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Recently, I worked with a client who is in the medical profession who had a strong foreign accent.  She related an interesting story to me about how her accent had interfered in communicating with a deaf patient.  One might wonder if the patient were unable to hear her, what difference would her accent make?  This patient could read lips; however, he had much difficulty making out what she was saying.  As it turned out, the patient could easily read the lips of her assistant, who spoke American Standard English and ended up serving as a “translator”.  In this particular case, my client was substituting ‘v’ for ‘w’ and ‘w’ for ‘v’ which are two very visible sounds.  For example, if she said, “You’re doing very well, and your next visit will be on Wednesday”, it would appear as if she said, “You’re doing wery vell, and your next wisit vill be on Vednesday”.  This was a wakeup call to her and while she had been considering working on reducing her accent for a while, it gave her the incentive to begin actively pursuing this goal.