Beware The Know-It-All Interpreter
By Dr. Alice Chen

Editor's Note: Ethiopian-Americans who are not proficient in English have the right to access interpreter services in hospitals, clinics and other health care settings. The following article discusses problems that arise when one is faced with a bad interpreter. Although Dr. Alice narrates her experience with a Korean patient, the problem is common among all immigrant communities, including ours.

When Mrs. Chon went to the doctor for the first time, she was exhausted and her whole body felt swollen. She had no insurance and had run out of her thyroid and blood pressure medications. But her biggest problem was that she didnít speak English and the doctor didn't speak Korean. Mrs. Chon talked to an interpreter. Instead of relating what she was saying to the doctor, the interpreter told her to stop complaining. "Everyone feels tired," the interpreter said. Mrs. Chon left her doctor's visit feeling discouraged, with no diagnosis or treatment. Several weeks later, Mrs. Chon came to see me at my clinic. As soon as I saw her, I knew something was wrong. She looked tired, and her face was swollen. I donít speak Korean either, but my clinic has trained medical interpreters available, so she was able to describe her symptoms to me in detail. I ordered blood and urine tests, and asked her to come back in one week. When I got the results back, I was shocked.

It turns out she had very low levels of thyroid hormone, one of the lowest levels I had ever seen. Fortunately, thyroid deficiency is something that can be treated easily by taking hormone replacement every day. After a few months of restarting treatment, Mrs. Chon felt back to normal. I was able to make a diagnosis and start treatment quickly because I could listen to and talk with Mrs. Chon. The interpreter didn't give medical advice or her own opinion, but instead focused on helping us communicate effectively.

I see lots of patients like Mrs. Chon, who often hesitate before going to the doctor because of language barriers. Little by little, things may be changing. More hospitals are recognizing the essential role trained medical interpreters play in health care. More clinics are realizing that not just any bilingual person can be an effective medical interpreter. Children, family members, and friends usually aren't familiar with specialized medical terminology in their own languages let alone in English. Nor have they been trained to develop the memory and communication skills needed to interpret accurately and efficiently. They make mistakes that can have serious and sometimes dangerous consequences.

If Mrs. Chon had had a trained interpreter the first time she went to the doctor, she may not have had to suffer those additional weeks. Trained medical interpreters are a critical part of the health care team, for both patient and doctor. Without them, we might as well be talking to a brick wall.

Ask for an interpreter if your doctor doesn't speak your language ‚ it could be a matter of life or death.

Copyright 2003 Pacific News Service. Dr. Alices's column brought to you courtesy of NCM.

 


Alice Huan-mei Chen, M.D., M.P.H., is a Soros Physician Advocacy Fellow based at the Asian & Pacific Islander American Health Forum, where she focuses on improving access to quality healthcare for limited English proficiency health consumers.