Sometimes it seems like patients and providers aren't speaking the same language. The patient uses everyday lanaguage while health care providers use the language of medicine. But what if they really aren't speaking the same language? Providers sometimes turn to family members to interpret or use tele-translators, which could both be problematic and, in some instances, mean the difference between life and death.
What can be done to meet this need? Certified Medical Interpreters. As part of National Foreign Language Week Brooke HildebrandClubbs, director of health communication and instructor for the Department of Communication Studies at Southeast held a discussion that featured Dr. Debbie Lee-DiStefano, professor
of Spanish in the Department of Global Cultures and Languages. Their discussion focused on the need for medical interpreters and how to bridge the gap between patients and health care professionals.
According to Di-Stefano, not only is this a linguistic and medical issue but it is also a cultural issue as well. She said, "Because I can be quite competent in my ability to use the language but if I'm not connecting with the person with whom I'm speaking or the person for whom I'm interpreting, I may miss something."
Clubbs noted that for English speakers in a medical situation, oftentimes the medical terms used can make them feel like they should be speaking a different language. If you multiply that feeling by NOT speaking the language, an additional barrier is created.
In 2012 the National College of Emergency Physicians found that if patients had a certified medical interpreter the percentage of error that would result in a clinical consequence (meaning you received the wrong medication for example) was only 2%. However with an ad-hoc medical interpreter the error rate could go up to 22%.
DiStefano said there is no national standard for medical interpreters and different schools have different requirements. An individual may even get certified online because they can prove their ability to speak the native language but there is no quality control. Since medical terms and practices can change, there is a need for re-evaluation to make sure medical interpreters stay current.
DiStefano is fluent in Spanish but said that she would never feel comfortable translating in a medical situation. She doesn't know medical vocabulary, drugs can be called by different names in different countries and the practices in the hospitals can be different as well.
"Having someone that understands all the aspects of what it is to be medical -- culturally and linguistically is what, I think, we're trying to advocate," DiStefano said.
In Health Communication, there is a drive to reduce risk factors. Clubbs notes that not being able to speak the language is a risk factor.
"When we talk about comorbid factors like diabetes, like high blood pressure...not being able to speak the language is one of them. When you're in a serious medical situation if people can't understand what you ate or what you drank or where you were or what happened, there is a very good chance that you're not going to get diagnosed correctly," Clubbs said.
DiStefano believes that the U.S. has fears about foreign languages. She believes two things can happen to help bridge the gap between patients and health care providers. First, teaching more cultural competency to hospital workers and provide training on cultural sensitivity. Secondly, hospitals should try to schedule staff members within various areas that speak the predominant non-English language for their area.
According to Julie Metzger, director of Case Management and Social Services at SoutheastHEALTH that because of their patient population size, they do not employ any on-site medical interpreters.
"What we use is a telephonic system that we phone in to a company that has qualified, I mean that is their business, they have qualified, trained medical interpreters and all we have to do is ask for the language and we even have a picture that we can show the patient and they can pick out the language," Metzger said.
They can ask for a Russian or Spanish interpreter or whatever language is required and then it becomes a three-way conversation by speakerphone.
SoutheastHEALTH does not use family members to do any medical interpretation. There may be cultural barriers that precludes the sharing of medical information. In the case of the child, a family member may try to explain it but not relay the information correctly, so the hospital uses their interpretation service in all cases.
Hosptial staff go through cultural competancy training yearly to meet the needs of all patients and she said that an assessment of the patient as soon as they arrive is very important, too.
"And then it's really asking the patient sometime too, if I'm the front-line clinician, I want to assess the patient. Is there anything that you need to tell me? Is there anything that I need to understand about your culture? Anything I [need to] understand about the care I will offer to you? So that's important, too, is just to assess and not to make assumptions about a patient," Metzger said.
Editor's Note:
SoutheastHEALTH is a corporate supporter of KRCU Public Radio.
KRCU contacted Saint Francis Medical Center to offer comments for this story but no one was available to talk with us.
