Category Archives: International Medical Interpreters Association (IMIA)

Lost In Translation: How Foreign-Speaking Patients Suffer Without Medical Interpreters –via WBUR

DIAZ RIVERA

** ADVANCE FOR TUESDAY, NOV. 16 ** Medical interpreter Carmen Diaz, right, interprets for Spanish-speaking patient Romualdo Rivera at Temple University Hospital in Philadelphia, Sept. 1, 2004. Temple University is among 10 sites in the Robert Wood Johnson Foundation’s Hablamos Juntos program that received grants to hire and train Spanish interpreters. (AP Photo/Bradley C. Bower)

Lost In Translation: How Foreign-Speaking Patients Suffer Without Medical Interpreters

By Dr. David Scales

When I met Mr. Y., he was sitting up in bed, sweating and breathing quickly. An elderly, Russian-speaking man, he was admitted to the cardiology ward at a large hospital where I was working. His blood pressure was dangerously high and he struggled to breathe. His fear was instantly apparent in his wide blue eyes. Panting, he told us that he had liver pain, pointing to just below the ribs on his right side.

It’s unusual for patients to complain about liver pain. In broken English, Mr. Y. explained that it began after starting new blood pressure medications a few months ago. But his chest X-ray told a different story. His lungs were drowning in fluid — the likely reason why he was so out of breath — and that couldn’t have been caused by the medications he was so worried about. Having already perused his laboratory results, his condition seemed like a straightforward case of heart failure, but I quickly realized admitting Mr. Y. would be linguistically and culturally complex.

I needed to understand what made him so short of breath, and why he thought his medications caused the problem. But no in-person interpreter was available for another hour and a half. The telephone interpreting service at this hospital was designed to be accessible — the interpreter can be paged from any hospital telephone and should call back. Yet, no one had called back after my two attempts. I imagined they were busy interpreting for other patients. In the meantime, Mr. Y. continued to pant and sweat, leaning forward in bed to help his breathing.

Reluctantly, I asked his adult daughter if she would interpret for me. She agreed, but was clearly reticent; her hesitance and discomfort apparent as she stumbled over questions about her father’s recent urinary and bowel habits. While I speak no Russian, I became suspicious of misunderstandings when she interpreted my question about previous “heart failure” as “infarkt,” which sounds like a medical term for a heart attack.

I know of studies showing patients suffer when clinicians do not use interpreters or use untrained, informal interpreters like family members. I learned this during medical interpreter training and in my own experience volunteering as an Arabic interpreter with Iraqi refugees in New Haven and Syrian refugees in Jordan. As was the case with Mr. Y.’s daughter, family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.

“Family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.”

I know of studies showing patients suffer when clinicians do not use interpreters or use untrained, informal interpreters like family members. I learned this during medical interpreter training and in my own experience volunteering as an Arabic interpreter with Iraqi refugees in New Haven and Syrian refugees in Jordan. As was the case with Mr. Y.’s daughter, family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.

As a trained interpreter myself, it is painful and frustrating when good interpreter services are not available. But it isn’t just a dearth of interpreters — it’s also a lack of time that presents challenges to providing good care to non-English speakers. If I had a leisurely day I could have waited or returned, but on an adrenaline-fueled day on call, waiting for the interpreter was not possible. I had to balance my limited time with Mr. Y. against preparing for the three other patients I expected to be admitted at any minute. Worried this would be my only chance to hear his story, I put my interpreter training aside.

To read more of this article courtesy of WPR Boston’s NPR—>click here

 

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Medical Interpreters Speak for New American Patients –via Seven Days

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A woman rushes to a hospital after taking her baby’s temperature. In English, she tells the nurse that her child has been crying nonstop and is burning up. She begs to see a doctor. The nurse turns to her colleagues and other patients and speaks in an unidentifiable language, presumably asking if anyone understands English. Most give blank stares. A patient speaks a few words to the mother but backs off when he reaches the limits of his English proficiency. By now, the mother is hysterical and desperate.

That’s the scenario depicted in a public service announcement video from the Texas Association of Healthcare Interpreters & Translators, produced in 2010. It concludes by telling viewers that 8 percent of U.S. citizens, or 25 million Americans, speak limited English. The video clip is one of an array of materials that Lynette Reep, interpreter coordinator at the University of Vermont Medical Center, uses to educate her colleagues about the challenges that deaf patients or those with limited English proficiency (LEP) face when accessing health care.

To drive home her message, Reep also cites famous cases of tragic outcomes that resulted from inadequate language access. One such incident took place in 1980 in South Florida. Eighteen-year-old baseball player Willie Ramirez became quadriplegic after a misunderstanding of a single word led to a misdiagnosis and erroneous treatment. A resultant lawsuit led to a settlement of $71 million.

Reep’s position at UVM Medical Center was created just a year ago; before that, technical training for the clinical staff revolved around use of phone interpreters or an app. “Burlington, historically, is not a community that necessarily had a huge need for interpreting services,” Reep said. “But over the last 20 years or so, we’ve had refugees resettled here.”

According to statistics provided by the medical center, the percentage of LEP patients has risen over the past three years from 1.25 to 1.38 percent. Each week, the medical center receives about 16 requests for ASL interpreters and 200 for spoken-language interpreters. The three languages for which interpretation is most often requested are Nepali, Bosnian and Arabic.

Reep, 55, said it is her mission to “provide language access in the interest of patient safety and to educate the organization as a whole about the link between language access and patient safety.” This means creating a culture in which trained medical interpreters are seen as part of the treatment team.

“It’s really important that patients and providers understand that,” Reep said. Even though the interpreters don’t provide care, she added, “they are the mechanism through which care is being provided.”

To read more of this article courtesy of Seven Days—->click here

In 2016, Health Care Providers are Required to Work with Certified or Qualified Medical Interpreters —OHCIA

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Oregon Health Bill 2419 has been revised for 2016 to include a requirement that health care providers work with certified or qualified health care interpreters whenever possible.

It is important for all health care interpreters to complete the certification and qualification process as soon as possible.

To read more of the Oregon bill with OHCIA—–>click here

Lobbying for Medical Interpreters in Congress

Lobbying for national language access reimbursement for all States.

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An open letter to medical interpreters via Izabel Souza (Arocha)

Izabel and Louis

An open letter from my wonderful colleague and co-founder of the National Board for the Certification of Medical Interpreters, Izabel Souza (Arocha).

Click here to read Izabel’s letter ———-> Open letter Izabel Souza (Arocha)

Please join me in congratulating Izabel for her magnificent contributions to the medical interpretation field and wishing her well in her new endeavors.

Please feel free to forward to your networks.

With best regards,

Louis

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