Have you ever thought about what it’s like to have limited English speaking skills? How would you handle things like a doctor’s appointment? There are things such as disabilities, and being a Limited-English speaking person (or LEP), which can affect your communication with your health care team and your access to support services. Today, we’re going to learn why an interpreter is a crucial part of health care for people who aren’t fluent in English.
18%, or 47 million people in 2000, spoke a Language other than English at home. 8.1% of the population, age 5 and older spoke English less than “very well” (2000 US Census)
A few years ago, our local clinic was getting a major renovation. For 2 years they jostled departments around and several times, even moved where patients checked in. When they moved the check-in desk from the 2nd floor to the 1st floor, I witnessed something that made me see how hard something as basic as a doctor’s appointment can be for someone who doesn’t speak English well.
I saw a little old lady who I would guess was from Russia or the eastern bloc. She made it all the way up to the second floor, pushing her walker an inch at a time, only to discover they weren’t doing check-ins there anymore. She tried to get the attention of the woman at the desk. Finally, the woman noticed her and said, “There was a sign downstairs. You have to go back down.” There was little sign of understanding. After some exchange, the little old lady returned to the first floor with great effort. Fifteen minutes later, she returned. Her doctor was on the second floor. She looked completely exhausted from the up and down and up again.
I imagined how hard it must be to immigrate as an old woman; a whole new country, a new language, and health problems, as well. She needed an interpreter.
Who has a right to a translator or interpreter*?
If you’re hearing-impaired, under Title III of the Americans with Disabilities Act (ADA), your health care provider must provide you with an interpreter, if you need one in order to clearly communicate with your healthcare provider.
Under Title VI of the Civil Rights Act of 1964, discrimination based on national origin is prohibited. Executive Order 13166 issued in 2000, says that people have a right to meaningful access to federally funded programs and activities. Many individual federal programs, states, and localities also have provisions requiring language services for LEP individuals. These provisions are valid, even in “English-only” states. For more information, check out the LEP.gov website.
*The difference between a translator and an interpreter is described well at Language Scientific’s website. Check it out.
What’s the process of getting a translator?
If you or a loved one needs these services, contact your health care provider prior to your appointment, to let them know. Don’t hire your own interpreter and expect to be reimbursed. Most medical facilities contract with a third-party company that provides translators and/or interpreters on an on-call, as-needed basis, at no cost to the patient. Covering the cost of the interpreter is one of the normal costs of operating a business for your clinic or hospital.
Just say “NO”
Occasionally, a health care provider may try to encourage you to bring a family member or friend to your appointment as a way to “save costs.” Say no. It is difficult for family members and friends to be neutral and properly translate everything they hear. It also puts an inappropriate burden on children who may be hearing something very frightening for them, such as the possibility that you have cancer, or that your disease is progressing. Using family and friends as interpreters can also have a negative effect on your patient confidentiality. Instead, if you are comfortable, bring a trusted friend to your appointment so they can keep an ear out for anything that might be lost in translation.
Also, Medical Interpreters are qualified in ways which even someone who is bilingual can’t compare to. They have expert knowledge of proper medical terminology, enabling them to facilitate communication effectively. This saves time and prevents medical mistakes based on miscommunication. They are also available on-demand, night or day.
“But I don’t need an interpreter.”
You may be wondering how this pertains to you. First, I hope that I’ve opened your eyes to something that many of us know little about. It also illustrates a picture of health care for all of us. It is a specialized area that many people don’t fully understand. It’s like they are speaking one language and the doctors are speaking another. This causes confusion and miscommunication. These are the root of many frustrations in life. Never be afraid to ask for clarification when you don’t understand something your doctor says or does.
For more information on using an interpreter see:
Office of Inspector General, Guidance and Standards on Language Access Services: Medicare Providers (Department of Health & Human Services)
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In 2012 doctors diagnosed my husband, Dan, with stage IV lung cancer. Since then, our family has been learning what it means to face cancer. I’ve focused my writing and speaking on helping cancer patients and their families advocate for themselves and live life to the fullest, in spite of their illness. My goal is to help people face cancer with grace.
My book Facing Cancer as a Friend: How to Support Someone Who Has Cancer, is available on Amazon.com
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