Sound advice: Study finds bias against medical advice delivered with an accent

Research shows doctors with foreign accents are thought to be less competent.

Katie Willis - 15 April 2019

Doctors with foreign accents are perceived as less competent than their peers, according to a new study by University of Alberta scientists.

"We were interested to see if there was a difference in a person's perception of a doctor's competence depending on the doctor's accent," explained Lorelei Baquiran, who conducted the research as part of her undergraduate honours thesis in the Faculty of Science.

Under the supervision of Elena Nicoladis, professor in the Department of Psychology, Baquiran had Chinese-Canadian and caucasian-Canadian participants listen to an audio recording of a doctor speaking. Some participants heard a doctor with a Chinese accent, while others heard a doctor with a Canadian accent. "We found that both groups rated the doctor with a Chinese accent as less competent than the doctor with a Canadian accent, regardless of the severity of the disease the doctor was discussing," said Baquiran.

The results show that regardless of background or the type of disease, participants rated doctors with Chinese accents as significantly less competent than those with Canadian accents.

"Previous literature suggests that co-ethnicity, or sharing a background or accent with another person, will increase liking and perception of competence," said Baquiran. "However, our research suggests that the degree of acculturation is important. That is, we expect newcomers to adapt to our culture. Their accent infers whether or not they are trying hard enough."

Approximately 18 per cent of physicians in Canada were not born or trained in the country. Options such as accent training and providing written materials to supplement verbal communications could serve as potential stop gaps, but the real issue is bias. "We know that the patients' belief in their doctors' competence is essential for high quality care," said Nicoladis. "If a foreign accent can interfere with the doctor-patient relationship, then, as Canadians and human beings, we have work to do."

Further research is required to prove the claim that the degree of acculturation is what is behind the speech accent effect that we see. "Another important next step is to develop ways that could help prevent specific groups of doctors and other foreign-accented individuals from being disadvantaged because they speak with an accent," said Baquiran.

The paper, "A Doctor's Foreign Accent Affects Perceptions of Competence," was published in Health Communication (doi: 10.1080/10410236.2019.1584779).