How to address inequities and communication barriers in healthcare

9 min read


Coordinating the many facets of healthcare requires clear communication at every step. Failure to effectively provide information — whether between patients and healthcare providers or within the organization — can harm healthcare organizations by:

Lowering the quality of care

Wasting resources

Decreasing patient and staff satisfaction

Increasing costs

Some common issues can stand in the way of the effective communication that’s so critical to providing outstanding care. But what are communication barriers in healthcare? And how can they affect patient care? 

Some barriers, such as language differences and implicit biases, can affect communication between providers and patients as well as between healthcare professionals. Other barriers — such as lack of trust in healthcare professionals — more frequently affect provider-patient communication. And barriers such as unclear messaging in patient handoffs primarily affect communication between healthcare providers

Communication barriers between healthcare providers and patients

Communication between healthcare providers and patients involves the evaluation of symptoms, delivery of a diagnosis, and recommendations about treatment. A range of barriers can complicate communication between providers and patients.

Differing expectations

Patients and providers may have different expectations about appropriate treatments and the amount of time available to discuss care. These conflicts can frustrate patients and medical professionals alike and affect patients’ attitudes about the quality of care they receive.

Abuse fears

Concerns about past medical abuses of marginalized populations can affect communication between healthcare providers and patients. A 2020 study by the Kaiser Family Foundation (KFF) and The Undefeated shows fewer Black Americans (60%) trust physicians than do white Americans (80%). 

Language barriers

Differences in language, including those related to the use of professional jargon, can create barriers to communication in healthcare. These barriers make it difficult to develop the strong relationships that are important in high-quality healthcare. The Journal of Participatory Medicine published a study in 2018 indicating that differences in the language spoken by healthcare providers and patients fostered distrust in communication and in care received.

Cultural biases

Preconceived ideas about how to treat people based on their race, ethnicity, or other characteristics also can hinder communication between providers and patients. In the KFF and The Undefeated study, for example, one in five Black adults reported being unfairly treated by healthcare providers, including having communication problems such as feeling that healthcare professionals didn’t believe them. 

Communication barriers between healthcare managers and staff members

Strong communication is a cornerstone of good relationships between healthcare managers and their staff members. From providing valuable information about health crises to issuing directives regarding new policies for care, this communication can be critical to providing the highest-quality care for patients.

Too often, however, many of the barriers that can affect patient-healthcare provider communication — such as implicit biases and language barriers — can also obstruct effective healthcare manager and staff communication. Additionally, issues such as confusing messaging and restricted access to information can be barriers to communication.

Unclear information

One barrier to communication between managers and staff members is a lack of clear, consistent messaging. Managers who don’t focus on delivering one message to all staff risk confusion, frustration, and a lack of trust. 

Implicit bias

Unconscious biases, whether based on a person’s level in the staff hierarchy or on traits such as race and gender, can affect staff decision-making and communication. A 2020 case study from Patient Safety Network noted that biases related to unspoken hierarchy of command structures as well as age and gender affected how groups of nurses and physicians reached conclusions about care and how they communicated with each other.

Imposter syndrome

Less experienced healthcare professionals may suffer from imposter syndrome (internal feelings of incompetence), doubting their expertise in making decisions about care — and they might be unwilling to defend their own ideas about treatment to providers with more experience and higher rank. In turn, higher ranking medical professionals may assume less seasoned staff to be incorrect in their assessments. This scenario can influence how these professionals communicate about patient care.

Limited reach

When healthcare leaders restrict their communications to only some staff members, they can alienate other employees. Staff members may respond by being less willing to freely share information themselves.

Communication barriers between healthcare peers 

Effective care coordination and provider handoffs are important steps in delivering top-notch care, and any breakdown in communication can jeopardize them. The importance of this communication is why The Joint Commission, which accredits and certifies healthcare organizations and providers, regularly includes improved staff communication on its annual list of national patient safety goals.

However, some factors are working against healthcare providers and their peers as they communicate with each other. Following are some of the barriers to communication between healthcare peers.

Patient load

When healthcare providers have a heavy patient load, their many responsibilities can mean frequent interruptions and fewer opportunities for quality communication. A study published in NursingOpen in 2020 found poor staff communication to be one of the negative effects of heavy patient loads among nurses.

Confusing handoffs

Patient care typically involves teams of healthcare professionals. Patient care handoffs — from physician to physician or from physician to nurse, for example — include verbal and written communication about the patient’s vital information. But the many handoffs that can occur in a patient’s treatment create a greater risk for breakdowns in communication regarding the details about a patient’s status that are critical to planning and delivering care.

Unprofessional behavior

Disruptive behavior among healthcare professionals, often rooted in a lack of respect, can impede the delivery of quality healthcare. Bullying and other unprofessional actions can affect staff morale and also become apparent in interactions with patients, affecting their satisfaction with the care they receive.

Essential communication skills for healthcare professionals

The U.S. Bureau of Labor Statistics (BLS) includes communication and related skills among its list of qualities recommended for top executives, physicians and surgeons, and registered nurses. Other key skills include the following:



Emotional stability




Communication tactics to address barriers in healthcare 

The key communication skills for healthcare professionals can help facilitate the exchange of information between providers and patients and between healthcare professionals. Among the ways healthcare providers can remove barriers and improve communication are the following.

Asking for feedback

Healthcare leaders and staff members should ask for input about ways to improve quality of care and ideas for treatment. In working with patients, healthcare providers should take a holistic approach, seeking information about the individual that can inform appropriate treatment measures.

Enlisting translation help

Whether addressing language barriers or overcoming obstacles such as vision and hearing difficulties, translators and interpreters can assist in communication. A 2020 article in Oman Medical Journal, for example, examined the value of translation tools at healthcare facilities, primarily in the United States. Studies showed the translation tools bolstered patient satisfaction and helped ensure that patients kept appointments. For translation and interpretation services to be most effective, healthcare providers should seek out certified professionals skilled in working with the group represented.

Focusing on a single message

Narrowing the focus of messaging between healthcare providers and between providers and patients can help eliminate confusion. All parties should provide consistent, clear information.

Following the SBAR steps

Using the SBAR approach can ease communication between the many different parties involved in patient care. The process includes these steps:

  • Situation: Providing one concise statement to summarize a patient’s condition
  • Background: Explaining the current status of a patient and goals for improvement
  • Assessment: Analyzing the situation and presenting options for treatment
  • Recommendation: Presenting suggestions for appropriate patient care

Including all staff

When healthcare managers convey messages about topics such as procedures or working conditions, they should include all staff in the communication when possible. Being open and honest instills trust and sets a good example.

Providing holistic care

A variety of factors — including their housing conditions, stress, and nutrition — can influence a patient’s health and the best approach to addressing their concerns. Healthcare providers should take these factors into account when communicating with patients and developing plans for treatment.

Showing respect

To encourage open communication, healthcare professionals should show courtesy toward patients and medical staff and managers. Offering respect can help healthcare staff overcome cases of imposter syndrome, and it can make patients feel at ease.

Overcoming biases

The American Academy of Family Physicians (AAFP) provides a framework for identifying and overcoming biases about other people. The process includes the use of empathy and appreciation for others as individuals, embracing differences among patients and colleagues.

Influence of socio-cultural factors on health equity

Elements of a culture can include a person’s race, gender, ethnicity, and language. Other aspects of a person’s culture can include occupation, education level, economic status, or the area where they live. An individual’s religious beliefs, customs, values, and behavior can all reflect their culture — and so can how they communicate. In healthcare, treating people of all cultures fairly and respectfully means acknowledging and honoring their various experiences with the medical community. It means using sensitivity regarding what language to employ as well as their cultural norms for when and with whom to communicate. Understanding cultural differences such as when to make eye contact or how a person’s lifestyle could affect their treatment plan can improve communication and effectiveness of care.

If not addressed properly, cultural differences can also deter communication among healthcare professionals and patients. Differences related to professional culture also can be detrimental to communication, as healthcare professionals might use medical jargon that leads to misunderstanding. This misunderstanding can be even more pronounced for those who speak different languages and those with different literacy levels.

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Social Determinants of Health (SDOH) are the broad range of non-medical factors that determine individual and population health. These factors encompass economic stability, education, income, language barriers, racial inequalities, and other discriminatory conditions that have a major influence on health outcomes and equal access to care, especially for the most vulnerable populations.

While sensitivity to working with people of different cultures can aid communication, ignoring these differences can create barriers that harm the quality of healthcare. Misunderstandings about cultural issues ranging from pain tolerance to race-related risk can further deepen distrust among patients and healthcare staff.

Importance of diversity and inclusion for patient care

In healthcare, one of the benefits of cultural diversity in the workplace is improved patient care. 

Diversity enhances workplace innovation

Diverse workplaces incorporate a broad range of experiences, ideas, and opinions that better reflect society as a whole. These diverse perspectives foster new and creative solutions to problems. A 2018 Harvard Business Review report showed a statistically significant relationship between workplace diversity and innovation — and the more diverse the organization, the stronger the link between diversity and innovation. Cultural diversity also promotes employees’ sense of belonging and workplace satisfaction.

Diversity improves workplace communication

A diverse workforce helps healthcare providers ensure that all communication among patients and staff members is properly translated, sensitive to cultural norms, and accessible to those with disabilities. Effective communication can help prevent mistakes and improve patient satisfaction.

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