It’s the sickest patients who have the hardest time communicating with their doctors, according to a recent study from UCLA Center for Health Policy Research. Californians with limited English skills report the poorest health and were more likely to have problems understanding their doctors.
Almost one out of eight HMO members in California is considered to speak and understand English with limited proficiency (LEP). That’s about 1.3 million people. This is the same group that reports having the most trouble communicating with their doctors.
That problem will likely worsen quickly as LEP speakers make up over a third of California’s newly insured population after the implementation of President Obama’s Affordable Car Act.
“The sickest people are having the hardest time talking to their doctors,” said Max Hadler, a research associate at the Center for Health Policy Research and the main analyst for the study. “If a patient can’t communicate, how can their doctor treat them effectively? Appropriate interpreter services and translated materials are a consumer right and key to providing high-quality care and reining in the growth in health care costs.”
While current regulations require health care plans to provide care in Spanish, the degree of actual compliance remains unclear. Some data suggests that many medical providers continue to rely on amateurs such as family members and untrained staff to supply interpretation services. Almost half of all LEP enrollees in California report receiving assistance from these non-professionals.
Every time this occurs, it means that patients are denied access to healthcare through denial of the basic principles of the translator’s trade. That code of ethics, the guarantee of confidentiality, tested proficiency in source and target language, health literacy, terminology training, all those essentials are denied to patients in violation of the law.
There is a “lack of consistent training of interpreters” and interpreting best practice makes for a big difference in outcome, says Dylan Robie, lead investigator.
Healthcare givers often weight the value of translation against its cost in scare resources. Reluctance to use professionals is often because decision-makers underestimate the life-threatening danger of bad translation for the same reason that the amateur interpreters fail: Lack of experience and training.