While federal regulations requiring the use of certified hospital language interpreters are clear, the data on their benefit is more or less mixed.

Last April we reported on a study conducted at two pediatric ERs which revealed that mistakes with potential "clinical consequences," like giving the wrong dose of medication to a non-English speaking patient, were about twice as likely if there were no medical interpreters available or if the language translator was an amateur.

Then in June we posted a story concerning a new study suggesting that treatment of Spanish-speaking patients with limited English skills by doctors with limited Spanish-language proficiency can lead to clinical consequences.

Now in his Inside Medicine column, Dr. Michael Wilkes, professor of medicine at the University of California, Davis, confirms there are studies showing that more communication-related errors occur with non-English speaking patients, and their follow-up care is also poorer than for English speakers.

One report cited by Dr. Wilkes claims that more than 3,000 deaths are the result of communications breakdowns. The same report claims that the situation is even worse for care involving children.

Dr. Wilkes outlines the evolution of hospital communications. “Since the creation of the first American hospitals 200 years ago, doctors have managed to provide care to those who spoke English poorly or not at all by using hospital staff members and family. Then came phone (language interpreter) services and, more recently, video telemedicine (language interpretation).”

“I find the phone and video services a hassle,” Dr. Wilkes continues. “Patient care is episodic and takes place in stages: check-in, history taking, the physical exam, then a wait for lab results, and finally termination and discharge with explanations of diagnoses and patient instructions.”

“The (language interpreter) on the other end of the phone or video, needs to be available for all phases. It is no surprise, then, that official (language interpreters) require enormous hospital or clinic resources. It is also no surprise that this is an unfunded mandate, meaning that the rule is clear and must be followed, but there is no one to bill for the expense,” admits Dr. Wilkes.

So the question remains. Do hospital-based (language interpreters) allow for better patient care?

According to Dr. Wilkes, in some ways they certainly do. They allow for clearer communication by having a trained person (interpret) exactly what the doctor or patient says without paraphrasing or summarizing.

“(Language interpreters) also improve confidentiality by taking the family out of the middle of communications such as giving a patient bad news about a cancer or talking about topics such as a sexually transmitted disease or unwanted pregnancy,” writes Dr. Wilkes.

“But with patients at our hospitals speaking more than 60 different languages, it is not possible to provide (language interpretation) services for everyone. In these cases telephone or telemedicine is the next best thing,” he concludes.

By Alex Dupont
Marketing Communications Specialist
Language Translation Inc.

See Also

• More about language translation
  An accurate professional translation can save a patient's life, win a bid, or persuade a shopper to buy your product.
• More about language interpreting
  Effective medical interpretation helps build bridges to better health care.
• Inside Medicine: A growing language barrier in medicine by Dr. Michael Wilkes
  While the rules that require the use of officially trained translators are very clear, the data on their benefit is mixed.