With some states now requiring hospitals to provide trained medical interpreters for non-English-speaking patients, the likelihood that clinicians will partner with professional interpreters is rising. Experienced medical interpreters offer tips on how clinicians and interpreters can work together for the benefit of their patients.
Recognize the Value of Trained Interpreters
Using trained medical interpreters results in more accurate diagnoses and better patient compliance, says Edgardo Garcia, translation services director for Children’s Medical Center Dallas. Trained interpreters are consistently better at facilitating communication between non-English-speaking patients and providers than patients’ relatives and children, who are often unreliable in interpreting complex or sensitive medical information, notes Sue Prieto, coordinator of interpreter services at Mount Auburn Hospital. Medical interpreters can also sometimes bridge patient-provider cultural gaps. “We don’t have to wear white coats, but a good, trained medical interpreter can be one of your best team members,” Prieto says.
Call Them Early
The earlier a medical interpreter is involved in a non-English-speaking patient’s care, the better. Ideally, a patient needing an interpreter will be identified when he registers, so an interpreter will be scheduled for all his appointments, Garcia says. If that doesn’t happen, however, clinicians should still call an interpreter as soon as they realize the need. It’s worth waiting for the interpreter to arrive, since the encounter will probably go more smoothly and quickly with an interpreter present, Prieto says. Many hospitals use video or telephone interpreters, so if a live interpreter can’t get to an appointment quickly, start with a remote interpreter and then switch to a live interpreter, Garcia recommends.
Take Time to Prepare
It’s useful for the interpreter and clinician to have a short preconference before seeing a patient to clarify the goals of the appointment and what will occur, Prieto suggests. A preconference could also help bridge cultural gaps. Prieto recounts how a Hindi medical interpreter was on duty for a basic physical exam of a 70-year-old Indian woman. The doctor was taking the woman’s history, asking her questions about the number of sexual partners she’d had. “If the doctor would have had a minute to discuss it with the interpreter before walking into the room, the interpreter could have told the doctor that females of this culture in this age group will be very hesitant to answer such questions,” Prieto says. If the doctor were receptive to the interpreter’s insights, the interpreter could have suggested ways in which to obtain the information in a culturally sensitive manner, Prieto says.
Speak Directly to the Patient
Even though an interpreter is in the room, on screen or linked via audio, clinicians should speak directly to the patient, not the interpreter. “The patient and provider have to understand that they are talking to each other,” Garcia says. “They should be looking at each other like they’re speaking the same language.” A trained medical interpreter will speak as the doctor and patient. “I always use the first person,” says Arthur Kaplan, a Russian-language medical interpreter for Language Access Network, an audio and video interpretation company. “If the doctor says, ‘How are you doing? Why are you here?’ I act as the doctor. I never say ‘the doctor says.’ Then I respond as the patient does, with ‘I have a pain in my heart’ or whatever words the patient uses.”
Use Short, Simple Sentences
Speaking in short sentences allows for complete and accurate interpretation, Garcia says. “Even though an interpreter is trained to develop a good memory, we cannot keep up with everything when a provider keeps on talking,” he says. The preferred method for medical interpretation is consecutive rather than simultaneous interpretation, which can be distracting, Garcia notes. Providers should also avoid using complicated medical terminology. Although trained medical interpreters can interpret that information, technical jargon can be confusing. “Interpreters will sometimes stop and say, ‘The patient looks confused. Can we say it this way instead?’” Prieto says. And a provider shouldn’t be surprised if an interpreter asks him to slow down or repeat critical information, such as medication names and doses, Kaplan adds.
Choose Your Interpreter Carefully
Providers in states that don’t require trained medical interpreters in hospitals should never use minors as interpreters, Prieto cautions. And if bilingual hospital staff will be interpreting, they should be trained just like other medical interpreters. “Bilingual ability doesn’t equal trained medical interpretation,” Prieto says.