The right-minded are always telling us to “talk to your doctor”, and become a partner in your own treatment. Fine, but what if you can’t, because you don’t speak the same language, quite literally? The New England Journal of Medicine has an article in the July20 issue on the mischief such mutual incomprehension can cause, and on the need for skilled translators. The use of family or friends as linguistic stand-ins can be risky too, and may only make a bad situation worse. A clinician might be better off in the dark about a patient, than be misinformed by well-intentioned but unskilled attempts at interpreting by family, friends or some guy off the street. Then, too where do you stop? A program to pay interpreters in Spanish might be very useful, almost everywhere. But many people from Latin countries don’t speak or read “Spanish” with real competence. They speak local dialects and Spanish is a second language. What about Chinese? Vietnamese? Igbo? Uzbek? In New York City, maybe yes. But in Lincoln, Nebraska the number of Uzbekis is probably pretty low. I’ve never been to Lincoln and I don’t know any Uzbeks, so I’m guessing. So where do you get “qualified interpreters” and what does that mean? A Spanish major may be able to read Lope de Vega, but can s/he describe the benefits and risks of a procedure? You can put this one in the “Never happen” column. Hospitals are cutting services like mad,things like diabetes counseling, because they don’t pay,and won’t shell out for something like this. If somebody showed up who could speak expertly ten or twelve languages native to, say, three or four geographically distant areas (such as Asia and Latin America) , and who had enough intelligence and sophistication to be useful in handling medical/scientific discourse, and who would be on call, never fail, around the clock throughout the year, and who wouldn’t ask to be paid anything, well then maybe the hostpital would give him/her a “volunteer” status and a free pass to the cafeteria.Maybe. Otherwise, no.
Language Barriers to Health Care in the United States, by Glenn Flores, M.D.
NEJM Volume 355:229-231 July 20, 2006 Number 3.
PS: Before the zombies come after me, I want to make it clear that I think Dr. Flores is right But being right is often not enough.