One important point to consider is that a trained interpreter is present to merely interpret what is being said, maintaining the register used by the medical staff, Dr. Cortés says. That said, sometimes interpreters are the physicians’ lifeline in terms of understanding what a patient is saying—or not revealing, Dr. Schned says. “I’ll often talk to the interpreters privately. They can tell me what they sensed from the patient,” he says.
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Explore This IssueJanuary 2010
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However, solid training as both an interpreter and in medical terminology is crucial. Sometimes, interpreters who have not had proper training will even make mistakes, Dr. Cortés says. For example, they may feel uncertain about asking the physician to stop talking so they can provide an accurate translation. Other times, they may misinterpret information. “A nurse was commenting on a patient’s blurry vision and said it could be part of uncontrolled diabetes. The community health worker [incorrectly] told the patient that she may have diabetes in the eye. However, that’s what that person thought the nurse actually said,” Dr. Cortés says.
Other times, translators are flummoxed by medical words that are nearly impossible to translate.
Even though the time crunch added with a translator in the exam room may present a scheduling squeeze, it’s important for physicians and other medical workers to respect that additional time, says Conceicao. She has seen patients overwhelmed by caring for their health problems or those of their children, and they additionally feel scared because they may not have health insurance or may be in the country illegally. The language issue is just one more stressor.
“Besides not speaking English, these patients are already overwhelmed,” she says. “Doctors should speak slowly for the translator’s accuracy.”
Culture and Literacy Also Play a Role
Culture and literacy are also sometimes intertwined with language barriers. Culture affects patients’ ability to understand what their rheumatologists are telling them. “Culture may be more important than language,” says Dr. Onel.
For example, says Dr. Robbins, a patient with a swollen joint that’s hot may believe the joint needs something cold, like a cold compress, because this would be the typical treatment in their culture. They may have trouble understanding the idea of using a heating pad. Other cultures may be hesitant to discuss certain symptoms because of a stigma that surrounds them—but not discussing those symptoms impedes their possible treatment. Sometimes, patients may not even be aware of how their culture is affecting their perception of their care, Dr. Ginzler says.