More than 25 million Americans are considered to be of limited English proficiency (LEP), accounting for 9 percent of the U.S. population over 5 years old. Earlier this year, Doximity did a deep dive into multilingual physician statistics. The report, available here, found that while a significant number of multilingual physicians exist within the U.S., there are still gaps between languages spoken by physicians and languages spoken by their patient populations.
While it is fantastic to see language diversity within healthcare provider populations, it is important to understand that regardless of whether the languages spoken by physician and patient intersect, professional interpreters should always be used to facility patient/provider information.
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Professional healthcare interpreters have been trained in effective communication and medical terminology. They will not omit, editorialize, or offer advice. Certifying bodies and extensive testing ensure that professional interpreters are qualified to handle medical situations.
Studies have shown that the absence of professional interpreters can increase a patient’s length of stay in a hospital, and increase readmission rates. So while it is incredibly understandable that a physician (or any other bilingual individual in a healthcare setting) would want to address a patient in their common language, it is always more prudent to bring in a professional to aid in communication.
How to provide effective language access in a healthcare setting:
Historically, healthcare organizations have relied on onsite interpreters for their LEP patients, but in recent years, technology has emerged that allows interpreters to facilitate communication remotely. Below is a summary of the three main interpretation modalities, and some pros and cons of each.
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Onsite interpreting
This is largely considered the gold standard of interpreting. In this situation, the patient, provider, and interpreter are all in the same location.
Advantages
- This is fantastic for patient satisfaction, as the interpreter and patient are often able to form an empathetic bond.
- It is easy to understand non-verbal communication cues with all three parties in the same room.
Shortcomings
- Onsite interpreters are extremely expensive. Agencies often charge for session minimums and for transportation to and from engagements.
- Onsite interpreters are not an immediate solution. In an emergency situation, it is not advantageous to wait for an onsite interpreter to arrive to commence treatment.
Over-the-phone interpreting
In this situation, the patient and provider are in the same location, but the interpreter is dialing into the conversation via phone call. This call can be taken on a dual-handset phone, or over speaker phone.
Advantages
- This is an immediate and on-demand option. Since the interpreter does not need to travel, agencies can staff interpreters in a call center 24 hours per day, seven days per week, 365 days per year.
- This is inexpensive, as the overhead costs are very low.
Shortcomings
- The interpreter cannot access the nonverbal cues of the patient and provider, which can slow down communication and create confusion.’
Video remote interpretation
This is the most recent type of interpretation to hit the market. In this situation, healthcare providers can call interpreters into conversations via video technology, much like FaceTime or Skype.
Advantages
- This is an immediate and on-demand solution. Much like over-the-phone interpretation, interpreters can be made available 24 hours per day, seven days per week, 365 days per year.
- Patients and providers benefit from non-verbal communication.
- This is less expensive than onsite interpretation.
Shortcomings
- Remote interpretation is not good in group situations, and should be limited to uncomplicated, unemotional conversations. If it is a group therapy session or an end of life discussion, it is best to call in an onsite interpreter.
Healthcare facilities should be able to offer all three of these interpretation modalities to their patients. Over-the-phone interpretation can be used to communicate with patients at home, video remote interpretation can be used for quick, simple interactions, and onsite interpretation can be reserved for intense, lengthy, or emotional situations.
When it comes to providing quality healthcare, the gap between languages spoken by physicians and languages spoken by their patients shouldn’t matter —professional interpreters should be handling communication either way.
Photo: bowie15, Getty Images
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