Physicians are often pressed for time, both in the hospital and the clinic.
And for those who don’t speak English, that represents a huge problem. Not only are many cash-strapped hospitals cutting back on interpreter services, those that have them aren’t always being utilized.
As surgeon Pauline Chen notes, “Patients who speak English poorly or not at all face longer hospital stays, an increased risk of misdiagnoses and medical errors, and decreased access to acute and preventive care services, often regardless of socioeconomic or insurance status.”
She points to an interesting study showing that doctors use interpreter services judiciously, triaging patient encounters into those that are “high stakes” or not. Conversations about advance directives, for instance, would be a high stakes discussion necessitating the need of a translator. Routine rounding on a patient would be considered less important.
The problem is, for a hospitalized patient who speaks little English, every encounter can be perceived as important, and ideally, deserving of proper communication with their doctor.
Related posts:
- Do electronic medical records increase physician communication of critical test results to patients?
- Should advance directives be stored online on Google Health?
- My take: Slow medicine, destroying the medical home, animosity, patient communication
- How poor physician communication leads to medical mistakes
- How should doctors handle the difficult patient?
- Doctors dealing with difficult patients, is it the fault of young physicians?
- How the patient-centered medical home can improve our health care system
{ 6 comments }
Where, exactly, does patient resposibility factor in to this? If I am in a foreign country and cannot speak the local language, is it not my responsibility to find someone that can help translate? I can understand it in an emergency (sometimes), but not in routine office visits or, as in the article, post liver transplant. Really? A person lives here and cannot speak English, and cannot find someone in the community to help them understand about a liver transplant?
So it becomes the reponsibility of the hospital and physicians, in an environment of declining reimbursement, and enforced by the legal community, to provide the service. So where does it end? Guess I better learn Mixtec, because ATT translator services only has one interpeter. No wonder the healthcare system is in so much trouble.
agreed. There is (or should be) some personal responsiblity on the part of the patient.
The language translator requirement is legislative and legal abuse on the medical community, plain and simple. There is no natural or legislated right to refuse to learn English in the U.S., nor is the failure to learn the language, absent a true disability, considered a disability in and of itself and deserving of accommodations under the ADA (itself another issue of an unfunded government mandate.) I can see where the U.S. English supporters find their adherents, from the people who are fed up with the government mandating requirements upon those who provide services for the benefit of those too uninterested in making even the most basic accommodation to living in this country.
i’ll use an interpreter all the time if the patient pays for it
I had guy who couldn’t speak English–been in the country 25 years–come in and tried to do the right thing and schedule an interpreter. 3 times in a row he and I were sitting there, but the interpreter, who had been booked through an agency did not show up. So I referred him to a Spanish speaking physician. Hasn’t been a problem since as I just happen to not have had any non-English speaking patient. I haven’t discriminated mind you–that would be against some unconstitutional law (and therefore illegal) law–but somehow they always happen to book with someone else.
We have requirements that the physician provide translation for any language. Just looked at my Medicaid list, and my Spanish-speakers are outnumbered by Russian speakers, Ukranian speakers, and a sprinkling of Bengali, Hindi, I don’t know. Oh and Vietnamese.
The requirements are codified into law and/or regulation, and there have been stiff penalties for failure to provide the interpreter, even when the physician felt communication was adequate, and one case in Oregon where the translator requirement was for a family member, not even the patient. The court decided to push the envelope.
Is there any other country on the planet with such regulations? If I end up in a Russian hospital or a Ukranian hospital, or French, English, etc……would I be able to demand a translator under penalty of law? Of course, English is usually fairly easy, someone around usually speaks well enough and I know I’d be happy.
How about if my aunt from Brazil, speaking only Portuguese, ends up at that same Ukranian hospital? Can I insist on a Portuguese tranlator?
It would probably end up like the scene from “I love Lucy”
http://www.youtube.com/watch?v=OACIfwkg7ns
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