Language Hurdles in Healthcare: Bridging the Gap

Author: Syed Siddiqi

The Issue

With a growing population of immigrants in the United States, limited English language proficiency results in a hindrance to medical care. The need for patients to describe their symptoms and the need for care professionals to make an assessment based on these symptoms is crucial in the delivery of correct diagnosis and treatment plan. Assuming one is able to get consent for a physical examination and further compliance for diagnostic testing despite the language barrier, there is still an issue when a care provider is unable to monitor a patient 24 hours a day for most cases. During these times, the patient is instructed on the etiology of their symptoms and the appropriate care that is necessary for relief. In surgical cases, comprehension of post-operative instructions is even more important to avoid infections and other complications after the procedure. If a language barrier results in misinterpretation from either end, the treatment progress becomes delayed, possibly worsening symptoms during that delayed period of time. Additionally, patients may be required to visit the care facility more often, resulting in rising costs for a symptom that could have been resolved in possibly fewer visits. The importance of communication between medical professionals and patients is crucial for appropriate delivery of care and relation between the physician and patient.

In-Person Translator Services

The current solution in place is the use of translator services. Several organizations exist for the case where a patient is unable to find a family member or friend to assist them. These organizations usually provide an in-person translator to accompany the patient during their visit or connect an agent via a telecommunication device remotely. Although a family member or friend providing the translating services would be the ideal option, utilizing one of these hired translators seems to be the next best choice. However, there are several issues that are involved with this alternative. In the case where an in-person translator accompanies the patient, there may be difficulties planning and coordinating the visit between all three parties (patient, translator and physician). For the digital translating option, difficulties are faced when a healthcare organization is unable or has difficulties in providing language services. Data shows that there can be upwards of 33% of hospitals that are unable to efficiently provide translators. For the cases where translators are able to be provided, the patient and the medical facility both experience longer treatment times and increased costs for the services.

Digital Translator Services

One study was able to show the benefits of free online translating services, specifically Google Translate. Out of 39 employees of the care team, 36 members reported mobile translating tools were helpful when communicating with patients of a different language, accounting for 92% of the study participants. Despite the beneficial effects for the care team, the results from the other end may not be as desirable. One study showed that Google Translate had an overall of 57.7% level of accuracy when translating ten common medical phrases from English to 26 languages and vice versa, citing certain phrases like “your husband has the opportunity to donate his organs” in English translated to “your husband can donate his tools” in Polish and “your wife needs to be ventilated” in Bengali translated to “Your wife wind movement needed” in English. Another study compared the translation reliability between English and Spanish versus the translation between English and Chinese when discussing diabetes education materials. The researchers concluded that accuracy was much higher between English and Spanish as compared to English and Chinese.

Plan for More

In a community-focused version of care, complete accuracy for translation between all languages is necessary prior to utilizing such tools in critical treatment settings, although the results thus far have been very promising. Further focus on innovative ideas to provide affordable, expedited, and accurate options when translating between different languages is crucial for better medical outcomes. In a digital age of medicine, translation services will be a major segment in patient care.

References

1. Whiteside, S. (2022, January 9). Healthcare standards across language barriers. University of Cincinatti. https://med.uc.edu/landing-pages/uccom-tribunal/com-chronicles/exploration-of-medicine/2022/09/01/healthcare-standards-across-language-barriers#:~:text=Language%20barriers%20in%20healthcare%20lead,not%20share%20a%20native%20language.

2. Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of Language Barriers for Healthcare: A Systematic Review. Oman Med J. 2020 Apr 30;35(2):e122. doi: 10.5001/omj.2020.40. PMID: 32411417; PMCID: PMC7201401.

3. Albrecht UV, Behrends M, Schmeer R, Matthies HK, von Jan U. Usage of multilingual mobile translation applications in clinical settings. JMIR Mhealth Uhealth. 2013 Apr 23;1(1):e4. doi: 10.2196/mhealth.2268. Erratum in: JMIR Mhealth Uhealth. 2013 Aug 07;1(2):e19. PMID: 25100677; PMCID: PMC4114476.

4. Patil, S., & Davies, P. (2014, December 15). Use of google translate in medical communication: Evaluation of accuracy. The BMJ. https://www.bmj.com/content/349/bmj.g7392

5. Chen, X., Acosta, S., & Barry, A. E. (2016). Evaluating the Accuracy of Google Translate for Diabetes Education Material. JMIR Diabetes. https://diabetes.jmir.org/2016/1/e3/