Friday, February 04, 2005

Safe Communication with Non-English Speaking Patients?

Today I observed yet another very interesting situation. While I was seated with my son in our pediatrician's waiting area I noticed that some of the patients also waiting to be seen by the doctor on that day seemed to be of Hispanic descent. As waiting mothers and fathers and their children were interacting with eachother they were speaking in Spanish to eachother.

Since the Hispanic population here in our corner of New England is ever increasing, I was not particularly surprised. However, having been with this pediatricians group for years, and knowing that there isn't a single staff member in this office that's of Hispanic descent, I couldn't help but wonder how their medical office staff might be handling the ethical and legal obligations of adequate patient-doctor interaction and interpersonal communication with their Hispanic patients without a bilingual staff member or interpreter aboard.

This situation is by no means new to me. More and more Spanish speaking patients are being seen by our doctors due to the large number of Hispanic families. What's interesting is, that I once have worked for a physician who felt that it was the patient's responsibility to make sure they bring along their own interpreters, such as a family member, to translate during their appointments. In many cases this was another family member, often a child (!!!), a neighbor, or friend, which caused me to question whether this was risky not only for the physician, but equally for the patient as well.

Personally, I do not agree with such an approach. In my opinion, only a trained person that is proficient in interpersonal communication, and proper knowledge of the foreign language, medical terminology, and health care related issues should be utilized to communicate and translate between physician, patient, and medical office staff. Otherwise, when you allow an untrained person, such as a family member, friend, or neighbor to come in and translate during a medical interview, you accept the risk of communication errors during such ad hoc interpretation and a chance on breaching confidentiality laws.

I take proper interaction, precise communication with patients, and patient confidentiality very serious. Proper communication plays a key role in properly diagnosing, treating, and caring for patient's needs. If Spanish, or any other foreign language, is the preferred language, or only language, of a patient who is seen in a medical office, then not having a bilingual staff member, or a trained translator available puts everybody at risk, and possibly the patient into harm's way.

Granted, ultimately it is the physician's responsibility to properly communicate with the patiens, but we, as the medical assistants, are also affected by with this unique dilemma of not being able to meet our responsiblities toward the patients unless we can communicate with them properly, and maintain confidentiality. As responsible and concerned health care professionals we sould keep in mind that trained translators have ethical and legal responsibilities regarding the physician's obligations toward the patients, where as a patien's family member, friend, or neighbor doesn't. Therefore there should be no question in any physician's and medical office staff member's mind that having a bi-lingual staff member available to translate, or utilizing one of the many available professional medical translation services to communicate with non-English speaking patients is the safest policy, and simply the right thing to do!!!

How is this situation being handled in your medical office or clinic where you work? Please comment!

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