When a patient who speaks little or no English meets with a doctor, “potential clinical consequences” – such as taking the wrong dose of a medication – usually result, a study by doctors of the Medical College of Wisconsin has found.
To counter this problem – and to comply with civil rights law ensuring equal medical treatment for all patients, regardless of their English proficiency – many hospitals, including those at the University, have expanded their staffs of professional interpreters and added interpreter training.
The Wisconsin study, which surveyed 13 doctor visits, found that when language barriers impeded communication, medical mishaps followed 63 percent of the time.
“A lot of this area is multicultural, and if the doctors don’t speak their language, it’s really hard to communicate with that patient,” said Jane Miller, an interpreter and staff trainer for the University of Michigan Health System’s Inter- preter Services Program. “By law we need to provide (interpreters),” because UMHS receives federal health care funding.
UMHS and University Health Service provide students and Ann Arbor residents with access to interpreters of several foreign languages, Miller said. She mainly interprets Chinese – one of the most sought-after languages for translation, along with Russian and Spanish.
“Lots of senior patients and U of M students in PhD programs (call and say) that their wife is having a baby, and I help them,” she said.
Miller said many of her calls also come from international students seeking services provided by UHS, but she can only deal with requests sent through UMHS.
“As I know, a lot of U of M students go to the health service, and that’s not our system,” she said.
Whereas UMHS maintains a staff of interpreters, UHS accesses a 24-hour national hotline – “Language Line” – for translation services. But both services come at a price.
“We have over a half-million-dollar budget right now,” ISP Program Coordinator Michelle Harris said, adding that the University foots the bill for the UMHS program.
Since 2000, fall enrollment of international students at the University has increased 22 percent, according to written statements provided by the University. At the same time, Miller and Harris said demand for interpreters is growing.
“We have over 1,000 requests a month for interpreters,” Harris said, referring to the need for translation services at UMHS. “We keep growing – we have 12 staff interpreters, and about 100 other contractors” to interpret less common languages.
By contrast, some hospitals in other U.S. cities have only a few interpreters. Primary Children’s Hospital in Salt Lake City has five interpreters, according to the American Medical Association.
Nationwide, 15 percent of health care practitioners seek external interpreting services to talk to Spanish-speaking patients, according to reports by Hablamos Juntos, an organization dedicated to improving communication between Hispanic patients and their doctors.
Professional interpreters do not need a license to practice. Nor do they undergo nationally standardized training.
But interpreters cited a need for professional workers, adding that amateurs often cannot provide comparable service.
“Using family and friends is not always appropriate, because it’s a violation of patient confidentiality,” Harris said. “Sometimes a (fluent bystander) might disclose information, but in some cultures they don’t want patients to know bad news.”
Miller said although many of the doctors she works with are multilingual, doctors cannot be expected to meet the behest of all non-English-speaking patients.
“A doctor cannot fill the medical interpreter position,” she said. “They’re very busy.”