Language Barriers in Medicine: The Prescription for Better Communication
According to the United States Census Bureau, the number of people ages 5 and older who spoke a language other than English, grew by 140% from 1980-2007, while the nation’s overall population only grew by 34% in the same three decades. Spanish speaking Latinos accounted for the largest numeric increase, accounting for 23.4 million more speakers in 2007 than in 1980. This unprecedented increase has drawn attention to the Latino community within the United States, with special consideration to the medical needs of this growing population subgroup.
Proper communication of medical information between health care providers and patients is an extremely important component in assuring the quality and safety of medical care. While it is the goal of achieving a mutual level of understanding between providers and patients, research studies in the United States have shown that language barriers between Spanish speaking patients and non-Spanish speaking health care providers commonly exist and have a large impact on the care provided and received. Impacts such as inadequate treatment, poorer patient compliance and decreased patient satisfaction, can ultimately lead to the dangerous consequences of patient harm. Inability to communicate effectively also creates mistrust in the provider-patient relationship, impacting future medical care as well. In light of this, both health care providers and patients within the Latino community are now voicing justifiable concerns over this language issue.
While many factors may contribute to this problem, the most successful means of alleviating this is through well-informed and knowledgeable patients. Understanding your rights as a patient is key to successfully obtaining appropriate resources to maximize medical care. According to the United States government; Title VI, the Civil Rights Act of 1964 prohibits exclusion from services and discrimination on grounds of race, color or national origin. This act is designed to also include and protect; non-English speakers or those with limited English proficiency from exclusion and discrimination. Currently the New York State Department of Health requires that each hospital must make appropriate staff available, such as interpreters and translators, to help explain or answer any and all questions about a patient’s rights and the care they are receiving while hospitalized. Any and all information given to the patient in regards to their medical care must also be provided not only in a language of their choosing, but also in a manner and context best understood by the patient. This must be done in order to allow for the most informed decisions to be made by the patient and their family with regards to their medical care.
It is therefore strongly advised against using informal means of interpretation in any clinical setting. This includes the use of bi-lingual family members, friends, hospital staff, medical students or physicians with limited language skills to interpret and/or translate information during medical encounters. Patients have the right to request a medical interpreter at anytime, even if they speak any amount of English at all. Requests for medical interpreters cannot be denied by any hospital staff, but may require some advanced scheduling in the setting of outpatient appointments. Skilled translators must also be provided to assist the physician and the patient in any translations or written transcriptions of important hospital forms or instructions if needed. Patients may also reserve the right to refuse any medical interpreter either present face to face or over the phone and can request a different interpreter or mode of communication be used.
While the use medical interpreters may not be a purely objective or neutral process, it remains the best option for limiting the opportunities for medical errors based on communication, thereby ensuring patient safety. Recent studies on the use of medical interpreters have shown an increase in effective communication, understanding of medical information, compliance with treatment along with better physician-patient coordination and satisfaction. Therefore the comprehension of patient rights by the Latino community and the physicians that serve them, along with the use of medical interpreters is the best prescription for safer and more effective medical care and communication.
For more information on free language assistance near you, the New York State Health Department hotline can be reached at (518) 486-1812, and for more information on “Your Rights as a Hospital Patient in New YorkState”, please visit www.health.ny.gov/publications/1449.pdf
Mykael Louis García was born and raised in Rochester, New York. He attended Boston College, graduating with a Bachelor of Science in Biochemistry and continued his education at the University at Buffalo for his post-baccalaureate training. He is currently a fourth year medical student at the University of Rochester School of Medicine and Dentistry, where he is the student coordinator for the university’s Latino Health Pathway, as well as an active member is the school’s local Latino Medical Student Association (LMSA) chapter, a national organization whose mission is to educate and advocate for the health needs of the Latino community. LMSA members, including him, are contributing to CNY Latino by raising awareness regarding the many health issues affecting the Latinos of Central NY and beyond.