“So, how are we doing today?” Dr. N walked into the exam room and sat on her stool as the accompanying registered nurse followed her and shut the door.
The nurse waited for the patient to finish speaking in Japanese, then turned back to the physician. “The patient said she’s experiencing chest pain.”
“Okay, let’s see what we can do.” Dr. N began a full body examination on the patient, lightly pressing into different areas of the patient’s chest and abdomen. When she reached the lower right area of the abdomen, the patient winced and recoiled.
“Ma’am, this is not your chest,” the physician said, pointing to the area she was examining. “Why did you say that you were having chest pain?” The patient turned back to the nurse with a puzzled expression. The patient was treated for appendicitis later that day.
Language and communication are important elements of healthcare that are often overlooked. Physicians who encounter language barriers when treating their patients should make better use of trained health care providers, but several obstacles stand in the way. Extra costs to the provider and patient, as well as administrative issues in organizing interpreter services, are the most common reasons that many medical practices fail to fully utilize these services (Brandl
Despite the need presented by immigrant and multilingual patient populations, physicians do not use professional interpreting services enough in their standard care plans. As globalization has caused populations across the world to become increasingly interconnected, it is imperative that those seeking healthcare in countries foreign to them are accommodated with regard to their language. Misinterpretation and limited communication could have detrimental outcomes for the patient and physician. For example, an article discussing the use of medical interpreters in American outpatient practices found that one out of forty medical malpractice lawsuits were at least partly related to lack of proper medical interpreter services (Jacobs
In an online cross-sectional questionnaire-based study, 599 primary care physicians were asked to identify the main barriers obstructing them from using interpreter services in their practice (Jaeger
With these barriers present, it is not surprising that physicians fail to incorporate more interpreter services into their practice. Physicians often have crammed schedules that leave little time for organizing these services or lengthening the time of visits to accommodate for interpretation. Furthermore, patients who are treated in trauma centers or emergency rooms often do not have the time to wait for an interpreter to be requested. The previously discussed study shows that doctors recognize that these barriers exist and that they require addressing, but there still remains a significant gap between understanding and taking action.
Current policies and pilot initiatives to improve access to medical interpretation in the United States healthcare system have either been unsuccessful or only temporarily beneficial in providing patients and physicians with services as needed (Jaeger
One of these fourteen states is Kansas, which was the focus of research conducted by
To improve relationships between patients, interpreters, and physicians, it is imperative that translator diversity, access to interpreters, and holistic training for both physicians and interpreters increase. Making these revisions to the current medical interpreter system would positively impact non-native patients’ treatment and health outcomes. A review that examined the different outcomes of using trained medical interpreters found that a majority of studies showed an improvement in care and that additional costs are minimal compared to other healthcare expenses (Brandl
In order to gain a better sense of how medical interpretation works and the implications it can have today, we interviewed Dr. N, an internist with over 25 years of experience. During the interview, Dr. N explained that she now often turns to Google Translate in her practice, since her nurse-interpreter was transferred from her private practice to the main hospital. Although the hospital she works for provides trained medical interpreters, Dr. N prefers the ease of using this software and the endless selections of languages, which meets the needs of her diverse patient population. Google Translate is the most accessible form of language translation since it is available on the internet, in hundreds of languages. If this and equivalent online translators were utilized in medical settings, there would be no need to hire and train interpreters in multiple languages. Furthermore, the cited financial barriers and funding issues would be eliminated since the software is free.
Similar to Dr. N, many physicians began turning to Google Translate when trying to deliver care in the presence of communication barriers. An algorithm update in 2017 to Google Translate proved to be promising as instructions for patients after emergency department visits were 92% accurate when translated to Spanish and 81% accurate when translated to Chinese (Khoong
Despite technological advancements, Google Translate’s accuracy continues to be questioned. Miller
Translation software may be convenient and free, but it is also missing one of the most important elements of medicine: human connection. Dr. N frequently cited the importance of making patients feel comfortable and heard, despite language and cultural barriers that may be present. In fact, she stated “[as long as] you make them feel comfortable and relaxed, somehow you can communicate with them.”
Medical interpreters serve a crucial role in the healthcare system by bridging language and cultural gaps between patients and providers. Software programs could translate a doctor’s instructions verbatim, but doing so would lose the personalization required to communicate emergencies and instructions and empathize with the patient. Unlike trained interpreters, Google Translate and similar technologies do not see puzzled expressions, hear the pain in people’s voices, or ask if there are any more questions.
The medical and healthcare industries must work to create a space with palpable, comfortable forms of communication for patients who are non-native speakers. Whether it be through providing more funding for training and employing interpreters or starting programs similar to those of translating softwares, properly understanding the needs of a patient is a start to reaping more fruitful connections between the patient and physician, creating better interactions and outcomes for both groups of people.