The communication challenges posed by diversity in consumers and health wor
kers prompted these researchers to seek information about how bilingual sta
ff use their language skills in patient encounters. Content analysis, using
the NUD.IST (Nonnumerical Unstructured Data Indexing, Searching, and Theor
y-Building) program, of the transcripts from 18 focus groups (n = 81) has r
esulted in new notions about bilingualism. Four types of bilingual workers
were defined within the Bilingual Health Communication Model, based on leve
l of fluency (no fluency to complex verbalizer) and the context of the inte
raction (social engagement to complex health information transference). The
se forms of communicators were found to be active and purposeful in languag
e skill clusters, language exchange programs, and individual bilingual work
er roles (direct caregiver, communication facilitator or consultant, and cu
ltural advocate or broker). Implementing the systems and roles proposed mig
ht transform the communication or indeed miscommunication patterns that are
widespread in our health cave systems.