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Lost in the translation: Ways to afford speaking your patients' languages

Physicians and hospitals struggle with a federal requirement to provide interpreters for non-English-speaking patients. Some have developed creative approaches.

By Markian Hawryluk, amednews staff. Dec. 2, 2002.

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In 1995, Primary Children's Hospital in Salt Lake City had a big problem: The number of non-English-speaking patients was surging, but the hospital couldn't afford to hire additional translators.

Then medical interpreter Lucy Cabal had a brainstorm. The Church of Jesus Christ of Latter-day Saints was full of young missionaries who had learned Spanish and other languages on two-year assignments to other countries. Cabal thought the missionaries might just be the answer to her prayers. She called a local newspaper.

"The article was published in the Friday newspaper. By Friday noon, I had 29 people call to volunteer."

The program has expanded to five full-time interpreters and 38 volunteers eager to maintain their language skills. The interpreters see almost 42 patients daily, translate discharge information, provide patient education for diabetes and asthma management, and conduct CPR courses.

Cabal's program is a prime example of the creative ways hospitals, physicians and other practitioners -- usually at their own cost -- are dealing with federal requirements to provide medical interpreter services.

Physician practices, already struggling with low reimbursement from public health programs, have turned to volunteers and community-based programs, and are developing other ways to ensure that their patients aren't lost in the translation. These innovative and creative solutions may serve as models for other physicians grappling with the cost and logistics of hiring interpreters.

The federal requirement for providing interpreter services stems from the Civil Rights Act of 1964, but was recently brought to the forefront by an executive order issued in 2000 by then-President Clinton. Policy guidance from the U.S. Dept. of Health and Human Services clarified that physicians who accept federal funds, such as Medicare or Medicaid, must provide language assistance at no cost to any patient with limited English proficiency. [...]