Interpreters Create a Healthy Dialogue

Imagine being injured and unable to communicate with your doctor—not because you are incapacitated, but because you do not speak the same language. For millions of people in the United States who speak little or no English, this scenario is a reality.

Research has shown that language barriers affect the quality of care a patient receives. However, medical (or health care) interpreters can help bridge that language divide, making communication between providers and patients possible.

In the United States, the need for medical interpreters is growing. The most recent U.S. Census data shows that there are 381 languages spoken across the country, and nearly 20 percent of the population speaks a language other than English at home.

Efforts by EDC to address this need span more than 15 years. “Our work with medical interpreters actually addresses civil rights law related to access of care for people with limited proficiency in English,” explains Maria-Paz Avery, who has led EDC’s work in this area.

While some facilities have on-site medical interpreters, others rely on freelance interpreters or interpreters who are reachable by phone. All interpreters, however, require more skills than just being bilingual. They must have knowledge of the health care system, including insurance procedures and terminology; an understanding of basic anatomy and physiology; the ability to assist providers and patients in overcoming cultural barriers; and a commitment to ethics and confidentiality. Most importantly, they must be able to convert messages spoken in one language to an equivalent message in another language in a matter of seconds.

“Interpreting is not about substituting one word for another in a different language: It is about making the meaning of the speaker accessible to the listener even when there is no direct equivalent of concepts across the two languages or cultures,” explains Avery. “There is a lot of technical language, and interpreters need to have a level of proficiency in both languages as well as an understanding of the influence of culture in order to do a good job going from one language to the other.”

Recently, Avery was part of a team that conducted an evaluation on language access and interpreter training in health care. This research, supported by the New York State Department of Health and led by the Center for Women in Government and Civil Society at the University at Albany, SUNY, examined the skills interpreters need to possess and how best to develop these skills through training programs. Among the key findings were that a lack of resources hinders health care providers from making language assistance an integral part of their services, and training programs that use skill-building strategies such as role plays and case scenarios are the most effective.

EDC’s work to prepare medical interpreters began in 1995, when the organization led an initiative to create a community college training program. This work ultimately led to a partnership with the Massachusetts Medical Interpreters Association (now called the International Medical Interpreters Association) to develop standards of practice for the field. Translated into multiple languages and used around the world, these standards were instrumental in professionalizing the field.

“Much work still needs to be done in continuing to evolve a set of standards that is inclusive and culturally responsive to the specific contexts and needs of the many cultural/linguistic communities that depend on interpreter services to access quality health care,” wrote Avery in the preface of the standards.