Brought to you by:

When was the last time you had to visit an Urgent Care as a patient? Perhaps it was for a COVID test or wrist pain following a trip and fall. Most likely you were a little stressed. Scared about the potential outcome (“What if this COVID test is positive…what does that mean for my young kids at home?” or “If my wrist is broken, how will I do my job if I’m in a splint for weeks?”) Now imagine you speak a different language than the clinic staff. Visiting an Urgent Care can be anxiety provoking on its own; add the stress of not feeling confident in your ability to communicate your reason for seeking care or your understanding of the diagnosis or plan and the experience is overwhelming. This common scenario is ripe for bad patient care and poor patient satisfaction.

We don’t want to provide subpar care just because a patient speaks a different language than us. And, in fact, it’s against the law to do that. Title VI prohibits discrimination on the basis of race, color, or national origin in any program or activity that receives Federal funds or other Federal financial assistance[1]. Persons with limited English proficiency must be afforded a meaningful opportunity to participate in programs that receive Federal funds (such as Medicare and Medicaid). 

Studies show that patients who speak a different language actually get much worse care. They are subject to 20% more labs, 66% less analgesia, 50% less patient satisfaction, and 50% less understanding of discharge diagnosis, treatment, and plan[2].  The legal standard and impacts on patient care make a clear case for the use of an interpreter for those who speak a different language. How should you implement this into your practice?

Best Practices for Using an Interpreter

  • Use a professional interpreter service and avoid using ad-hoc interpreters, such as a family member or clinic staff.

The use of a trained interpreter helps you be a better diagnostician. The subtleties of the history are often lost when using a family member or ad hoc interpreter. Studies comparing ad hoc interpreters to formal interpreters have demonstrated that ad hoc interpreters are twice as likely to make significant clinical errors. False fluency errors are a common error in interpretation when people are not actually skilled interpreters. Importantly, the use of a professional interpreter increases patient satisfaction, which leads to better comprehension and compliance with a treatment plan.

  • Professional video-based or in-person translation services are best practice when available.

Patients remember their discharge diagnosis and their discharge plan better if a video interpreter is used. Realistically, professional phone translator services are readily available and sufficient when video or in-person is not available. Do not use Google Translate which has been demonstrated to misinterpret half of discharge instructions[3].

  • Ensure that your discharge instructions are in the patient’s primary language.

In addition to using a professional translator, providing after-care instructions in the patient’s preferred language will facilitate better understanding about the diagnosis, treatment, and follow-up plan.

Introducing a professional interpreter helps close the equity gap between patients who speak different languages and patients who speak English. Put yourself in their shoes. Recognize that your patient is scared, unwell, deserves to be spoken to in their own language, and the numerous benefits of utilizing these services.

[1] Civil Rights Requirements: Title VI of The Civil Rights Act.

[2] PMID: 15894705PMID: 27789567, PMID: 11054199 

[3] PMID: 25512386