1. Just because there isn't a majority of ESL doctors in the US doesn't mean there isn't a majority of ESL working on your account. Different parts of the country have different ethnic percentages.
2. Maybe your account isn't paying or treating doctors the way they should and ESL doctors have taken the jobs.
3. Maybe your account has in-house MLS's that are cherry picking the good stuff and sending Nuance the ESLs.
4. It is August, the non-ESL providers could be on vacation.
5. The non-ESLs could be using SR or scribes or a combination of both for their notes. It wouldn't make sense for an ESL to do this if the system or the scribe can't recognize what they're saying.
6. Some facilities put physician lists on their site, it's probably out of date, but it's a start. When you look at the physician list is it mostly american names? You could also check the reference sites and do a doctor search by the city the account is located in. Admittedly, this isn't the best way to make a determination, since there are many other factors involved, as noted above.
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