hôpital Montfort and chairs the Working Group on Ontario’s Francophone Communities, which includes researchers, health care professionals, patients and representatives from community organizations. His goal? To better document the disparities in French health services delivery in order to develop better strategies and more effectively meet the needs of Francophones in Ontario.

“I got an appointment to get my son examined at the Children’s Hospital of Eastern Ontario. The medical specialist didn’t speak French, but his nurse did,” says a Franco-Ontarian mother whose son was abused by his father and who preferred to remain anonymous. “My son was comfortable with her. When the conversation is held in his language, he’s calmer, more open, and able to talk.”

Dr. Denis Prud’homme
Scientific Director, Montfort Hospital Research Centre

The testimony of this mother who fought to obtain social, legal and health services in French for her boyFootnote 1 shows how important it is for a patient, no matter how old they are, to be able to communicate with health care professionals in their first language – even more so when there is an emotional aspect to take into account or when time is a risk factor.

Obstacles such as having to understand the medical vocabulary and worrying about medical conditions are exacerbated by a language barrier that can carry heavy consequences for patients who are unable to, or can barely, communicate with their doctor because they do not speak the same language. We need only think of the complications that can occur when a patient misunderstands a physician’s questions or the information provided on treatment options. And what about patients in critical condition who, because they have difficulty making themselves clearly understood, may have their lives endangered?

To date, 232 health organizations throughout the province, including hospitals, have been designated to offer all or part of their services in French under Ontario’s French Language Services Act. Yet only 20% of Francophone adults in Ontario say they speak French when visiting a place “other” than the office of a family doctor to receive health care.Footnote 2

Audio clip – Health services delivery in Canada excerpt from an interview with Dr. Prud’homme (only in French)


Dr. Denis Prud’homme: Once you have a health problem, health professionals aren’t always skilled at explaining the concepts properly. A lot of scientific medical language gets used in our interventions, so that’s already a problem for patients. It only gets harder for Francophone patients. It’s not their first language, and often, Francophones are hesitant; they’d rather not ask for service in French for all kinds of reasons, whether it’s for fear of having to wait longer or of not having access to the best specialists.

In order to better identify the issue and to adapt French language services delivery in the province, Dr. Denis Prud’homme, Associate Vice-President of Research and Scientific Director of the Institut de recherche de l’Hôpital Montfort (IRHM), established the Working Group on Ontario’s Francophone Communities. With help from the Ontario SUPPORT Unit created as part of the Strategy for Patient-Oriented Research (an initiative that is co-funded by CIHR and the provincial government), this working group will support health researchers so they can answer important questions regarding fairness and accessibility, and propose solutions.

“There is a glaring lack of data on the linguistic variable and its potential impacts—for example, on the issue of understanding treatment options when access to French-language health care is lacking,” explains Dr. Prud’homme. “We have anecdotes and cases, but we lack sufficient evidence on which to rely to establish priorities and strategies to meet Francophones’ needs.” But Dr. Prud’homme says that creating knowledge and objective data remains difficult because the clinical research capacity is still underdeveloped. “In Francophone communities, there is no critical mass. We need to bolster research capacity. Even here, at Montfort, we still have a lot of work to do.”

Audio clip – Language barriers excerpt from an interview with Dr. Prud’homme (only in French)


Dr. Denis Prud’homme: What kind of information is retained by a patient who was seen by an English-speaking clinician, and vice versa? What information does an English-speaking physician collect from a French-speaking patient? How would that information have been enriched if the patient had consulted with a clinician in their own language, for example? It’s a simple study, but we still don’t have a clear answer. We say that language is a barrier, but that needs to be documented objectively. We have anecdotes and cases, but what we need is solid data on this element.

As the former dean of the University of Ottawa’s Faculty of Health Sciences, where most programs are bilingual or French-language, Dr. Prud’homme is very familiar with the problem of access to French-language health care. It was partly because of his Francophone roots that he decided to become the Scientific Director of the Institut de recherche de l’Hôpital Montfort, created in 2012 to improve the population’s overall health – especially among Francophone communities.

He is often called a missionary, to which he answers that his goal is not to request that the same services be offered everywhere, but rather to be creative and innovative in developing strategies that would allow a Francophone to have access to health services in their own language when needed.

“Although French and English have equal legal status under the Canadian Constitution, we can question their equality in the field of health services... Our research provides evidence of social and health disparities that can be attributed to being part of a minority population.”

Dr. Louise Bouchard, Institute of Population Health and School of Sociological and Anthropological Studies at the University of Ottawa.

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