¿Tu hablo inglés?

What did you say? ¿Cómo? Many hospitals, emergency rooms, clinics, and healthcare personnel must deal with language barriers every day. With the numbers of immigrants in the United States increasing rapidly, the need for translators also increases dramatically. But, it seems that the lack of translators is not the problem, as is the doctors’ attitude towards using translators. In the article, “Lost in Translation,” physicians admit to not using translation services because it takes too much of their time, which can be used for more time with more patients. They admit to having a negative attitude toward employing translators when visiting patients in the hospital, even surgical patients. Dr. Pauline Chen, author of the article, when meeting with a Spanish-speaking patient after performing kidney transplant surgery, admits, “Pressed for time and acutely aware that a couple dozen more patients were always waiting, I never called an interpreter to Armando’s room during my daily rounds after his operation. Although interpreters were available at all times, it would take time, I thought, for one to arrive, and then the translation itself could slow things down.”

The article reports that there has been numerous research studies conducted on the use of translators and the effect of language barriers in healthcare. “…according to a new study published in The Journal of General Internal Medicine, doctors’ assumptions about communication — what they deem important in a conversation — may also have a role.” Dr. Chen says that although she would use translators to speak with patients about lab results, potential complications, or medication regime, she did not use them for “more routine checks.” She admits to “getting by” by feebly stumbling “through three, maybe four, words of Spanish.” In the recent study published by the Journal of General Internal Medicine, Dr. Alicia Fernandez and her research team at the University of California, San Francisco, studied language barriers at two hospitals with “excellent translator services.” Her study found that “While the doctors acknowledged that they were underutilizing professional interpreters, many made the decision not to call an interpreter consciously, weighing the perceived value of patient information against their own time constraints. Moreover, despite their personal misgivings, the doctors often felt that this kind of shortcut was acceptable and well within the norms of their professional environment.”

It seems clear from the results of the study that many physicians are bothered by the need for translators and see them as irrelevant and a waste of time. But what does this say about their attitude toward the patient? Does not their attitude toward using translators emote an attitude of resentment toward non-English-speaking patients? Do they not value their quality of life the same as those of English-speaking patients? Is it not the creed of physicians to “first do no harm,” regardless of race, creed, or in this case, language? Dr. Fernandez even admits about herself that she if “‘rounding late at night, (I) might just decide not to use an interpreter.” Through conducting this study, Dr. Fernandez realized that not employing the use of translators “‘…has become an acceptable shortcut in care. But the truth is that the patient deserves to speak to the doctor as well.’” She admits that this negative attitude towards using translators is not reflective of their feelings toward translators, their patients, or even their time pressures, but “yet “how we (as doctors) think about communication with our patients.”

According to the study, 43 percent of people in California do not speak English in their homes. So, the use of translators in a medical setting is critical to their ability to communicate with almost half of the California population. Too, not only does the doctors’ lack of translator use cause a problem, but the study also cites costs of translator services as a cause. Acknowledging this issue, Dr. Fernandez reports that “…many doctors simply do not have access to basic interpreter services…(however) California recently passed an unprecedented law mandating that health and dental plans supply interpreters and translated material to H.M.O. and P.P.O. patients.” Although this law may be a positive step towards increasing the number of translators in a medical setting, the article reports that “…still leaves a growing segment of the population – more than 20 million people in the United States – with inadequate care.”

If we are to improve quality of care for all United States residents, congress must acknowledge the growing need for quality healthcare for every one, even those non-English-speaking people. But where in the long line of problems with healthcare does the need for translators fall? With all the issues with healthcare today, including the millions of people without healthcare insurance, rapidly increasing nursing shortages, and the FDA coming under fire for controversial drug approvals, where does the effect of language barriers on quality of life fit in? What gets first priority? Not to knock language barrier problems or FDA drugs, but as one without healthcare insurance, I hope it is first in line. But that’s just my selfishness showing. Forgive me, I am working on it.