Population studies and demographics tell us that there is a sizeable non-English speaking population – about 45 million of them – living in the U.S. alone, of whom about 21 million have difficulty communicating in English and are categorized as persons of Limited English Proficiency (LEP). While they are able to get by with this limitation in their day to day activities, the situation takes on a slightly more serious note when it comes to health care services when the circumstances warrant their admission to a hospital or seeing a physician.
Interpreter and translation services for health care centers
Health care providers can only ensure quality care for their patients if they are able to communicate freely without the impediments posed by language difficulties. This is specifically so in case of emergencies, where the lack of precise, comprehensive, and timely information can be critical to the delivery of quality care, even to the extent of saving lives. LEP patients are likely to face serious problems in such situations.
Studies reveal that less than 25% of U.S. hospitals have professionally trained interpreters, which is far from being reassuring. The lack of adequate funding could be the reason for this, and as a result, hospital staff with no relevant training are asked to interpret or translate as and when the occasion arises. Most often, it is the relatives, neighbors or even children of the patient who deal with this issue. The repercussions on treatment outcomes can easily be imagined.
Flawed treatment caused by faulty interpretation and translation
Medical mistakes leading to serious treatment outcomes are well documented in various journals. In a recent study reported in the Pediatric Journal, patient-physician encounters were recorded, and the 400 page report recorded 396 interpreter errors! Untrained interpreters were far more likely to make mistakes in interpreting the patient's remarks, putting the patient at greater risk.
One of the cases reported is that of a 14-year-old Hmong girl who was interpreting on behalf of one of her family members admitted to a Minneapolis hospital. She was informed by the hospital staff that the patient needed to have X-rays taken, but the girl misinterpreted the advice and said that the patient had to be put through the microwave. The outcome was a lawsuit against the hospital on grounds of duress and emotional trauma caused to the patient.
The statistics relating to commonly occurring interpreter errors were as follows:
Approximately 52% of the interpreter errors were those of omission, where the interpreter left out an important piece of information; in around 16% of the cases, the interpreter used words or phrases that didn't exist in a particular language, and was categorised as false fluency. Another 13% consisted of instances of substitution of words or phrases that did not convey the exact meaning as was originally intended by the speaker; and the last 18% consisted of situations where the interpreter put in his own uncalled for opinion, which was likely to distort the communication process.
(Source: Language Barriers Lead to Medical Mistakes http://www.kyha.com/OCRLanguage/Language%20Barriers%20Lead%20to%20Medical%20Mistakes.pdf)
State regulation of interpreter and translation services
Currently, the five American States of Hawaii, Maine, Minnesota, Vermont and Washington provide for insurance cover to include the services of an interpreter. Many large hospitals in Milwaukee offer full-time interpreter or translation services, and the State-owned Children's Hospital employs both full-time and part-time Spanish-speaking interpreters. Many hospitals arrange for interpreter and translation services on call, but a number of healthcare establishments have yet to take the essential step of hiring interpreters.
The situation at Lucile Packard Children's Hospital in the Bay Area comes as a refreshing change, for they have the dedicated services of David Peschard, a Mexican native, who has a team of professional and volunteer translators to interpret for Spanish-speaking LEP patients and their families. Peschard also helps find interpreters for patients who speak other languages including Russian, and some of the European and oriental languages.
With the world moving towards achieving the status of a global village, the trans-border migration of people in search of a vocation or for business opportunities is escalating at breakneck speed. Health care is one of the major concerns today, in era of technology and vast lifestyle changes. In this scenario, the role of translators and interpreters is growing larger by the day. Health care centers would do well to follow the example set by the authorities of Lucile Packard Children's Hospital as a way to improve the care delivery system for people with language limitations.
