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N-LAAN

When Language is a Barrier to Care Demand: for medical interpreters booming as demographics shift.

Tuesday, November 10, 2009

Gayle Tang remembers the time she thought she was speaking English but only realized she had lapsed into Cantonese when one of her doctors spoke it back to her.

That was 14 years ago, but she recalls the uneasy feeling of not knowing what was wrong with her and undergoing tests for heart palpitations. The doctor's words in the language she needed to hear and speak at that sensitive time moved her, she said.

Kaiser Permanente has been on the forefront of a movement toward greater linguistic and cultural competence in health care. Kaiser routinely asks patients which language they prefer to speak, and developed a voluntary physician assessment tool that lets health-care organizations determine if doctors have enough foreign-language proficiency to speak with patients in that language independent of an interpreter. About 1,000 doctors have taken the test so far. As the nation's population grows and ages, the demand for language services in hospitals, doctor's offices and other health-care arenas is booming, experts say.

Federal law mandates that any entity that receives federal funding, whether it's Medicare reimbursement or research grants, must provide a patient with limited English proficiency an interpreter at no cost to the patient. In early 2009.

An estimated 15,000 to 17,000 people perform medical interpreting work in the U.S., according to Common Sense Advisory, a Boston-based research firm. Interpreters typically earn $15 to $30 an hour.

Driven to Standardize

As hospitals look to boost patient safety and limit their exposure to potential lawsuits if a crucial detail gets lost in translation during a fast-paced medical response, some are open to a new national certification standard for the people they hire to provide medical interpretation.

In October, a nonprofit group launched a first-of-its-kind national interpreting standard that will allow interpreters working in the medical field to be tested and credentialed as certified medical interpreters, or CMIs. The CMI designation first will be available to Spanish language interpreters, with national certification for several other languages starting next year.

The field of medical interpretation has come a long way from when patients would rely solely on their minor children or when hospital staff would comb their ranks for candidates or ask if anyone in the waiting room spoke Polish, for example, said Dr. Eric Hardt, medical consultant to interpreter services at Boston Medical Center.

Such services don't come cheap. At M.D. Anderson, the annual price tag comes to $2 million, Palacio said. The cancer-treatment center has 25 staff interpreters covering nine languages, but it provides services in about 30 languages by tapping a phone-based medical interpreting agency.

About 60 percent of M.D. Anderson's non-English business is Spanish; another 28 percent is Arabic. Turkish, Vietnamese and Mandarin Chinese round out the top five languages it hears.

Offering interpreters also pays off in public-relations gain

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