How to Work with a Medical Interpreter

Although there are two national certification procedures for medical and healthcare interpreters, South Carolina does not have a regulation requiring their use. This results in many untrained bilingual people working as interpreters. Because they have not been properly educated or trained as healthcare interpreters, they often do things that professional interpreters would never do.

This creates confusion for case managers and other healthcare professionals dealing with interpreters. Here are some examples of actions taken by professionals that might be ignored by non-professionals doing the job.

Convey the entire spoken message:  The interpreter’s role is to serve as a conduit of communication. They attentively listen to the speaker, ensure understand the message, translate it, choose the appropriate words in the target language, and then generate the interpretation.

It is common for untrained interpreters unfamiliar with the code of ethics to hold a conversation with a case manager in front of the patient. Patients not speaking English might assume that they are talking about him.

Professional interpreters will provide a rendition for all statements, even bad jokes, the description of the TV show you were watching yesterday, or even the story of your son acting badly. Therefore, if you don’t want the patient to hear something, don’t say it out loud.

The same applies to the patient. If the patient tells me out loud, “That *%#* doctor *%$# my hand!”  It might just be that the patient didn’t intend for that vulgar statement to be repeated. Perhaps he was addressing it to the interpreter.  However, certified interpreters will provide a complete rendition of what the patient said.  Additionally, before the appointment, professional interpreters will provide the patient with a friendly reminder that all statements made will be interpreted.

Look at the patient:  Professional interpreters should be as invisible as possible. If you look at the interpreter and say, “As him what his pain level is on a scale of 1-10,” the interpreter might ask you to look at the patient and speak directly to him. It is just a simple matter of respect to look directly at the person to whom you are speaking, even when an interpreter is present. In this case, the patient, and not the interpreter, is being addressed.

Speak to the patient: This one is similar. Talk to the patient directly and not the interpreter. Think of the interpreter as a phone or a communication device. When you speak to the interpreter, you take away dignity from the patient.

Terminology:  In English, if you tell someone that a L4-L5 discectomy is recommended, they might not have any idea what is being said. Even more so with a patient using an interpreter. Expect that patients using an interpreter will need more clarification. Explaining things in a simple way can make working with an interpreter easier.

Opinions:  Interpreters are supposed to stay unbiased. They are not supposed to take sides or express opinions.

In the medical profession, it is common for case managers to ask doctors and therapist how the patient is progressing. Most case managers are aware that workers’ comp interpreters are aware of the progress. For this reason, they might naturally ask the interpreter how the progress is going. Ethically speaking however, professional interpreters recognize that they are not qualified to share an opinion on medical progress.

On the other side of the coin, patients will often ask the interpreter what he thinks about what the doctor is recommending. However, sharing an opinion can open up a can of worms and legal troubles for the interpreter not qualified as a medical professional. Most patients can seek out another doctor for second opinions, not the interpreter.

However, this is a common mistake among well-meaning bilingual people with no training or certification.

Leaving the room: You might notice that most hospital interpreters are never alone with the patient. They enter when a healthcare professional enters and leave when they leave. This is to keep the relationship with the patient formal. Often when patient and interpreter become familiar with each other, the interpreters unbiased position can be compromised.  Although many workers’ comp interpreters don’t observe such a rule, many certified interpreters choose to adopt it for the same reasons the hospital established it.

Hopefully these points can help you to understand why interpreters take certain actions.

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