How to Prevent Communication Breakdowns in Medical Settings

The statistics are unsettling. According to the Joint Commission of Accreditation of Healthcare Organizations, 65% of hospital deaths and injuries are directly related to communication breakdowns. Nearly 55% of medication errors are caused by faulty communication. These are preventable, treatable problems that would not have occurred if the communication had been clear.

We all know that more paperwork is not the answer. But how can we prevent the needless deaths? What can be done to reduce errors and improve patient outcomes?

One area that must be addressed is that of foreign-born doctors’ accented English. Even those who are proficient in English often still speak with such a thick accent that it is difficult for nurses and patients to understand what they are saying. Unfortunately, it is difficult for them to see the problem because, often, they’ve been speaking English since they were a child and it was good enough to get them through medical school.

But here’s the reality. It’s not an issue of a deficit in their expertise or knowledge and it’s not an issue of their needing “speech therapy”; it’s simply a matter of needing some extra training to improve communication skills.

For example, let’s suppose that a doctor treating a patient turns to his nurse and asks her to administer fifteen milligrams of a medication. She misunderstands him and proceeds to give the patient fifty milligrams of the medication. Now, the doctor knew exactly what he was doing, and the nurse followed instructions as precisely as she could. The problem occurred because of one simple mispronunciation — and could have had disastrous results.

The solution? Providing onsite or online accent reduction training for foreign-born medical professionals. With programs tailored specifically to the medical community, accent reduction specialists can provide the pronunciation training that healthcare workers need while adapting to their hectic schedule.

Depending on the needs of a particular hospital or private practice, accent reduction training can often be provided individually, in small groups, or even in a large group seminar. With virtual training now available via Skype, classes can literally be scheduled anytime and anywhere in the world, as long as there is internet available.

Please don’t expect your staff speech pathologists to provide this service. They have enough on their plates, and asking them to “treat” the doctors would reinforce the stigma that something is wrong and requires therapy. Instead, locate a speech pathologist off site whose specialty is accent reduction training. That way, this person is brought in as an expert trainer offering continuing education opportunities.

Communication breakdowns are one of the biggest causes of error in medical settings – and many of them are preventable. Accent reduction training is one effective way to reduce the number of communication-related mistakes. What are you doing to improve the communication skills of the foreign-born healthcare workers in your practice?

To find out more about Medically Speaking classes, accent reduction classes for the medical community, please visit You can also get a FREE online accent screening with personalized tips for practice.

American English Pronunciation: How do you say Pecan?

Do you say “pu-KAHN”, “pe-KAHN”, or “PEE-can”? The latter reminds me of an emergency restroom substitute — but I digress.

I only mention the pronunciation of pecan because today is Pecan Day. Did you know that the pecan is the only nut tree native to North America? Or that the name pecan comes from an Algonquin word meaning “nuts requiring a stone to crack”? Or that eating pecans could improve your love life? No kidding — I learned all these wonderful facts and more from the National Pecan Shellers Association.

But what I did not learn was the official American English pronunciation of the word pecan.

In honor of Pecan Day today, I decided to take a survey to see if we can figure out where the different English pronunciations of the word pecan originated. It’s a highly debated topic, and one that doesn’t appear to have a definitive answer. The major dictionaries list more than one pronunciation, though “pu-kahn” is listed first and seems to be the most widely accepted.

Does it depend on which American accent you have? Some say the split between “pu-kahn” and “pee-can” falls on the Mason-Dixon line, but my research so far says not. Though many southerners say “pu-kahn” and many from the Northeast say “pee-can”, it isn’t consistent. One theory I read suggested that people from more rural areas, regardless of location, say “pee-can”, while those from larger cities say “pu-kahn”. Another said that the accepted pronunciation has changed over time. So, has it changed? Do you pronounce pecan differently from your parents or grandparents?

Here’s your chance to contribute to some unscientific but fun research:

Tell us where you grew up, whether it was a small town or larger city, and how you pronounce pecan. If you pronounce it differently from other family members, tell us that too. If you learned English as a second language, tell us whether or not your English teachers were native speakers and if you know where they grew up. Invite your friends to participate as well; the more responses we get, the more accurate the results will be. I’ll post a summary of the results in a few days.

Happy Pecan Day!

Remember to tell us about your American English pronunciation of pecan in the comments below.

Note: When this post was originally published, there was one comment:

  • 9/23/2010 4:07 PM buttercup1 wrote: I’m currently in the Niagara Region of Ontario, and almost everyone here says PEE-can πŸ™‚ I was actually surprised.

Improve Spoken English with “Handy” Expressions

Have you ever had a conversation with someone that you thought was in English — at least the words were in English, but you had no idea what the other person was trying to say? Then, very likely, the other person was using idioms, or expressions, that were unfamiliar to you. An idiom is an expression whose meaning is not predictable based on the usual meaning of the individual words. The English language has hundreds of idioms, which can be quite confusing, but important to understand in order to improve spoken English.

Let’s look at the word hand, for example. This word typically refers to the body part at the end of your arm, but when paired with a preposition, such as up, over, out, down, or to, the meaning changes completely.

Read over the paragraph below. I’ve highlighted every expression using the word hand. Try to figure out the meaning from the context, and then check yourself with the definition list below. Have fun!

I’ve got to hand it to you, Bob. That was, hands down, one of the best written handouts I’ve seen. I understood exactly who is responsible for each part and who is hands off on this project. Details like that come in handy. I will hand out assignments at the next meeting and I’ll ask Mary to give me a hand with the proposal. We’ll hand it over to the purchasing department by next Wednesday. John got the heaviest load, so before it gets out of hand and he throws his hands up in despair, tell him to call me. I’ll give him a hand to make sure we get everything finished on time.

  • hand it to you –- congratulate you for a job well done
  • hands down –- without question, easily
  • handout –- informal written document containing information pertinent to a project or meeting
  • hands off –- not involved
  • come in handy –- helpful
  • hand out –- give out or distribute
  • give me a hand –- help someone
  • hand it over –- turn over responsibility or possession
  • out of hand –- not controlled
  • throws his hands up –- gets frustrated
  • give him a hand –- help him out

So, how did you do? Did you figure out what most of them meant? If you did, give yourself a hand (a round of applause or congratulations for a job well done)! If not, read back over it a few times and improve your spoken English by trying to use some of the idioms in your conversations this week.

To receive my FREE guide, 6 Secrets of American Pronunciation, just type your name and email address in the boxes at the top of the page. I’d love to send it to you!

What Can the 2010 Winter Olympics Teach Us About How to Lose an Accent?

Many of us are feeling a bit sleep-deprived this week, having spent more hours than usual in front of the television, cheering on our country’s athletes in the Winter Olympics. We hear the stories of determination, overcoming obstacles, hard-earned success….and sometimes unexpected defeat. While they all arrived at the Olympics on different paths, they share the same goal – of doing their personal best and having a chance at going home with the Gold.

But what do the Winter Olympics have to do with being able to lose your accent and improve your spoken English? It’s the determination of setting a goal and doing what it takes to achieve it.

I have been working with a young man named Ashraf, who has moved away from his native Egypt to earn his doctorate at a top university in Japan, where they speak English as the common language. He really wants to speak English like an American, so we have been working together via Skype, with a 14 hour time difference.

It’s not always easy to make the scheduling work out, and I wondered how he would find the time to practice in the middle of his doctoral studies. But, he has the determination and discipline to make it happen. He told me this week that he sets aside an hour and a half every day just for practicing his English vocabulary and pronunciation. All while he is a full-time doctoral student.

He is speaking English more clearly every day, and I am convinced that he will achieve his goal of being able to speak English like an American.

There may not be a gold medal in the Winter Olympics for improving your English pronunciation, but if there were, this man would be a serious contender. Determination, focus, and a passion to do your best – that’s how to lose your accent!

If you would like to know more about how to lose your accent, please visit