EDITORIAL
As the Texas population continues
THE NECESSITY FOR IN-PERSON
TRANSLATORS IN HEALTHCARE
By Emmanuella Oduguwa, Yasmeen Alayli, Whitney Stuard, Tanooha Veeramachaneni, Nedeke
Ntekim, Phillip Keys, Omar Shaikh, Andrew Murphy, Emily Liu, Jingyan Yue
to grow more diverse, the healthcare
system must adapt to meet
the evolving needs of its patients.
When patients from diff erent ethnic
and cultural backgrounds lack the ability to
communicate with healthcare providers in
the same capacity as native English speakers,
disparities arise within the healthcare system.
Diverse Texas Population
Over 35 percent of Texas households speak
a language besides English within their home,
and 14% of Texans report limited English
profi ciency. Texas has the second highest
population of individuals with limited English
profi ciency in the United States.1,2 In 2017, inhouse
interpreters at Parkland Hospital, one
of the largest public hospitals in Texas and the
United States, were able to accommodate
only 30% of the 1.1 million patient interactions
that required interpreters.3 This enormous gap
in care underscores the demand for healthcare
interpreters to provide adequate service
to the growing population of patients that are
not profi cient in English.4 There is an urgent
and unmet need for medical interpreters present
across the nation and continuing to grow
exponentially each year.
In-Person Translators as an
Invaluable Resource
Gaps in communication have been shown
to disproportionately aff ect patients from
racially and ethnically diverse backgrounds.5
Miscommunication due to language barriers
between medical staff and patients leads to
a myriad of undesirable patient outcomes,
such as adverse drug interactions, improper
medication counseling, and overall poorer
quality of healthcare.6 Therefore, improving
culturally sensitive communication between
patients who are not profi cient in English and
medical providers remains crucial in minimizing
the health disparities these patients face.7
Explaining medical procedures to patients
who are not able to communicate in English
prior to an invasive procedure puts these
patients in a more vulnerable position since
they cannot ask questions and may not fully
understand what is occuring.8,9 And while
family members may seem like a useful tool
to circumvent these scenarios, studies have
reported that when patients in the emergency
department use their family members or other
non-certifi ed translators, there is likely to be a
higher chance of errors in the interpretation.10
Interpreters serve as an invaluable resource
in facilitating communication between patients
and healthcare providers. In order to
become a certifi ed healthcare interpreter, one
must complete 40 hours of interpreter training,
be at least 18 years old with at least a General
Educational Development (GED) and demonstrate
suffi cient oral profi ciency in both English
and the second language to the certifying
examiners.11 These services can be provided
virtually or in-person.
While virtual translators are a valuable asset
in healthcare settings, studies have reported
patient preference for and higher satisfaction
with in-person interpreters in comparison
to virtual translators. Research demonstrates
that the utilization of in-person interpreters
conferred shorter wait times, decreased late
arrivals and no-show visits, and in turn lead
to greater patient adherence and clinical
productivity.12-14
Furthermore, nonverbal
communication and body
language are important
tools that interpreters
are trained to analyze.
In comparison to phone
translating, in-person
interpretation allows the
interpreter to use dialectal
nuances and nonverbal
cues to inform the
provider about a patient’s
level of comprehension.
15 In hospitals, using
certain online platforms
for interpretation cannot
be guaranteed to have
adequate encryption,
thereby violating the privacy
of a patient’s medical
history or the Health Insurance Portability
and Accountability Act (HIPPA).15 Therefore, it is
critical that in-person translators are available
to counter disparities in access to healthcare.
Additionally, during instances in which cell
service is limited, lack of connectivity complicates
communication between the patient,
healthcare provider, and translator.10 Translations
during emergencies happen in real time,
and a break in communication due to poor internet
service can cause irreparable damages.
Even if connection can be re-established, the
time lost cannot be regained.
Reduced communication effi ciency,
coupled with the intensity of emergencies
and interventional procedures underscores
the necessity for more in-person translators in
emergency settings.9 Overall, as we continue
to progress into a more diverse population
with a multitude of languages providing inperson
translator services will be a necessity to
provide the most comprehensive care for our
patients. DMJ
26 | DALLAS MEDICAL JOURNAL • April 2022 References:
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AH16195
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