Working Through Language Barriers
Imagine: You wake up one morning feeling absolutely awful. Your body aches. Your nose is running. The room feels like it’s spinning. You’re afraid if you try to eat breakfast you won’t be able to keep it down. You get your spouse to drive you to the doctor. You approach the front desk and try to check in, but the girl behind the glass just stares blankly at you, not understanding a word you are saying. She speaks back, and you also have a hard time understanding her. Another young woman approaches and speaks to you, her words garbled. You understand most of what she says, but she has a hard time understanding you. Finally, after a struggle, you get checked in and sit down in the waiting area. You wait and you wait and you wait… and finally, someone calls your name and you head back to an exam room. You go through all the motions. They record your height, weight, blood pressure, temperature, heart rate, the usual. The nurse asks why you’re in today, at least you think so. You try to explain it to her, but there is still trouble understanding. You pantomime your symptoms, gesturing to what feels bad and she writes down what she can. The nurse leaves and you wait some more until the doctor finally shows up. All you want to do now is sleep. You are tired, and frustrated, and you feel so terrible… And you just know this conversation with the doctor isn’t going to go well. And similarly to your encounter with the nurse, he struggles to understand you and you struggle to understand him. You leave the office just hoping that he understood what you were trying to say so that you can start feeling better.
Doesn’t that sound awful?
This is a situation that many Limited English Proficient (LEP) people living in America struggle with when they go to get healthcare. Not every office or clinic has staff that are fluent in other languages. Many people, if they can speak another language, speak it at an elementary level at best. With this in mind, you can imagine the struggle of a non-English speaker trying to communicate what is wrong with them to someone that doesn’t understand them and that they don’t understand.
So, how do we handle these situations when they arise?
Really, this just depends on the percentage of LEP people that live in your community and how frequently they visit your clinic. If you have a high number of LEP people visiting your facility, then you should probably invest in hiring an interpreter for your clinic. Some LEP patients may visit you with a relative that speaks better English than they do, but relying on a patient’s family member to translate isn’t recommended. Translations can be faulty and are being filtered through a biased opinion, so it is best to have an unbiased professional on your team. For clinics that don’t have a high number of LEP patients, there are services available that offer video call translators. You must be wary of these and ensure that they are working through a reputable source. You wouldn’t want to use someone unreputable that would share the sensitive medical information of your patients.
It is also important to provide medical paperwork in a LEP patient’s preferred language. They need to be able to read what they are filling out and signing, as well as whatever they may receive from you about their diagnosis.
Never charge a LEP patient for any language assistance. And more importantly, never turn away a LEP patient that comes to you for medical care just because you cannot understand them as that is a civil rights violation for the Department of Health and Human Services.