Disparities in the U.S. health care system fall disproportionately on minorities, particularly immigrants who are not native English speakers. Yet little is known about how language barriers actually affect patients’ health care experiences and outcomes. Thomas Ricento will investigate physician-patient communication at the University Family Health Center in South Texas, a clinic which primarily serves a Hispanic clientele. Ricento will examine the relationship between the Spanish fluency of providers and the quality of health care patients receive, as evaluated by the patients themselves. The study will include a survey of 500 of the clinic’s patients and in-depth interviews with 100 of these individuals, covering patients’ background, language use, attitudes about medicine, and interactions with health care providers. Ricento will also interview six physicians, including three native Spanish speakers and three bilingual individuals, as well as a sample of their support staff. In addition to these surveys and interviews, Ricento plans to conduct observations of patient-physician consultations, documenting instances of comprehension and confusion on the part of patients, as well as instances when physicians make use of implied assumptions that may lead to misunderstandings. Better communication between health care providers and patients who are not fluent in English may be crucial to improving immigrants’ access to health care, and Ricento’s study will shed light on how that communication can be facilitated.