Medical interpreter role grows

1
Medical interpreter role grows

• By Joann Loviglio / Associated Press
• November 22, 2004

http//www.detnews.com/2004/health/0411/23/A05-120
62.htm
2
Language Issues

• PHILADELPHIA -- Romualdo Rivera arrives at the
  emergency room with what seems to be a complaint
  of chest pain. But it's hard to be sure -- he
  doesn't speak English.
• He's a pale but solidly built man with thinning
  gray hair, and his face reddens as his shirt is
  removed, his pant legs are pushed up and
  electrodes are attached to his calves and chest.
• As nurses and technicians come and go from the
  small curtained examination area, his eyes dart
  from one person to the next, hoping for a
  familiar phrase, even a word.
• Unlike TV portrayals of frenzied big-city
  emergency rooms, the scene slows in real-life
  hospitals when a doctor and patient can't
  communicate. It becomes like a game of charades,
  as one doctor put it, with lots of pointing and
  gesturing.

3
At Temple University

• Nationwide, the approach to care for
  non-English-speaking patients is hit-or-miss.
  Fewer than a fourth of U.S. hospitals have
  professionally trained interpreters, a study
  found. In some places, hospital employees with no
  medical training are called in to interpret. In
  others, relatives, neighbors or acquaintances do
  the job.
• In the worst cases, the patient's problem gets
  lost in translation.
• Hospital officials realize they need
  interpreters, but most haven't figured out how to
  pay for them. The Temple University Health System
  took action when two hospitals had a surge of
  Spanish-speaking patients.
• Now, Temple and nine other medical institutions
  nationwide are taking part in a program that
  could show why hospitals can't afford to be
  without formally trained medical interpreters.

4
Interpreters

• Last spring, Temple hired four interpreters with
  an 850,000 grant from the Robert Wood Johnson
  Foundation and began sending them to medical
  classes.
• Temple and the other hospitals getting grants
  must develop a comprehensive medical interpreting
  program.
• Health care advocates are convinced that having
  no interpreters means longer stays, unnecessary
  tests, more repeat visits and even medical
  mistakes.
• Hospitals have long relied on friends or
  relatives of patients to help translate, but it's
  an arrangement that comes with risks.
• Patients sometimes hide details from children or
  friends filling in as translators. And sometimes
  family members want to shield patients from
  unwelcome news from their doctors, said Marbella
  Sala, who manages medical interpreting services
  at the University of California-Davis.

5
Several Economic Issues

• Information How do you get the right
  information?
• (Related) Cultural customs These include
  appropriate examinations (sometimes race,
  ethnicity, or culturally related).
• Compliance If its hard to communicate
  initially, how can provider be sure of compliance
  with diagnoses and prescriptions?