Sued for failing to provide an interpreter

in Physician | 32 responses

A solo rheumatologist was not willing to pay the $150 to $200 per visit fee an American Sign Language interpreter would have cost to treat a deaf patient, especially in the setting where Medicare paid only $49 per visit.

He was sued as the patient didn’t understand the side effects of the medications he was prescribing for her lupus:

But the patient claimed she never really understood the side-effects (swelling of her treatment), and that when she insisted the doctor was obliged to pay for an interpreter.

Half of the $400,000 verdict was for punitive damages, and was not covered under his malpractice insurance.

Should the doctor have provided an interpreter at a clear financial loss to his practice? Should there have been a moral obligation to do so?

PointofLaw.com further comments on this somewhat alarming case.

topics: interpreter, malpractice

Comments

The Happy Hospitalist
Our government is like the Mafia. You know in the movies where they show up at your place of business and tell you that they will hall away your garbage for 3X the normal fee and in return they promise not to cut your arms off.
The government mandates services available for the deaf and nonenglish speaking, but they won’t pay for it. The solution is not to accept patients into your practice that don’t speak English or are deaf.
Problem solved. They can go to the federally funded clinics with their 3 month appointment lines.
Anonymous
That is just wrong, on so many levels. We need tort reform, like yesterday.
For those of you who think all Dems are pro-trial lawyers: Obama supports tort reform. But regardless of who wins the election, we need to get this changed.
Anonymous
Actually, Anon, you’re showing your ignorance of the tort “reform” issue here. This is almost certainly a statutory claim based on the ADA. No current “reform” proposal even comes close to addressing this.
What’s more, it really doesn’t matter if Obama supports tort “reform”. It’s a state law issue.
You should understand a problem before you attempt to solve it.
Matt
While I don’t agree with the verdict, it should come as no surprise. The AMA has has issued recommendation to make sure providers are in compliance with the ADA. (see http://www.ama-assn.org/ama/pub/category/4616.html )
In this statement the AMA points out that “the single factor of the cost of an interpreter exceeding the cost of a medical consultation generally has not been found by the courts to be an undue burden.”
It also makes me wonder how well the rheumatologists documented in his charts. If, for example, the patient/provider communicated by pen and paper did he keep a copy of that written communication, that could indicate that he discussed the adverse effects of the medications with the patient, in his chart. While I don’t do this for an everyday patient, I defiantly would for a patient such as this…. especially if it was for something like MTX, Remicade, ect.
Again, I don’t agree with the office having to provide an interpreter, we do, however, use interepters for key visits at our office. The (somewhat) good news is that “the IRS may allow a credit of up to 50% of cumulative eligible access expenditures made within the taxable year that exceed $250 but do not exceed $10,250.This tax credit may be applied…in order to provide qualified interpreters “
DR. MARY JOHNSON
What the Happy Hospitalist said.
This verdict is horse-hockey.
This patient could read? Yes? If she had questions – or the doctor needed to explain something, there's this little technique called pen & paper.
I agree with Matt. This was about documentation (sounds like there was not enough of it) – notsomuch methods of communication.
Moreover, any presciption you pick up these days – from anywhere – has detailed side-effects listed.
"The moral obligation" argument is bogus. The woman was not lying on the doctor's doorstep dying. The doctor has the right to pick and choose patients (just like patients choose doctors) – and he chose to take her on/help her. Yet she turns around and sues him over an SE?
The additional service she wanted the doctor to absorb is NOT free (i.e. provided by Medicare). That's the only way this verdict would make any sense.
In the end, the legal system has once again put into motion something that will ultimately impede access to care.
Doctors are just going to say no.
Anonymous
Excuse me, doctors, but did not this physician accept payment from a deaf individuals. This physician was not under any obligation to treat the deaf, but decided to take the money of the deaf. If you do so, then the physician is obligated to ensure that his patients understand what what going on–and that sometimes may require an interpreter.
DR. MARY JOHNSON
The point is, Anon, that the payment this doctor “accepted” for his services is woefully inadequate to cover the additional service this patient required.
One price does not fit all patient encounters – but Medicaid and Medicare certainly treat it that way.
If doctors are going to be REQUIRED by the government/courts to provide interpretors – they need to be PAID enough to cover their real costs.
Moreover, patients have responsibility in this equation too. The lady did not provide or want to pay for the interpretor.
That’s just not reasonable, fair or realistic.
DR. MARY JOHNSON
P.S (Anon) you’ve certainly driven home the argument that doctors who are not properly reimbursed for taking of patients that require special services can avoid the problem by avoiding the relationship all together . . . or dropping the patient.
Anonymous
So where does this end?
Here, a deaf patient wants an ASL interpreter; a written exchange wouldn’t do? Why?
And why did she go back to this doctor if his method of communication was so deficient as to merit a lawsuit? Over and over again. Moreover, to refuse referral elsewhere where presumably she might be more satisfied.
I am aware of certain instances where deaf persons have refused some certified ASL interpreters in favor of friends or family members who demand fees for their “services”. No one said deaf people weren’t clever. Or criminal.
The award seems unjust, given the circumstances. The patient’s actions belie the claim of failure to accommodate.
Anonymous
Sign or common or even uncommon foreign language skills would be something to look for on resumes that come in for jobs in the office.
IF you had an employee there already you could pull them in for these appointments and not incur the special charge.
alexa-blue
Leaving aside the malpractice decision, the doctor absolutely had an obligation to provide a translator or refer the patient (at the outset, probably, and certainly after she asked) to a provider who could. This is, like, medical professionalism 101. To Dr. Mary Johnson – according to the link, the physician occasionally communicated through her partner “who had better written English skills.” Y’all are wack. Or letting anger about crappy medicare pay scales and a poorly designed malpractice system cloud your judgement.
David
As a physician, what can I do to avoid this? You say that I can just refuse to serve patients who are deaf or who speak a different language, but is that safe either? Won’t some patient come after me with a civil rights action of some sort for discrimination?
DR. MARY JOHNSON
Yes, Alexa, there is a whole lot of anger out here in the real world about the way physicians have been treated over the last decade. They are being pushed into impossible corners and they are pushing back.
I personally know a great deal about that.
But once again, no one in this thread who is maintaining that doctors must fulfull their "moral obligation" by providing interpretors wants to fairly reimburse the doctor who you say must provide the service.
Do you think that the service/interpretor magically falls out of the sky? Do you think doctors' bank accounts (especially in private practice) are a bottomless pit of money that their patients can tap into anytime they like? Because if you do, then I'm not the one who is "whacked".
By the way, I look forward to the day when I can disagree with someone in a thread without being called a name during the course of the thread.
On several occasions, I've worked with deaf children and their parents. I also know a little bit of sign language because a dear friend & colleague during residency went deaf and we had to do quite a bit of improvisation until she got her cochlear implant.
The greatest miracle I have ever seen in my life was the day they turned the implant on. The most beautiful thing I have ever seen was the expression on my friend's face when she realized she could hear my voice. Darkness and despair became light.
My point is this. In all instances, these people were grateful for the extra efforts I did make to communicate on their terms – they did not feel "entitled" to anything.
Look at it this way, other public servants (policemen/firemen/teachers) are given the support they need to do their jobs (on second thought, maybe I should not assert that too strongly). Lawyers defending defendants who do not speak English are provided with interpretors by the system – they don't have to absorb the bill themselves.
But you argue that doctors must.
Doctors these days have to make more and more choices that go against our grain. This rheumatologist was trying to help this woman. As far as I can tell there was no malicious intent – and no true negligence – given that we're talking about the side effect of a drug that, when it is picked up at the pharmacy, should be coming with detailed, written information concerning the side effects the woman sued over.
But the doctor gets sued anyway – because the patient does not want to assume any personal responsibility for her own care – knowing her circumstance are special.
So we're right back to the choice for the doctor in this skewed equation: If you cannot afford to provide the interpretor that (1) those requiring the service – i.e. the government, and (2) those getting the service – i.e. the patient, do not want to pay for . . . what do you do to avoid going bankrupt or being sued?
You don't see the patient.
And the patient can thank the legal system for that.
Anonymous
Well said Mary. The fact is dear Dr. Alexa-Blue is correct on strict interpretion of the law, she is in training. Whenever as a trainee she needed an interpretor one magically appeared courtesy of her hospital (or the double-phone dial an interpretor). Without a penny coming out of her pocket. She has never worked in the real world were small business costs do matter. Yes, the law guarantees the interpreter. But the simple reality of the situation is that a small business cannot tolerate negative 150.00-200.00 a visit for the interpretor. Who loses, the patient because she will get refused care and end up in a county/fed health care with their three month waits and possible long drives. I suspect morethan a few doctors just made up their mind not to accept interpretor-needs patients based on this thread. That is the fact. Alexa, you have a lot to learn about medicine. Residency teaches you NOTHING about the business of medicine. No malpractice occurred, simpley a very well known side-efect of steroids. Yet a 400K judgement is made against the doc. In the long run the special-needs patients will suffer this legal travesty.
alexa-blue
Well, it seems that Mary Johnson reads too much into my response, and Anonymous not enough. I’m all for paying doctors enough to provide reliable interpreter services, but that is an independent question from one of whether the doctor has a responsibility to provide interpreter services or refer the patient to a provider who can* (note that this is different from simply discharging the patient from your practice, or refusing to see them). All this seems to fall under the umbrella of ensuring your patient can and does comprehend the information you are giving them. And yes, that is the doctor’s responsibility.
As a side note, I suppose a strict free-marketeer can construct an argument against professional obligations altogether (since in theory, the market should allow pts who want conscientious doctors to obtain them), but most of you ought to be wary of that line of thought, since it’s also an argument against professional licensure altogether, and would put an end to relatively high(er than average) physician salaries.
Side side note: it’s wack, not whacked. And it’s not a name, it’s a state of being. Also, a joke (who talks like that anyways!?)
*Obviously, situations may arise, such as dire need, or where they patient is offered a referral to an accomodating practice and refuses, in which the onus of providing an interpreter is shifted/absolved. In such cases, the doctor needs to be especially cautious of miscommunication; the doctor in the linked article clearly was not.
Devin
Holy crap. It’s worth reading the article to see that the patient HAD NO REAL ADVERSE OUTCOME. She got $400000 dollars because she had FACIAL SWELLING THAT STOPPED ONCE SHE STOPPED THE MEDICATION!
Oh my god. This country is truly insane. Words fail me.
DR. MARY JOHNSON
Alexa, as a comment on your comments, perhaps you did not flesh yours out enough – and as it stood, it appeared incredibly naive and entitled. Maybe you need to work on that and stop blaming the reader.
Re: the responsibility to “refer a patient to a provider who can (provide an interpretor at a $150-200 loss)”. Do you not understand that you just described what Matt rails against – that the doctor is forced to discharge the patient to the “non-profit”/charity sector?
In some circles it’s called a “dump”.
So it would be nice if the system, would get around to solving this problem FOR ALL DOCTORS – rather than forcing some of us to make choices based on economics. A truly “conscientious” doctor would advocate for that.
As Devin pointed out, in terms of the law, one of the components of winning a malpractice action is to prove long-term/permanent damage to the patient. In this case, it did NOT happen (at least from what I have read). It seems this case turned on the nebulous-at-best notion that this patient was “discrimnated” against. And, at the risk of repeating myself, given the fiscal circumstances we’re talking about here, that’s just a load of horse-hockey.
Your “thought-police” pseudo-threat (hidden within the free marketeer argument) was amusing. Please, please, please SPARE ME the notion that the medical licensing boards would (1) ever give up their power by dissolving or (2) take action against a doctor based on what he/she thought. On point #1, medicine once was professional AND a free market – until we sold our souls to the third-party payers. On point #2, a medical license is a privilege granted by the state. Once you’ve have it, unless you screw up bigtime (or an institution is out to get you – ala “bad faith” review), it’s fairly hard to lose it. Medical Boards generally coddle and protect protect their own. It’s called the White Wall.
I know a little something about that too. I’ve been banging my head against the one in NC for a long while. Read my blog. And walk a mile in the shoes sweetheart. Hope your soles are thick.
Thanks for correcting my typo. I guess it proves my stupidity.
alexa-blue
You could also "dump" the patient on an academic medical center, which as anonymous points out provides translators for its patients, or a multi-specialty practice that can afford to do the same. In any case, it's your obligation to do some leg work to find a physician willing to treat the patient properly, not just tell them to find another doctor.
I don't know what you mean by "thought police." To be clear – the same (free market) argument that can be constructed against an obligation for physicians to provide certain services for their patients (in a market for physicians, price will match patients who want such services to physicians willing to provide them) can also be constructed against licensing all together (in a market for physicians, price will match patients who want professionally licensed physicians to physicians willing to obtain licenses), allowing unlicensed physcians to compete and undercut physician salaries across the board. Since physician prestige and salary largely rests on the ability of licensing bodies to block such competition, you should expect those things to decrease in a purely free market economy.
The only system that will free doctors (& patients) from needing to make decisions based on economics is a single payer system, and that is because it shifts those decisions onto the payer (government, practically speaking). I don't hear many people advocating for that here (but maybe you do, in which case, congrats on being internally coherent! [that was a joke]).
Anonymous
How will a single-payer system resolve a problem created when professional obligations and the law require you to provide services, such as an interpreter, that the system will not fund or allow you to charge for? Either, way, the doctor is screwed. The doctor has an obligation to communicate well enough to provide quality care, and if that requires and interpreter than he must make that a part of this patients care. The problem is not allowing him to charge for it. It is economically equivalent to requiring car dealers to provide a wheelchair lift equiped van to those so handicapped for the price of a subcompact.
It is in short, state sponsored theft.
DR. MARY JOHNSON
It’s also called “redistribution of wealth”, Anon.
Alexa, a dump is a dump is a dump. The patient had a responsibility to communicate in some fashion that she did not understand something – or needed better translation – or wanted a doctor who could communicate better. And (again) SHE SUFFERED NO PERMANENT INJURY.
I’ll note that residents trained in academic centers tend to be very dismissive of doctors in private practice/rural areas – until they become one.
The “argument” you make about unlicensed physicians is way beyond tortured (not to mention unlikely in the extreme). When you decide to hop off the Starship Enterpise and join the real world, let the rest of us know.
Your jokes are not funny and the reasoning behind them (re: single payers) again demonstrates a really really scary naivette about how the real world works.
alexa-blue
In no particular order:
The “argument” you make about unlicensed physicians is way beyond tortured (not to mention unlikely in the extreme).
Really? ‘Cause I think I heard it from Milton Friedman
The patient had a responsibility to communicate in some fashion that she did not understand something – or needed better translation – or wanted a doctor who could communicate better.
That seems like a particularly stupid burden, since one of the problems with misunderstanding is that the one misunderstanding often has limited ability to know what (s)he has misunderstood. For example, this conversation!
Your jokes are not funny and the reasoning behind them (re: single payers) again demonstrates a really really scary naivette about how the real world works.
Well, I plead guilty to the first charge (dammit, I’m a doctor not a comedian(enne?)). As for the second, fair ’nuff, as well. Except I strongly suspect you’ve misunderstood my point re: single payer (basically, it was tautological: in a single payer system, the single payer pays!). Now, who am I morally obliged to hold responsible for that?
DR. MARY JOHNSON
In order.
“Really? Because I heard it from Milton Friedman.”
Despite what they may tell you in academia, anyone is capable of making a tortuous and unlikely argument.
“That appears to be a particularly stupid burden.”
Get real and grow up. The patient has responsibilities in the “realationship”, Alexa. I would assume this particular patient intitiated the relationship (by walking into the doctor’s office), and I will also assume she can read and write (because she had to fill out all the paperwork to get her Medicare card . . . AND she went to a lawyer – who I KNOW did not have an interpretor waiting at the door).
[Again, my dear, if you could try to make your point without slamming someone, people might be more inclined to take your musings (and those of Mr. Friedman) more seriously. But that's just "stupid" ole me - with my inability to understand simple arguments.]
As for the “moral obligations” of physicians (the real ones as opposed to the fake ones), I know something about that too (and at the risk of being deleted, I’ll use them here to make my point).
I did my time in public service (to Uncle Sam/Big Brother/Chief Single Payer – whatever you want to call him). And one night I answered a phone call when another doctor screwed up. I cleaned up a mess and saved a child’s life – and, for my trouble, was rewarded with the utter destruction of my life and practice in my own hometown.
God help me if I had needed an interpretor. Actually I did. I needed a nurse to help explain to the parents just how badly the other doctor had screwed up. And if I had not had that nursing interpretation on my side and that baby had died, I would have needed the “interpretor” in court.
The girl is ten years old and I get a Christmas card from her grateful parents every year.
So I can tell you first hand, Dr. Alexa Blue. that our government – the one you trust so much to solve all medicine’s problems and pay your future bills, (1) could care less about – and does not protect/defend – the REAL moral obligations/duties it currently requires; (2) does not enforce even the most basic of laws; and (3) is incapable of decent oversight.
And OBTW, if you do get what you want, good luck in getting Chief Single Payer to treat you like a professional and pay you what your services are worth.
Like I said – walk some in the mocassins before you spout off.
lynetteallcountyinterpreting
As the owner/operator of a sign langauge interpreting agency (and an expert in the field) I refer you all the the National Associate of the Deaf website: http://www.NAD.org. Click on Legal Rights and then on on Healthcare, and then scroll down and click on Doctors. This explains it all.
English is NOT a Deaf person’s native language. Therefore, writing back and forth as an effective means of communication is not sufficient. Also, asking the Deaf person to bring a friend or family member who “signs” is a breach of the patient’s confidentiality. The friend or family member is also personally and emotionally involved, and can not be expected to remain neutral.
Same goes for using a staff member that may “know some sign”. Family, friends, and staff are not trained indviduals. Furthermore, signing and interpreting are two totally different things. Sign language interpreters are highly trained and experienced professionals. They are not only fluent in American Sign Language, but must also understand positioning of individuals during an assignment, how to relay the message to the Deaf client using the same tone as the person speaking, (and in turn voice to the hearing client using the same tone as the Deaf signer), never judge or counsel the person they are interpreting for, (must remain completely unbiased), never add to or delete from anything the Deaf client is signing, or the hearing client is speaking.
Interpreters read facial expression and body language; we can tell if the Deaf client does not understand difficult medical terms that normally do not exist in their American Sign Language. We can ask if they need clarification, and then ask the medical professionals to explain the terminologies in simpler ways.
Another misconception: All Deaf people do not read lips! If they are not fluent in English (and they are NOT), how can they lip read? If you send me to China (and for the record I am not fluent in Chinese), and ask me to read someone’s lips as they are speaking to me, I will NOT be able to do it! So, just to recap…Deaf people do not read lips any better than you or I. Just as an experiment, turn the volume off on your television the next time you’re watching the evening news. Now, try to figure out what is being said. Keep in mind, you ARE fluent in English. I guarantee, you can not do it.
Please read the info on the NAD website. It explains the laws, I don’t need to reiterate. I am so happy that a Deaf person finally stood up for their rights! Maybe more health professionals will begin following the law now.
One more thought – if you decline seeing a patient based on the fact that they are Deaf and require an interpreter for effective communication, you can be sued for discrimination. Keep that in mind.
Your office buildings are required to provide wheelchair ramps for the physically handicapped. It’s the same as being required to provide qualified sign language interpreters for the Deaf.
Anonymous
BS. I challenge you to find a case where a physician met someone who was deaf, declined to accept them as a patient and was held liable without outright saying it was because they were deaf. Despite preferences to the contrary, there is still a tiny bit of freedom of choice for doctors in this country.
It is patently absurd to expect this guy to pay FOUR THOUSAND DOLLARS a year for the privilege of… working for someone! Who can still sue you! I’ll take my chances any day with the lawsuit. Decisions like this will only serve to ensure deaf people’s access to physicians is limited to big medical centers where interpreters are not a big deal.
David
While I certainly have nothing against those who are deaf (or blind, or have any other disability) I DO have something against forcing others to make up for their disability. Regardless of how unfortunate it is that some individuals have been born with or acquired a disability, it is unjust to force others to make up for it. You must OWN your disability, just as I must OWN my own difficulties. Perhaps I don’t have the winning good looks of Brad Pitt, the intelligence of Einstein, or the composing skill of Beethoven – I make of my life what I can with the abilities (and deficits) that I have. I must OWN the good and the bad and not expect, under threat of lawsuit or otherwise, others to ‘make right’ or somehow ‘even out and redistribute’ what has transpired by chance.
If this idea is forgotten, and everyone is granted ‘rights’ to everything they wish (as in having the right to an interpreter), then in the end no one will take responsibility for anything that happens (or doesn’t happen) to themselves. This creates a rather sickening society of unaccomplished whiners leaching off the few who still work hard and take responsibility for themselves.
DR. MARY JOHNSON
I second the BS.
This lady (1) did not have to be “fluent” in English to ask for help/let someone know she didn’t understand/needed more help, and (2) apparently knew enough English to get a lawyer and sue the doctor who tried to help her.
alexa-blue
To Mary: Maybe the lawyer had an interpreter.
To Lynette: Don’t know if you’re still around. I explicitly tried to avoid the question of reimbursement in this discussion so far, because I believed it irrelevant to questions of moral obligation (and also because I agree with most of the commenters here that serious reform is needed). But I’m curious how you would address the questions they rightly raise. Legal obligations to treat deaf people at a loss impose a perverse incentive not to accept deaf patients. You can avoid this effect by harshly punishing doctors for their refusal, but that is only a short term fix, since the ultimate effect will be to drive physicians out of practices where profits are at a thin margin, such as primary care, which will hurt deaf and hearing people alike, and, as you’re seeing in this thread, will alienate doctors.
It seems there are several ways we could fix this: one would be to reimburse physicians better for their time so that cognitive work w/ deaf patients was lucrative enough to afford interpreters w/o incuring loss. Another would be to mandate interpreters be provided to physicians for their deaf patients and pay those interpreters 10-25% of what they could get for their time on the open market, with the threat of discrimation suits if they refuse to take on that sort of work. Judging from the tone in your original post, I would expect you to favor the latter option.
DR. MARY JOHNSON
Alexa, I sincerely doubt the lawyer had an interpretor waiting at the front door (unless prior arrangements were made) – or even "on call" to use – which is what you are saying that doctors must have as a "moral obligation" and/or to avoid the discrimination suits Lynette apparently would love to see filed.
I see you're re-thinking the actual nuts & bolts of your position now that you've seen its real-life folly. That's good.
Treating & paying Lynette/other interpretors as she would have physicians be treated/paid is a delicious irony.
Jaz
“Should the doctor have provided an interpreter…” YES. All businesses in the US are required to comply with the Disabilities act. My Web sites must. Supermarkets must. Doctors must.
” …at a clear financial loss to his practice?” YES. All businesses in the US are required to comply with the Disabilities act. My Web sites must. Supermarkets must. Doctors must. These costs are called costs of doing business.
The difference being, very few other businesses operate wondering about whether each 15 minute period is profitable; you run a business, act like one. I lose money some quarter hours, I make money other quarter hours. Some days are a loss, some days are a gain. This is business.
“Loss leaders”. “Bread and butter” customers. These are terms that may come in handy.
“Should there have been a moral obligation to do so?” NO. There is a legal obligation to comply with the law. If we were all moral businessmen, we wouldn’t need laws.
Anonymous
can anyone add, paying $150 out to provide a service that you will be reimbursed $50 for is not sustainable……..
if you can show me how it is sustainable by all means do it
Anonymous
I don’t think a $400,00 verdict in a case where a patient suffered no real damage is necessarily fair. However, deaf patients have to go SOMEWHERE for treatment. And how often do hearing people, whose first language is English, understand half of the stuff their doctors are explaining? The average reading level of deaf people in the US (those who lost their hearing before school age) is second to third grade. Would you be able to properly conduct a medical appointment with a third-grader? Would you trust that the third-grader understood all of your directions and would be able to follow them? This is why note writing is not sufficient, why those deaf people need interpreters, and this is why the ADA requires that their communication needs be met. If every doctor in the US refused to treat a deaf person because of the expense involved, where would those patients go? How would they receive medical treatment? Doctors in private practice are running a business; providing interpreters is a cost of doing business, as is installing wheelchair ramps, lighted fire alarms, and handrails in the building. As is every ther aspect of providing services to your patients. It may not feel that way, because it is attached to a single patient, but that’s how the ADA designed it to be.
Out of all of the patients a doctor sees, how many are deaf? How many times does that person seek medical treatment? I am appalled at the suggestion that deaf people should be refused care so a doctor can avoid a relatively small business cost. An interpreter’s fee is not going to break the bank. By the way, you should also know that, if the patient is savvy enough and can prove that you have refused to see him because of his deafness, he can sue you for that, too. And should. It’s sad that there has to be a law to force you to do something that is humane and necessary, sad that you think of your patients as dollar figures instead of people. There is not a doctor out there who is on the brink of financial ruin because he had to pay an interpreter, but there are thousands upon thousands of deaf people who are not getting adequate medical care because their doctors don’t want to provide interpreters. What if it was your family member? My mother is deaf, and has diabetes, and we have to constantly fight to get interpreters for her. She can’t write English beyond a very basic level — certainly not enough to conduct a medical appointment — and I can’t be there to help her every time she needs to see the doctor (on account of I have 3 kids, and my own appointments to go to). This whole discussion just makes me sick, and scared for my mother. And you’d better believe that if a doctor’s refusal to provide an interpreter for my mother results in serious harm, I will be next in line to sue. My mom’s life may not be worth an extra $100 to you, but it’s worth more than a few million to me.
PS Thank you Jaz. Well said.
Anonymous
I'm an interpreter. I would just like to ask the person who suggested that, instead of his absorbing the occasional interpreter fee, I ought to reduce my income by nearly half and work for 10 – 25% of my usual fee for a medical appointment, how they think I might pay my bills when they come due? Given that I make half of my living interpreting for medical assignments, if I were to be legally obligated to provide the service for what would amount to around $4 per hour, I would be on a pretty quick slide toward food stamps. I run a business, too. I have to pay all of my expenses. Between driving from location to location, invoicing and then chasing unpaid invoices, and scheduling/rescheduling/explaining to doctors why they do, in fact, have to pay my invoice, as we have a contract, and then doing the actual interpreting work, I invest about ten hours per day in my work, but I only get paid for six of them. I don't ask you to pay me for that time or trouble, I just figure it into the overall cost to me of providing this service, and then charge the same fee to everyone, one that would make it feasible to run my business. You know, like a business owner. I don't charge you extra for having me drive that awful route that takes an hour and a half and burns half a tank of gas, I just chalk it up to the fluctuating expenses of being a business owner, and rest with the knowledge that I have measured accurately the cost of running my business and that it will all work out in the end. Especially since I don't do that crummy job very often (kinda like you don't see deaf patients that often). So that you know, I have a good college education, and plenty of skills, as do most interpreters (the average in my area of the world is a bachelors degree, but a very high number of us have masters degrees, and quite a few of us have Ph.Ds, in fact), and if it were no longer feasible to continue interpreting, I would simply quit, as there is PLENTY else I could do. Reduced supply –> increased demand –> skyrocketing costs –> 10-25% of quadruple the fee would put you almost back where you started. I am not just guessing, here; in my community, several events contributed to a sharp decrease in interpreter supply and a correspondingly sharp increase in interpreter pay. I currently earn, at market rate, more than double what I earned four years ago, with the only change being the decrease in interpreter supply. So, your proposal is not a good solution. Here's a better one: find a way to fund deaf education adequately, help resolve the literacy problem, and contribute to producing a new generation of deaf people who can read well enough to have a medical visit in private. Because, FYI, they don't want to need us any more than you do. Or, how about this, learn ASL. I vote for that one, actually, even at the risk of becoming obsolete. Like I said, I could easily do something else.

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Sued for failing to provide an interpreter

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