A Matter of Interpretation?

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<p>Approximately 47 million people in the U.S. speak a language other than English at home, and more than 21 million have problems speaking or understanding English. When seeking health care, patients with limited English proficiency often have worse access to care and lower satisfaction levels compared with English speakers.<br><br>A recent special supplementary issue of the <em>Journal of General Internal Medicine</em> examining language barriers in health care includes <a href="/publications/in-the-literature/2008/jan/language-barriers-in-health-care--special-supplement-to-the-journal-of-general-internal-medicine
">three Commonwealth Fund-supported studies</a> that focus on medical interpretation methods and practices:<br><br><strong>The Impact of Medical Interpretation Method on Time and Errors.</strong> Francesca Gany, M.D., M.S., of New York University School of Medicine, and colleagues report that the use of remote simultaneous medical interpreting (RSMI)--the interpreting style used by the United Nations--results in fewer medical errors and is faster than three more commonly used interpreting methods. The analysis shows the non-RSMI interpreting approaches were associated with a 12-fold greater rate of potential medical errors of moderate or greater clinical significance, compared with RSMI.<br><br><strong>Patient Satisfaction with Different Interpreting Methods: A Randomized Controlled Trial.</strong> Gany and her fellow researchers evaluated patients' satisfaction with several common medical interpreting approaches, including RSMI, proximate consecutive interpretation (where the interpreter is in the room with provider and patient), over-the-telephone interpretation, and ad hoc interpretation by family, friends, or untrained hospital staff. Seventy-one percent of patients who received RSMI reported that doctors treated them with respect, compared with 64 percent of patients who received the other methods. Patients also rated RSMI better at protecting their privacy.<br><br><strong>Providing High-Quality Care for Limited English Proficient Patients: The Importance of Language Concordance and Interpreter Use.</strong> Quyen Ngo-Metzger, M.D., M.P.H., of the University of California, Irvine School of Medicine, and colleagues find that Chinese and Vietnamese patients with limited English proficiency reported receiving less health education and worse interpersonal care compared to patients with providers who spoke their language. According to the authors, "Having an interpreter present did not mitigate this effect, but in fact appeared to exacerbate it."</p>