Comments on: Sued for failing to provide an interpreter http://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-91387 Anonymous Sat, 16 May 2009 02:28:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-91387 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. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-91385 Anonymous Sat, 16 May 2009 01:52:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-91385 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.<br /><br />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.<br /><br />PS Thank you Jaz. Well said. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-88477 Anonymous Fri, 05 Dec 2008 00:31:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-88477 can anyone add, paying $150 out to provide a service that you will be reimbursed $50 for is not sustainable........<br/>if you can show me how it is sustainable by all means do it 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

]]> By: Jazhttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87800 Jaz Mon, 27 Oct 2008 19:26:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87800 "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.<br/><br/>" ...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.<br/><br/>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.<br/><br/>"Loss leaders". "Bread and butter" customers. These are terms that may come in handy.<br/><br/>"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. “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.

]]> By: DR. MARY JOHNSONhttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87718 DR. MARY JOHNSON Wed, 22 Oct 2008 16:38:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87718 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.<br/><br/>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.<br/><br/>Treating & paying Lynette/other interpretors as she would have physicians be treated/paid is a delicious irony. 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.

]]> By: alexa-bluehttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87710 alexa-blue Wed, 22 Oct 2008 00:58:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87710 To Mary: Maybe the lawyer had an interpreter.<br/><br/>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.<br/><br/>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. 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.

]]> By: DR. MARY JOHNSONhttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87706 DR. MARY JOHNSON Tue, 21 Oct 2008 17:51:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87706 I second the BS.<br/><br/>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. 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.

]]> By: Davidhttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87699 David Mon, 20 Oct 2008 22:14:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87699 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.<br/><br/>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. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87698 Anonymous Mon, 20 Oct 2008 22:01:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87698 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.<br/><br/>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. 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.

]]> By: lynetteallcountyinterpretinghttp://www.kevinmd.com/blog/2008/10/sued-for-failing-to-provide-interpreter.html#comment-87695 lynetteallcountyinterpreting Mon, 20 Oct 2008 20:25:00 +0000 http://clients.emmense.com/kevinmd/2008/10/sued-for-failing-to-provide-an-interpreter.html#comment-87695 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: www.NAD.org. Click on Legal Rights and then on on Healthcare, and then scroll down and click on Doctors. This explains it all.<br/><br/>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.<br/><br/>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.<br/><br/>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.<br/><br/>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.<br/><br/>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.<br/><br/>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.<br/><br/>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. 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.

]]>