Hospital Translation

Visiting a doctor or hospital can be an uneasy experience, even when you can speak the native language. For individuals that cannot fully communicate with their doctors, these visits can leave them upset and confused and can be alienating or even dangerous.

Laws require that health care providers offer translation and interpretation services, but many providers do not know the depth of their requirements. Many providers and their organizations also face limitations of funding and access to quality interpreters.

Misunderstandings and health scares

In the past 15 years, research has established that when professional interpreters aren’t used in the healthcare field, language errors and misunderstandings are commonplace. 

“The reality is, if you can’t communicate with a patient, you can’t provide care,” Mara Youdelman, managing attorney at the National Health Law Program in Washington, D.C., said in a recent NPR article. Common safety risks reported among patients with low English-language proficiency are medication errors, re-admissions for the same health problem, and prolonged length of hospital stay.

Short of a misdiagnosis or injury, research also indicates that without trained interpreters, patient satisfaction plummets. A 2016 review of palliative care services, for example, concluded that patients who struggle with English don’t adequately grasp their diagnoses without professional interpreters and also had more pain and anxiety during their care.

In many cases, families and friends of patients act as interpreters, which can lead to a plethora of issues. Another NPR article quotes Helen Eby, a certified medical interpreter: “You know, you’ve got a 10-year-old in a gynecology appointment,” she says. “Is this where you would normally take a 10-year-old? Not likely. Or [you’ll] have a child — an adult child even — interpret a parent’s cancer diagnosis. That’s got to be highly traumatic.”

Equal access to care

Census data suggest that as many as 1 in 10 working adults in the U.S. has limited English-language proficiency.

For the many patients for whom English is not their first language, their difficulty navigating the healthcare system depends on a variety of factors: Which state you live in; whether you are in an urban or rural area; how many people speak your language nearby. Patients and providers often don’t understand their right to access language services under the law.

According to 1,563 physicians surveyed between 2011 and 2016 by Critical Measures, a consulting company in Minneapolis, roughly half were “relatively unfamiliar” or “unfamiliar” with the legal requirements of working with interpreters.

Since 1964, federal and state laws have required hospitals and some medical facilities to provide “meaningful access” to patients, so they can make informed decisions about their health. With a few exceptions, this means that providers must offer qualified interpreters to their patients, as well as translations for prescriptions and other medical documents.

Although in-person interpretation isn’t always available or financially viable for many practices, the costs of hiring professional interpreters are almost always less than those of lawsuits resulting from misdiagnosis or mistreatment.

A 2010 report by the University of California, Berkeley School of Public Health and National Health Law Program found that of 1,373 malpractice claims, at least 35 were linked to inadequate language access.

Limitations of language technology

Technology is helping to address language barriers — though relying on Google Translate or another system without a nuanced understanding of medical language can be problematic. One study, for example, pointed out that in some British medical contexts, having seizures is sometimes referred to as “fitting” — as in, “having a fit.” But one Swahili language app translated the English “Your child is fitting” to “Your child is dead” in Swahili.

At Children’s Hospital of Philadelphia, locally referred to as CHOP, staff members say that the app translates the phrase “Please come to CHOP” as “Please come to be cut into pieces.”

An experienced and educated approach to translation is essential when it comes to health care, which is often a stressful experience even to native-speaking patients. Don’t leave your practice open to error or miscommunication. Work with a translation company you can trust.