According to health policy research organization KFF, nearly half of immigrant adults in the United States have limited English proficiency (LEP), representing around 9% of the population. The top languages spoken by adults with LEP are Spanish, Chinese, Vietnamese, Arabic, and Tagalog, with nearly a quarter speaking a language other than these.
The American health system can be tricky for anyone to navigate. Imagine what it might be like to try to get the right care and treatment with a language barrier. Indeed, LEP has such an adverse impact that the lack of readily available interpreters is a medical ethics issue. Here, we’ll take a look at what a medical interpreter does, what’s necessary to get qualified, and what types of healthcare situations require interpreters.
What Is a Medical Interpreter?
A medical interpreter is a qualified professional who helps medical care providers communicate with patients who speak a different language. Interpreters must complete training and earn a certification, demonstrating high proficiency in two or more languages along with strong knowledge of medical terminology and concepts, as well as adherence to ethical standards. They might work in hospitals, clinics, telehealth settings, or emergency rooms.
A medical interpreter is not the same thing as a translator. While both rely on a deep understanding of multiple languages, the process and requirements are very different. Since interpretation involves spoken language, professionals must be able to switch between tongues without pausing to look things up. Translators, on the other hand, work at a very different pace, since they’re not providing an immediate response.
Interpreters are also expected to have high levels of cultural sensitivity, helping to build trust between patients and their care staff.
Key Responsibilities of a Medical Interpreter
When a patient doesn’t speak the same language as their care team, an interpreter must help doctors and nurses understand what the patient is saying, and vice versa. Examples of crucial points of communication include:
- Patients describing their symptoms to doctors
- Doctors explaining to patients how to take prescription drugs
- ICU patients’ families discussing end-of-life arrangements with hospital staff
Throughout all interactions, an interpreter must maintain not only accuracy, but also cultural relevance. From recognizing cultural-specific ways that patients may describe their symptoms (as with the cold and hot syndromes framework in traditional Chinese medicine) to acknowledging deeply rooted cultural beliefs around health (like the concept of the evil eye), interpreters build trust and cross-cultural understanding.
As with anyone working in the medical arena, interpreters must maintain confidentiality and adhere to standards like the Health Insurance Portability and Accountability Act (HIPAA). HIPAA compliance is always part of the medical interpreter job description.
Skills and Qualifications Required
Becoming a healthcare interpreter is much more complex than simply taking a few years of a language at a college level. The depth of fluency required is much greater, because people’s lives might depend on your ability to capture nuances and understand specific dialects.
If you choose this career, you’ll need to demonstrate:
- Strong proficiency in both source and target languages. This includes slang, colloquialisms, dialects, and other ways that communication may vary within a language.
- Knowledge of medical terminology and pharmacology. An interpreter in healthcare settings needs to know these at a deeper than basic level.
- Completion of training programs. Be sure to choose coursework that prepares you for national certification, such as ALTA’s medical interpretation program.
- Nationally recognized certification. Aspiring healthcare interpreters demonstrate their qualifications with certifications like CCHI and NBCMI.
- Soft skills. Active listening, neutrality, and cultural sensitivity are all very important.
The Impact of Medical Interpreters in Healthcare
A common result of a lack of language access is that LEP patients disproportionately use the emergency department (ED) in lieu of conventional primary care, indicating that these patients are losing out on proper preventive and early-stage treatment.
Better patient-provider communication helps guide patients through the health system, leading to improved patient outcomes, fewer medical errors, and better patient satisfaction and trust. In fact, the cultural sensitivity imparted by a professional medical interpreter can have long-lasting benefits, setting people up for more productive engagement with the health system.
Although it’s not commonly recognized as being part of the role of a medical interpreter, healthcare interpretation also helps medical caregivers who lack foreign language skills to improve their cultural competency, as the interpreter can explain certain cultural beliefs and expressions.
When Do Healthcare Providers Need a Medical Interpreter?
When hospitals fail to provide adequate language access, there can be severe legal consequences in addition to devastating consequences for the patient. This was the case for Cuban baseball player Willie Ramirez, who was suffering from food poisoning. His family told the Florida hospital staff that he was “intoxicado,” which the staff wrongfully assumed meant overdosing. Ramirez ended up paralyzed for life, while the hospital eventually had to pay his family $71 million.
A medical interpreter can both save a life and prevent a health system from engaging in medical malpractice. Under Section 1557 of the Affordable Care Act, qualified interpreters must be provided for LEP patients in discussions of diagnoses, informed consent, and similar scenarios if the provider is receiving federal assistance.
Does a hospital need an interpreter if the patient’s family and friends have the requisite language proficiency to help? Unfortunately, this could put the patient in an uncomfortable situation, potentially discouraging them from revealing important symptoms. As a neutral third-party, a professional medical interpreter is more likely to foster trust and openness.
Will AI Replace Medical Interpreters?
Good interpreters, particularly for lower-density languages like the Mayan languages of Guatemala, can be hard to come by, prompting many people to wonder whether AI might bridge the gap.
AI has too many shortcomings to be a reliable medical interpreting solution. The technology confuses words frequently, lacks cultural sensitivity, and also fails to take into account where a person is pointing (to indicate the source of pain, for example).
Perhaps most importantly, AI doesn’t know what it doesn’t know. A human interpreter would admit when they don’t understand, but AI just keeps going, giving incorrect translations with the utmost confidence.
Similarly, one of the key medical interpreter responsibilities is to let the physician know when a patient isn’t understanding certain information. Failure to understand pre-operative instructions or pharmaceutical dosage can be fatal. An AI system wouldn’t be able to detect a lack of understanding.
Medical Interpreters Play a Vital Role
Medical interpretation, performed by real human interpreters, can save a life. So, if you’re a doctor trying to improve language access for LEP patients or a student interested in becoming a medical interpreter, know that the need for medical interpreting services remains high, even in the age of AI.
If you’re a healthcare provider looking for qualified professionals to support clear, culturally sensitive communication with LEP patients, consider working with ALTA. We provide onsite, face-to-face interpretation as well as over-the-phone and video remote interpreting services for telehealth. We also train! Whether you’re just getting started, studying for your national certification, or earning credits to keep your certification, ALTA’s interpreter training courses let you advance your career at your own pace and on your schedule. Healthcare systems with a large number of bilingual staff members can take advantage of our group training to build a community of interpreters onsite.
Author: Robin Kallsen
Robin Kallsen is a freelance copywriter based in Seattle who also works as a musician and Pike Place Market busker. With a love of language learning and world music starting in childhood, she frequently sings in languages like Spanish, French, Russian, and Romanian and strives to create rhyming, singable English translations of her favorite foreign-language songs.