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Patient/provider relations via medical interpreter

While meant to facilitate communication in hospitals and doctor’s offices, the fact that a third party is involved in very personal matters can often lead to awkwardness and even misunderstandings. Healthcare providers are well advised to educate themselves and their patients so both can reap the full benefits of having a professional interpreter assist during appointments and procedures.

The elephant in the room

As with the proverbial elephant, it is helpful to start by acknowledging the presence and clarifying the role of the interpreter at the very beginning of each meeting. Everybody will be more at ease if introductions are made and it is established what kind of interpreting services are required. For patients with little to no knowledge of English, the interpreter will translate consecutively what is said. This means that he/she speaks after the respective source-language speaker has finished, rendering the message in the target language.

Turning invisible

In this process, the consecutive interpreter will actually take him/herself out of the conversation as much as possible by translating in the first person. While such a linguistic device is not a cloak of complete invisibility, it does make the dealings between healthcare provider and patient as direct as possible. The interpreter relies on memory, so the segments need to be short enough to memorize. If the answer to a physician’s question is more complex—for instance if asking about a patient’s medical history—or the doctor or nurse is explaining a diagnosis or procedure, it works best if the speaker pauses after every other sentence to allow for translation.

Keeping it familiar

The interpreter can also serve as a comfort factor, especially if the patient is visiting from another country or seeking treatment abroad. The anxiety often associated with a doctor visit tends to be heightened in unfamiliar territory. In such a situation, the presence of someone who speaks your native language and knows the local customs and conventions will have a calming influence. Cultural differences and barriers can be more easily addressed and overcome, with the interpreter acting as intermediary. Even if the patient speaks basic or conversational English, having an “ally” who shares his or her native background will create a feeling of safety.

One-way might be the way

A patient in this kind of scenario may opt for having the interpreter translate only what the healthcare provider says and express him/herself in English. The interpreter will then stand by and assist if anything is unclear. This also works the other way around: Some patients may feel confident that they understand what is said but are insecure about their own language skills. However, if the care provider prefers that everything be translated, the linguist will proceed with the consecutive interpretation. The same applies if the patient requests that the interpreter only be present during the consultation and not during the exam or procedure. While the physician will in most cases grant the patient’s request to make him or her as comfortable as possible, it is ultimately the physician’s choice since the services of the interpreter are usually a requirement on the part of the hospital or practice to ensure effective communication. 

Party of four

That’s one of the reasons why some patients are actually surprised and—in most cases—relieved to find an interpreter when arriving at their appointment. Since they are not notified in advance, some bring a friend or caregiver to help with the translation. Pursuant to hospital guidelines, however, family members or friends of the patient should not act as interpreters, since the risk of mistranslation is too great. Errors can have serious consequences on diagnosis and treatment—and the healthcare provider must be able to rely on the language skills of the interpreting individual, which is only possible if the service is provided by a certified professional. But the cooperation between interpreter and caregiver can be valuable, since the person accompanying the patient is usually familiar with his or her medical history, allergies and prior doctor’s visits leading up to the appointment. The situation may sometimes be complicated by the fact that more than two languages are involved or the patient’s difficulty to focus on the interpreter, especially if the patient is elderly or a young child. Different scenarios may require different solutions. The interpreter will be glad to offer his or her professional opinion and always defer to what the healthcare provider deems best.  

Red tape

A patient’s Odyssey at a clinic or practice often continues beyond the end of his visit or procedure. The assistance of an interpreter may be needed even more urgently when the patient is dealing with office matters such as payment, scheduling, and insurance. Especially the latter can be quite complex and involve foreign language documents that need ad hoc translation. Medical interpreters are trained accordingly and will stay with the patient at the hospital or practice until all bureaucratic issues are solved as well.   

Jack of all trades, master of none?

In the daily life of a healthcare interpreter, he or she may spent one morning assisting in an MRI procedure, then move on to an OB/GYN appointment and finish the day interpreting in a neurological consultation. The terminological challenge is tremendous. Patient and medical staff must be aware that they cannot expect the interpreter to know every term in the book. Based on their experience and training, interpreters will have certain fields of expertise but are required to serve across the board, including questions of insurance and billing as mentioned above. All professional interpreters in the healthcare industry, however, are trained in general medical terminology, ethics as well cultural traditions and idiosyncrasies. They continue their education on an ongoing basis by attending classes and seminars and master the art of interpreting, which requires a high level of skill and concentration.

So when everyone is on the same page and knows what to expect, an office visit aided by a professional interpreter will be just what the doctor ordered.

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