‘They are not really accommodating’: Willingness To Accommodate in a Medical English as a Lingua Franca context

Abstract This paper introduces the concept of Willingness To Accommodate (WTA)—a readiness to adapt communication to foster understanding—in the context of Medical English as a Lingua Franca (MELF) in Hong Kong. Drawing on interviews with ethnic minority patients and local healthcare staff, the study explores how patients often perceive low WTA from staff, leading to perceived exclusion and unfairness. Staff, meanwhile, report that anxiety, low perceived English competence, and institutional constraints contribute to limited engagement. However, when both parties signal their WTA, such as through translanguaging, interactions were perceived as respectful. The paper proposes a WTA framework informed by factors such as perceived competence, anxiety, responsibility, security, and institutional pressures, with translingual practices as observable attempts to display WTA that facilitate (M)ELF interactions. WTA can be used for understanding ELF workplace communication and institutional fairness. The study contributes to existing ELF scholarship which underexplores the predisposition for accommodation and to applied linguistics research by extending Willingness to Communicate theory into professional ELF contexts and highlighting the role of translingual practices in mitigating perceived unfairness.