On October 28, 2010 I attended the Spanish medical terminology session held at Boston College. Lisa Morris, BC alumna and Director of Cross Cultural Initiatives at the University of Massachusetts Medical School, lectured on the consequences of having a language barrier when providing healthcare to limited-English proficient patients. This problem is rooted in the fact that there is no good way to measure how proficient someone is in the English language. To resolve this, Morris stressed the importance of language services because they provide access to care, decrease the cost of care (eliminating unnecessary tests), and lessen the risks misunderstandings can cause.
We learned about the laws designed to insure patient safety with respect to language and culture. Specifically, Title VI under the 1964 Civil Rights Act states that everyone is entitled to the same treatment regardless of any of his or her differences. Lisa Morris pointed out that although Title VI has existed for so long, an individual’s right to sue is very limited. Additionally, Massachusetts has an Emergency Room Interpreter Bill from 2001 that mandates all emergency rooms and acute psychiatric care facilities to provide competent interpreter services. Morris commented that this is indeed a good service but there is room for improvement. Interpreters should be available 24 hours a day, in person (not just by telephone) and must be culturally competent.
Towards the end of the lecture, we focused on the Spanish language because of its existing and expected rising popularity in the United States. Currently, there are about 35 million Hispanic and Latino people living in the U.S. and our healthcare system has to meet their needs. Although many institutions have been translating documents in Spanish, an important issue to consider is health literacy. Patients may not understand what certain terms, diagnoses, or treatments mean. In order to bridge the language gap across all cultures, a network of competent interpreters is essential in healthcare communities.
Lisa Morris explained a situation in which a Spanish speaking man died because there was a communication problem between his family and a Florida emergency room staff. In Spanish, the patient’s family described him as “intoxicado”, a dangerous cognate. The staff thought this meant intoxicated, as in the man was inebriated. However, “intoxicado” also means poisoned. The man died from food poisoning because he was not treated for the right ailment due to the lack of a fully competent interpreter provided for the patient. This incident shows how interpreters are integral members of the healthcare team. As future healthcare providers, it is important to be aware of both the implications and benefits of interpreters and cultural competency.