Healthcare providers have multiple challenges when working with Limited English Proficiency (LEP) patients. These patients come from a variety of cultural, socio-economic, and educational backgrounds. Consequently, breaking down cultural and language barriers with LEP patients requires additional effort in order to set the right expectations and provide adequate healthcare.
Title VI of the Civil Rights Act mandates that interpreter services be provided for patients with limited English proficiency who need services. Providing these services is also a way to ensure that your patients feel welcome and well cared for, and that your practice is protected. According to the American Family Physician, “The use of professional interpreters (in person or via telephone) increases patient satisfaction, improves adherence and outcomes, and reduces adverse events, thus limiting malpractice risk.”1
I have worked in the language industry for over 14 years, three of which I spent as a medical interpreter. This experience exposed me to various types of complicated situations, including routine medical exams, emergency procedures, and labor and delivery. Some of these situations were intense and challenging. They helped me to understand how a healthcare provider’s task of communicating and exchanging information with LEP patients would be very daunting without the assistance of qualified and professional interpreters.
Here are my top tips and advice for healthcare professionals when working with LEP patients and medical interpreters:
• Identify patients who may need an interpreter as quickly as possible
• Allow extra time for the appointment, if possible. Build rapport, and set goals
• Document the interpreter’s name and ID number when they arrive to the appointment
• Realize that most patients understand some English, so do not make comments you do not want them to hear
• Speak directly to the patient, not the interpreter. Use first-person statements (“I” statements); avoid saying “he said” or “tell her”
• Speak in short sentences or short thoughts
• Ask only one question at a time
• Allow appropriate time for the interpreter to finish each statement. Prioritize and limit the key points to three or fewer
• Do not use idioms, acronyms, jargon, or humor
• Insist on sentence-by-sentence interpretation to avoid tangential conversations
• Allow 10-minute breaks for every hour of interpretation
• Use the “teach back” or “show me” technique to ensure patient comprehension
It is always important to remember that in addition to acting as a conduit for the discussion, a medical interpreter may serve as a cultural liaison between the physician and patient. When a bilingual clinician or a professional interpreter is not available in person, phone interpretation service is crucial to have as an alternative backup.
Language Link has been providing medical interpretation since 1991, and supports over 2100 healthcare providers nationwide by providing access to 240 languages, 24x7x365. With connect times averaging just 20 seconds, Language Link telephone interpreting services are an essential tool in every healthcare setting.
