Language discordance
Language discordance refers to a situation where a patient and their health care provider do not share a common language.
Linguistic insecurity
“Linguistic insecurity is expressed as discomfort or anxiety when speaking. It refers to a speaker’s own evaluation of their way of speaking as inferior to another language variety that they perceive as “correct” or more prestigious. This insecurity emerges when the speaker becomes aware of a distance between their own language and the variety that they consider to be legitimate.” (Bouchard, Marie-Eve. What is linguistic insecurity and why we should dismantle it. Janvier 2023)
A French-speaking person may choose to speak English out of fear of making too many mistakes in French. This may lead to omitting important health information due to a lack of precise vocabulary.
Regional and cultural variations of French
Several varieties of French coexist in Canada. From one region to another, French speakers use different vocabulary and expressions that reflect their culture.
- “J’ai mal aux reins.” (“My kidneys hurt.”): The person is not requesting dialysis but rather needs physiotherapy to treat back pain.
- “Mon enfant s’est engotté avec un bonbon.”: Doctor, what do you make of this, and how would you respond? (In Acadian French, the pronominal verb “s’engotter” refers to choking on something, in this case, “My child choked on a piece of candy.”)
Apparent bilingualism
Francophones are often bilingual and may work or study in English, but they might struggle to clearly explain symptoms, concerns, or details about an illness (Timony et al., 2016).
Read the full research report Barriers to offering French language physician services in rural and northern Ontario.
A common and dangerous misconception is to assume that a person who speaks some English does not need interpretation or a professional who speaks their language. In such cases, there can be an increased safety risk due to an “illusion of communication” (Bowen, 2015).
Read the full research report The impact of Language Barriers on Patient Safety and Quality of Care.
On access to health care
- Delays in booking appointments
- More complicated admission processes
- Limited access to information about health services
On quality of care
- Diagnostic errors
- Medical errors
- Delays in receiving services
- Inadequate medication or treatments
On access to virtual health services
Online health service portals rarely incorporate the active offer of French services. Even when some pages are available in French, this does not guarantee that services can be provided in that language.
To provide equitable, patient-centred care for French-speaking patients, health technologies must develop portals that consider the cultural and linguistic diversity of their target audiences.
On respecting ethical standards
Clear and effective communication with caregivers is essential for patients to understand the implications, risks, and benefits of a proposed treatment.
See the impact of an existing active offer through Doris’s case (In French only)
See the impact of a missing active offer through Doris’s case (In French only)
To learn more, click here
Understanding the active offer
Explore the fact sheets, videos, or documents to learn more about the active offer
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Francophonie in a minority Setting
Resources on the diversity and specificities of French-speaking minority communities
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Language Rights and French-Language Health Services
Laws and regulations affecting French-language health services in Canada
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Equitable health services for Francophone minority communities
How to provide quality health services
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Linguistic and Cultural Barriers
Barriers related to active offer, plus benefits and drawbacks
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Active Offer and Cultural Competencies
Learn more about the definition and behaviours related to active offer
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Working in Health Care in Francophone Minority Communities
Working in a Francophone Minority Setting: Challenges and Best Practices
