Language Barriers in Health Care : Interpreting Services

The National Counsel on Interpreting in Health Care is an excellent resource for answering questions that health care professionals may have about language interpreters.

Click here to see answers to common questions regarding language access services!

Knowing the patient population you will be serving before starting your rotation or job is extremely important! 

Find out the hospital's or clinic's interpretive resources for the LEP population before finding yourself face-to-face with a serious situation. This will impress your supervisor and prepare you for language barriers in the future.

If you would like more information on Interpreters, please visit: the U.S. Department of Health and Human Services' Office of Minority Health

When working with an interpreter, keep these points in mind: 

• Use trained bilingual/bicultural interpreters whenever possible.

• Allow extra time because everything has to be said at least twice. Explanations will generally take longer, especially if the patient is not knowledgeable about Western medicine.

• Before meeting with the patient, give the interpreter a brief summary about the patient and set the goals and procedures for the sessions. On entering the examination room, introduce yourself directly to the patient, allowing the interpreter to interpret. This helps to set the tone for the visit and establishes the health care provider as the one who is directing the interaction.

• Remember that some patients who require an interpreter may actually understand English quite well. Any comments you make to other providers or to the interpreter might be understood by the patient.

During the Interview:

• Document in your notes the name of the interpreter who interpreted for the patient.
• Face the patient and speak directly to the patient.
• Speak slowly and clearly. Don't raise your voice or shout.
• Sentence-by-sentence interpretation works best. Expecting an interpreter to remember long explanations is unreasonable and will lead to information being left out.
• Watch the patient during interpretation. This will allow you to observe the patient's body language and other behavioral cues. The bilingual/bicultural interpreter will be able to help you understand nonverbal messages.
• Allow the interpreter to ask open-ended questions, if needed, to clarify what the patient says.
• Use simple language and straightforward sentences. Avoid metaphors, slang, and jargon.
• Observe and evaluate what is going on before interrupting the interpreter, for example if the interpreter is taking too long to interpret a simple sentence; if the interpreter, outside his or her role, is having a conversation with the patient; or if there are no words in the target language to express what the provider said.
• Explain all medical terms in simple language, especially if the patient or the interpreter is not knowledgeable about Western medicine. It is the provider's responsibility to communicate with a patient at a level the patient can understand. The provider should not let go of this responsibility just because there is an interpreter in the triadic partnership.
• Question the interpreter if he or she seems to answer for the patient. The interpreter may have interpreted for the patient on prior occasions and be familiar with the history, but it is important that you obtain an accurate, current history.

Concluding the Interview:

• Always allow time for patients to ask questions and seek clarifications.

• Always ask the patient to repeat instructions to you to be certain he or she has been properly interpreted and understood.