Ojai Physician Working to Bridge Language Gap : Health: Robert Feiss developed program to help Spanish-speaking patients access services and to train doctors and other workers to interact with clients.


Fresh out of college, Robert Feiss headed for the jungles of South America two decades ago, following a youthful dream to explore the Amazon before going to medical school.


Now a 42-year-old Ojai physician with years of experience in the emergency room, Feiss is finally pursuing what he sees as his true calling: helping Spanish speakers navigate the jungle that is the American health care system.

Fluent in Spanish after many long stays in Latin America, Feiss has developed a program to teach Spanish-speaking patients how to better access health services.


Featuring videotapes, audio cassettes and a 51-page manual, the program also is designed to train doctors and other workers to interact with patients who only speak Spanish.

“There is a great lack of bilingual, bicultural physicians to serve a growing community using the American health care system,” said Feiss, who has spent the past two years developing the program out of his Ojai home. “I also don’t think there can be a proper use of health care if we don’t educate [Spanish speakers] how to do it.”

Feiss recently finished minting 500 pilot sets of “ Medicina Bilingue " for clinics, hospitals and medical associations across the country. But Feiss is thinking big, and he estimates that more than 100,000 health care providers nationwide could eventually use the $400 program to meet the needs of their Spanish-speaking patients.

According to new state laws, health care providers with a significant number of patients who speak a foreign language are required to offer medical services in that language. And many physicians generally agree that any efforts to smooth communication between patients and health care professionals will cut costs and ensure better service.

“I think that if we could institute [ Medicina Bilingue ] as it is designed, and that is the trick, we would see a dramatic drop in health care costs,” said Stanley Frochtzwajg, a bilingual private family physician in Ventura, whose patient load is 30% Latino. “We would also see increased efficiency and improved medical care.”

For the program to work, Frochtzwajg said, a provider would have to encourage its doctors, patients and health care workers all to participate, which could be difficult.


One of the program’s videotapes, designed to be played in clinics, doctors’ offices and hospital waiting rooms, provides dozens of tips for patients in Spanish. Tracing a family’s visit to a health clinic, the 11-minute tape advises patients to remember medication names and doses and to bring immunization cards to medical appointments.

The narrator also suggests patients call to confirm appointments so they avoid making unnecessary trips to clinics or costly emergency rooms.

“These things may seem very common-sense,” Feiss said. “But these are things that hospitals deal with every day and cost them lots of money.”

Feiss cites a study by two California researchers earlier this year concluding that unnecessary trips to the emergency room added between $5 billion and $7 billion to the nation’s medical bill in 1993.

Feiss estimates “ Medicina Bilingue " could save patients and administrators collectively between $175,000 and $300,000 a year at a mid-size hospital in California. Feiss bases his figures on the average number of Spanish-speaking emergency room patients who could safely defer treatment for at least 12 hours.

Deliana Garcia of Migrant Clinicians Network based in Austin, Tex., said a program that walks patients through a typical appointment can teach Spanish speakers how to get better medical attention.


“It used to be that hospitals and health care centers could take the time with patients and make them good consumers,” Garcia said. “There really isn’t that time anymore.”

A Cleveland native, Feiss graduated from Ohio State University in Columbus and earned a degree from the Medical College of Ohio in 1981. Feiss said he first became aware of the needs of Spanish-speaking patients while working in migrant clinics in rural northwestern Ohio.

But it was working in emergency medicine at Los Angeles County-USC Medical Center between 1981 and 1985 that sensitized the doctor to the need for more Spanish-speaking physicians.

Feiss said young children often had to translate for hospital doctors while the youngsters’ mothers underwent pelvic exams. And Latinos, who are twice as likely to suffer from diabetes as other people in the United States, often were not accurately informed about the doses and potential side effects of their medication.

“I saw that happen all the time, and similar occurrences in small community hospitals and clinics where the providers don’t have adequate language abilities,” Feiss said.

Feiss’ program sets out to make physicians proficient in Spanish with pronunciation tapes, body diagrams in English and Spanish, medical charts in both languages and other bilingual documents.

But Feiss said physicians learn more than that soplo del corazon means heart murmur in Spanish. Videotapes coach physicians on performing physicals in Spanish and how to be more culturally sensitive.

“While it has a language basis, it is not a language program,” Feiss said. “It is more a health care management and health education program that really facilitates communication between patients and all types of providers.”