Posted on 09/03/2003 5:19:04 AM PDT by Damocles
Posted on Tue, Sep. 02, 2003
Hospitals struggle with growing language barrier
Inaccurate translation leads to medical errors
LAURAN NEERGAARD
Associated Press
WASHINGTON - The nurse ordered an oral antibiotic to clear up the 7-year-old's ear infection. But the mother spoke no English -- and a bystander pulled in to translate told her to pour the drug into the girl's ears.
It was one of dozens of dangerous translation errors Dr. Glenn Flores uncovered when he taped exams of 70 Spanish-speaking children in Boston emergency rooms and clinics.
And that's just examining the nation's most common foreign language -- imagine the difficulty when a hospital encounters its first patient speaking, say a Hmong dialect of the Miao-Yao language of Southeastern Asia.
About 21 million people in the United States speak limited or no English -- 50 percent more than a decade ago -- and health workers are struggling to cope.
Hospitals "are reeling from the major change in the number and diversity of languages they're encountering," says Ellen Pryga of the American Hospital Association. "The reality is ... if someone shows up who needs services and doesn't speak English, you have to figure out how to communicate with them. It doesn't matter if they're the only one you've ever encountered who speaks Swahili."
Unable to hire an interpreter for every language, they're trying creative methods: volunteer translator clubs, telephone interpreters, teaching foreign phrases to doctors, and hiring bilingual nurses, clerks, even janitors who can translate in a pinch.
But the question is what works. Special training is probably crucial because general fluency in a language seldom guarantees knowledge of medical terms, says Yolanda Partida of Hablamos Juntos, a program started by the Robert Wood Johnson Foundation to improve Spanish health communication.
Hablamos Juntos is funding 10 experiments around the country to find innovative solutions, especially in rural areas like central Nebraska.
Six counties where the Hispanic population more than tripled in the 1990s are preparing to test a videoconferencing system that would let emergency rooms and maternity wards share 24-hour access to Spanish-speaking interpreters -- and train additional translators long-distance.
Doctors generally can't turn away sick patients because of language barriers. Civil rights law requires health facilities that accept any federal funding to make provisions for non-English speakers.
Just how many languages different facilities must be able to tackle, and using what methods, the law doesn't make clear.
But studies show many non-English speakers go without an interpreter -- and thus shun health care until they wind up in the emergency room -- or use untrained bystanders.
"The default position of many providers is to rely on family members and friends because that's what's convenient and the provider doesn't have to worry about how to pay for it," says Mara Youdelman of the National Health Law Program. "The end result is there are significant medical errors."
Interpreter services are supposed to be free to patients, but health workers report paying from $7 an hour to $50 an hour for professional interpreters. Medicaid [tax payer] allows states to draw federal matching funds to help cover the costs but only nine -- Idaho, Hawaii, Maine, Massachusetts, Minnesota, Montana, New Hampshire, Washington and Utah -- so far do. Pennsylvania and Kansas are preparing to.
"Ultimately this is costing the system more" to skip an interpreter, says Flores, citing research that found access to interpreters increases cheaper preventive care.
You said the magic word: motivated. What motivation is there when everyone translates everything into your original language? Answer: none. I wonder why Hispanic leaders/groups never seem to think that this makes their people look really stupid, especially considering that Spanish is considerable closer to English than Chinese or Russian?
What gripes the heck outta me is when they don't understand and can't speak a word of English but let their paychecks be late and it's amazing how much English they know.
Good for you! My wife is fluent in Spanish and she loves just laying back and letting people think she doesn't understand them, until she launches into them. She has surprised and embarrassed many by doing that and I always get a chuckle.
[I never noticed but you spell your name with a K just like Marx did]
The mandate for hospitals to provide free services could have worked as long as hospitals could charge other customers to make up the difference. It would have been immoral (theft), but it could have worked.
Under Federal, state, and local price controls, it cannot work. It is breaking hospitals all across the country, especially in rural areas and areas affected by illegal immigration.
Of course, our masters do not rely on such institutions for their own needs, so it doesn't matter.
The root of the problem, of course, is the unconscionable EMTALA, which is, unbelieveably, supported by many FReepers and others. EMTALA is looting, plain and simple, and it will eventually bring down the whole system if it is not repealed.
Maybe that's the point.
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