New York Times Columnist Discusses 'Complex' Issues Surrounding Use Of Interpretation Services

Main Category: Primary Care / General Practice
Also Included In: Public Health;  Medical Students / Training
Article Date: 27 Apr 2009 - 4:00 PDT

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New York Times columnist and physician Pauline Chen examines a new study by researchers from the University of California-San Francisco and at Yale University that examined language barriers between patients and doctors of health providers at two teaching hospitals. Chen says that the study shows a "complex" situation where many of the doctors opted against using trained medical interpreters, even if they were available, because of "their own time constraints." She writes that "despite their personal misgivings, the doctors often felt that this kind of shortcut was acceptable and well within the norms of their professional environment."

According to Chen, "Doctors will triage their conversations with patients, categorizing discussions about advanced directives or risky medications as 'high stakes,' and those that occur during routine rounding on a stable patient as 'low stakes.'" She continues, "Doctors will then tend to use interpreters in 'high stakes' conversations but will muddle through 'low stakes' topics themselves, resorting to gestures, mimicry or bilingual family members in order to communicate." Chen describes one particular experience she had with a patient, writing, "Although interpreters were available at all times, it would take time ... for one to arrive, and then the translation itself could slow things down" when a "couple dozen more patients were always waiting."

Chen writes that doctors' assumption that conversations during routine exams are not "important" enough for an interpreter might play a role in the health care disparities that non-English-speaking patients face.

The authors of the study noted that while time and costs can affect a physician's decision to use interpretation services, improvements need to be made to ensure that interpretation services are a more centralized and easy option for physicians (Chen, New York Times, 4/23).

An abstract of the study is available online.

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