Language Access and Medical Schools

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Gaurab Basu, MD, MPH, Vonessa Phillips Costa, and Priyank Jain, MD have contributed a valuable commentary to the American Medical Association’s Journal of Ethics regarding the use of medical interpreters.

In it, they present a case in which a medical student encounters an LEP patient on a rotation with resident physicians. The student speaks the patient’s preferred language and intervenes, explaining to the uncomfortable patient that she is part of a teaching session, and is then scolded by the resident physicians for conversing with the patient in a language they cannot understand. The student worries that this may have a negative affect on the outcome of his matching in his specialty to continue his education.

In the commentary, Drs. Basu Costa, and Jain use a rights-based framework “to explore the legal and ethical responsibilities that health care professionals have to their patients with limited English proficiency (LEP)“ and then use the NCIHC’s national standards as the basis of their argument that in this case, the medical student was put in a difficult situation that resulted in his acting as ad hoc interpreter, which the physicians deem inappropriate. They also argue that “good informed consent is impossible without the use of a qualified medical interpreter.“

The physicians successfully authored a commentary geared toward fellow healthcare practitioners that may bring new attention to a perhaps under-explored topic in their realm, that is, language services. They propose that hospitals „employ qualified medical interpreters in the major languages of their patient populations and contract with telephonic or videoconference services for access to additional languages on demand.“

However, if it were simply a matter of enforcing a patient’s right to an interpreter, these kinds of scenarios would not be happening at such a shocking frequency as we experience in our industry. They are in many areas not the exception, but rather the rule.

We do agree wholeheartedly with the statement that “Medical educators have a responsibility to role model medical professionalism, to teach students about patient rights, and to create a healthy learning environment.“ This suggestion is perhaps a much more realistically-implemented solution than their assertion that “interpreter services should be easily accessible at all points of care via in-person, telephone, or videoconference technologies, and these services should be advertised to the clinicians and patients.“ (This is obviously something that we are all in favor of—but how do we implement it across the board?)

This article is a blessing to medical students and healthcare providers who themselves can perhaps relate to the student’s dilemma, if not the patient’s discomfort.

We want to take it a step further and provide some concrete steps toward overcoming the lack of availability or utilization of qualified medical interpreters, from the front lines of the language services industry.

See the first-hand recommendations from interpreters, language access coordinators, hospital administrators, and interpreter trainers here.

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