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Interpreting in Medical Settings

DHHAP Information and Technical Assistance Series

Interpreting in Medical Settings
(Source: Registry of Interpreter´s of the Deaf, Inc.)
Interpreting In Medical Settings
In medical settings, effective communication between consumers and health care professionals is essential. When the health care professional and the consumer do not share a common language or communication method, communication presents a challenge. The communication gap may be between the medical professional and a patient who is deaf or between the medical professional and a responsible person other than the patient, such as the deaf parent of a minor child or the deaf adult responsible for an aging parent. A qualified RID interpreter can bridge the communication gap between medical professionals and those they serve.
  Health Care Professionals Using Interpreters  
The health care professional in need of an interpreter may have several questions.
How do I know an interpreter will be needed?
The deaf patient (or family member) should inform you of the need for an interpreter when making an appointment or when receiving services. It is important to remember, the health care professional and the patient should work together to ensure that the necessary accommodations are provided.
Who is responsible for arranging interpreter services?
Health care providers are responsible for providing "auxiliary aids and services under the Americans with Disabilities Act to ensure that communication with people who are deaf is as effective as communication with others. Federal regulations define "auxiliary aids" to include interpreters.* Adapting scheduling procedures may be necessary in order to provide an interpreter; for example, a walk-in clinic, where appointments are usually not made, might have to make an appointment. The health care provider cannot legally charge a patient for the interpreter services
For what types of care should I provide interpreter services?
An interpreter should be present in all situations in which the information to be exchanged requires effective communication, such as taking a medical history, explaining tests, procedures and diagnoses, planning treatment, providing discharge instructions and scheduling follow-up care.**
For what services and programs should I provide an interpreter?
You will want all services and programs you provide to be available and accessible equally to consumers who are deaf and hearing. For example, a deaf individual might wish to take a childbirth class, access a substance abuse program, obtain psychiatric services or attend a free lecture on health care.
How do I find a qualified interpreter?
You can engage a private practice interpreter directly or through an interpreter service agency. You will have most assurance of quality by hiring an RID certified interpreter. Interpreters certified by RID have demonstrated skills related to language and communication, as well as knowledge and practice of ethics and professionalism. To be effective, the interpreter´s communication must be compatible with that of the deaf individual; therefore, it is important that the deaf individual be consulted on the choice of interpreter. For this reason an individual who is deaf may decline to use a specific interpreter. Ethnic, cultural, and linguistic concerns of the patient and family members should be considered in the selection of an interpreter. Prior to hiring, the health care professional should inquire about the credentials of an interpreter.***
Why not use a family member as interpreter?
While using a family member may seem logical and convenient, it is not advisable, for several reasons. You have no assurance the family member´s language skills are adequate for communicating medical information. The relative may have attitudinal or emotional issues that could affect objectivity and impartiality and prevent accurate communication. For example, a family member might feel compelled to "protect" the patient from painful news, or to withhold potentially embarrassing information. Using a family member may compromise the patient´s right to privacy and confidentiality.
Why not use a person on staff who knows sign language?
Unless the staff person is an RID certified interpreter, you have no assurance that communication will be effective and accurate. Inaccurate or incomplete communication in general can cause greater risk than no communication. This may jeopardize patient care and become a liability issue.
What about emergencies?
In emergency health care, it may not always be possible to immediately provide a specific type of communication accommodation. However, you will want to provide the most effective communication as soon as possible. To reduce delays in acquiring an interpreter, make sure emergency and crisis staff know the policy and procedures for requesting an interpreter for all hours the facility is open. Also, maintaining phone numbers of qualified private practice interpreters and interpreter service agencies can reduce delays in acquiring interpreters on short notice. Following an established policy or procedure for effective communication with individuals who are deaf is vital to emergency patient care.
Where can I learn more about providing services for patients who are deaf?
A booklet, ADA Questions and Answers for Health Care Providers, is available from the National Academy, Gallaudet University, 800 Florida Avenue. NE, Washington, DC 20002-3695.
What do I need to do in order to work effectively with an interpreter?
As you work with an interpreter, you can facilitate communication in several ways:
  • Work with the interpreter and the deaf individual to determine the best possible placement for all parties in the situations.
  • Speak directly to the individual who is deaf rather than saying to the interpreter, "Ask him...." or "Tell her..."
  • Realize that the interpreter cannot provide any information or opinions about the patient.
  • Expect that the interpreter may occasionally pause to ask you for an explanation or clarification of terms in order to provide an accurate interpretation.
  • Recognize that the interpreter is responsible to interpret all that is said in the presence of all individuals and will not edit out anything spoken as an aside or anything that is said to others in the room.
Can I be confident the patient´s right to confidentiality will not be violated?
An RID interpreter adheres to a Code of Ethics of which confidentiality is a fundamental tenet and may be covered by the "cloak of privilege" when interpreting for a professional who has legal privilege.
Will the interpreter have safety concerns?
As interpreters become part of the health care scene, they may have questions and concerns about their personal safety. The medical professional can help the interpreter by answering questions, by offering guidance regarding universal precautions, sharing action plans for volatile behaviors, and by providing appropriate protective equipment and clothing.
The Association believes that effective communication is essential to quality health care. By using qualified RID interpreters, health care professionals can do their best to provide the same standard of care to individuals who are deaf as to those who are not deaf.
RID has a series of Standard Practice Papers available upon request. Footnotes frequently reference these materials.
* see 45 Code of Federal Regulations 84.52(d)1,3 and 28 C.F.R. 36.30(c)
** see Professional Sign Language Interpreting, Use of a CDI and ADA questions and Answers for Health Care Providers, National Center for Law and Deafness
*** see RID information on Certification