The question of whether language services are essential in hospitals in the United States is non-debatable. More effort needs to be put to increase these services in anticipation of increased demand for interpretation between the patient and the healthcare providers.
It is estimated that of all the residents of the United States, 18% of them have a second language in addition to English. Consequently, the American population boasts of having over 100 languages that are frequently spoken [Sobralske, et al, 2008]. Additionally, out of the total population of the United States, about 20 million people are categorized as having a ‘limited English proficiency; this segment was estimated to be about 8% of the population in the year 2000; this was an increase from 6% just a decade before. By all manners of measurement, the limited proficiency group is among the fastest-growing segment of the population in the United States [Dobson, 2007].
Apart from the growing number, limited proficiency patients offer unique challenges to the medical practitioner. First of all, the clinician has to extract information from the patient to enable the accurate and quick arrival at diagnoses; if the patient cannot communicate effectively; this very important step in medical treatment is made impossible. The doctor or nurse cannot get accurate medical history to make very important decisions regarding the treatment of the patient; consequently, persons with a poor understanding of English are overrepresented in misdiagnosed cases.
During treatment, information also has to come from the doctor to the patient; this information is usually complex and requires in-depth understanding; some may even be essential for the survival of the patient. The patient and/or the family may get confused by the complexity of the information; compounding this with a language barrier makes it even worse. Consequently, the right medication may not be bought or properly used. Additionally, the family may not be able to make informed decisions regarding consent to medical and surgical procedures.
Studies have shown that poor English-speaking patients are at a much higher risk of having potentially fatal events in American hospitals than the other patient population [Dobson, 2007]. This is attributed to the lack of trained interpreters in most American hospitals and clinics; the country’s health service has grossly underinvested in language services for its clients since only about 25% of all the health facilities have training programs for medical interpreters. Additionally, most healthcare workers do not have the training of working with medical interpreters; in most cases, a bilingual nurse act as an ad hoc interpreter on a case-to-case basis. During medical examination and treatment, the patient may be reluctant to admit his/her language limitations thus fooling the medic that s/he is understanding; additionally, many do not ask as many questions as they would if they had good English proficiency; thus leaving the facility dissatisfied {Sobralske et al, 2008]. There are obvious benefits of providing language services in healthcare settings; the patients’ safety is increased since proper diagnoses are made, and the patient understands all the medical information given. Additionally, such would reduce the time required to serve one patient; therefore allowing optimum utilization of hospital facilities.
In 2006, the Joint Commission of Accreditation of Healthcare Organizations released new standards that required all the hospitals to record the patients’ ethnic language and any need for language services {Sobraslske et al, 2008]. This is in the aim of providing optimum service that can transcend even the language barrier; this in my view is the step in the right direction in the healthcare system.
References
- Dobson Roger (2007): US hospital patients with poor English have more serious adverse events than proficient speakers: British Medical Journal 2007; 334:335.
- Sobralske Mary, PhD, RN. Ellen Raney, MD Brian Carino, MD (2008): Ethnic Diversity, Language Barriers, and Interpretation in a Children’s Orthopedic Clinic: Washington State University; Intercollegiate College of Nursing.