Article Date: 9/1/2003

language barrier
Transcending the Language Barrier
This optometrist developed a form of cross cultural internal marketing that really made a difference with his foreign patients.
BY ALAN N. GLAZIER, O.D., F.A.A.O., Rockville, Md.

We're all aware of the common methods of internal marketing: displaying point-of-purchase items; offering promotional materials including pamphlets, in-office videos and knowledgeable, friendly staff; and exam lane review of refractive options. Internal marketing is one of the strongest practice-building tools a business-minded person can wield.

Optometrists all over the world promote their knowledge, skills and concern for patients' well being through internal marketing by providing a thorough examination and a detailed explanation of their diagnoses and recommendations. The most overlooked and perhaps most difficult aspect of internal marketing to gauge is the rewards it generates in terms of patient referrals. A patient impressed with your knowledge and skill set as well as your office décor and the information they glean from their visit can start a referral chain worth many tens of thousands of dollars to your practice over time.

I'll talk about an unconventional way to market your practice internally and the benefits you can expect to reap.

Step up your marketing

You can demonstrate your care and concern for your patients' well being in many ways, but none of them speaks louder than you making a genuine effort to understand their needs (both medical and cultural). And understanding where your patients come from culturally is how you can start to enhance your internal marketing. Here's my story.

Attempting to speak Hindi

My office is located in a diverse community outside of Washington, D.C. Many diplomats, foreign scientists, professors, academics and their families work in the area for the biotechnology industry, the National Institutes of Health and the Food and Drug Administration, and many other private and governmental firms. Years ago, I noticed that the number of Indian families we took care of had increased.

On one occasion, an Indian lady came into my exam room along with her son who translated. After frustrating efforts to question the son, who translated to the mother, who answered the son, who translated back to me, I decided that when performing applanation tonometry I'd ask the son how to say, "Look at the round, yellow light" in Hindi. When I repeated his words to his mother we all had a laugh (I assume they were laughing at my poor but appreciated attempt to speak their language).

Saved for future reference

I wrote down the Hindi sentence and finished the patient's exam. Weeks later I had another patient from India who brought a translator with her. The exam was as difficult as ever to perform through a translator, but when we sat down to do tonometry, this time I just about floored my patient and her translator when I barked out, "Look at the round, yellow light" in Hindi. I could see the appreciation on her face.

Imagine how difficult it would be for you to seek health care in a foreign country -- so much is lost in the translation of subjective complaints! Language is the thread that connects you to them during subjective testing. Plus, making an effort to speak a patient's language improves not only your internal marketing but your data collection as well. The entire equation leads to a better experience for your patient. And if you're lucky, then you'll start seeing their friends and family too!

Welcoming diversity

In America we're surrounded mostly by individuals who speak English. Statistically speaking, few Americans speak more than one language and the bulk of bilingual Americans speak only English and Spanish.

To contrast that, in Europe, the languages change every few hundred miles, so it's common for most people from certain regions of Europe to speak three or more languages and to be familiar with the cultures that speak those languages.

As an American, mastering different cultural linguistics doesn't come naturally -- it's a task that requires a concerted effort -- and interest -- to master. It requires a paradigm shift in the way you think and look at the person in your exam chair. This shift opens up a world of diversity for you and gives your foreign patients a more favorable perception of you.

More than words

Of course language isn't the only barrier in subjectively testing someone from a foreign land. Cross-cultural differences and customs exist in multitudes that no one can expect to master. For instance, in America a handshake is seen as a solid form of respect, but individuals in Japan may consider this gesture an insult. Or a female patient who practices orthodoxy may find it insulting for you to touch her eyelid.

While understanding a language can benefit your internal marketing within these populations, a move that's customarily interpreted as insulting could possibly damage your respect and standing in the eyes of your patients. I recommend that before seeing a foreign patient you ask a translator about the proper method of greeting for the gender of the patient in question and proceed from there.

Patients help bridge the gap

My patients have helped me compile a list of transliterations of optometric terms in the many languages that have presented in my office (see the chart that begins on page 58). This list is by no means complete or even correct -- it's merely a primer to help you get started with your cross-cultural internal marketing attempts. I may have omitted some major languages because many are difficult or almost impossible to transliterate and I purposely omitted some, such as Arabic, because dialects can change every few miles in some Arabic-speaking countries, making translation a thankless task.

Don't be afraid to ask your patients how to say something in their language; you'd be surprised at the pleasant reaction you receive when they see that you're making an effort to try and understand them. The benefits of this exciting, interesting and eye-opening attempt at internal marketing will be financially rewarded as well.

If you want to find another language or want to figure out more phrases, then go to and type in "English-Italian" or whatever you're looking for to find free translation programs where you can type the English word, hit a submission button and get the transliterated word immediately.

Dr. Glazier practice features a specialty contact lens clinic. Feel free to e-mail him at



Optometric Management, Issue: September 2003