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For thousands of patients in New England, the services provided by medical interpreters are priceless.

"Nothing can be more terrifying than being really sick, or involved in a car accident and not being able to explain what happened to a doctor," said Elaine Ullian, CEO of Boston Medical Center.

Ullian has the hospital expenditures to back up what she says. Boston Medical Center (BMC) invests $3.5 million annually for interpreter services.

The hospital maintains a team of 49 interpreters on staff who assist more than 194,000 non-English speakers a year with 18 languages, 24 hours per day, seven days per week.

On any given day, a patient can enter the ER (emergency room) and announce: "Tenho dor de cabeça" ("I have a headache") - and a BMC medical professional can take action for the Portuguese speaker's headache.

And if Portuguese interpreters are unavailable, the hospital has two other options that it can depend on: interpretation by phone and interpretation by video conference.

In the phone option, a BMC employee calls a designated phone number to reach an interpreter, who comes on the line within 60 seconds.

The patient and medical professional can listen to the interpreter at the same time, using a telephone that has two ear pieces.

Through the phone-interpretation service, BMC can access interpreters for 150 languages.

In the video-conference option, an Ohio-based company provides interpreters to BMC via a TV-like machine. The patient and medical professional can see, hear and talk to the interpreter on the "TV."

For BMC's director of interpreting services, Oscar Arocha, the array of choices has prompted patients to come back more frequently to the hospital.

"We are a crossroads of cultures here. When patients know they can be understood, and don't have to struggle with communication barriers, they come back," he said.

Arocha's team handles an average of 200 requests a day for language interpretation.

The video-conference interpretations account for 1 percent of those requests.

"It's a fairly new technology. Patients are becoming so familiar with it that in Philadelphia, teenagers undergoing their physical evaluation feel more comfortable talking with a TV screen than to a real person," said Arocha.

When New England Ethnic News tested the video-conference service, a live interpreter in Ohio was accessed within seconds.

Until she received training to be an interpreter, Carmen Blair, one of the video-conference interpreters in Ohio, said she didn't realize the technicalities of medical interpretation, terminology, and the need to be familiar with the human body.

"Many of the patients come from very small towns, and some have never seen a doctor in their lives. As soon as they see my face, they go 'Ahh,' and they're relieved," said Blair, a Mexican citizen who abandoned a 15-year-old career in interior design to become a video-conference interpreter.

Each year, Boston Medical Center uses 1,000 to 2,000 minutes of video interpreting - and the cost is not cheap.

Arocha's interpreting department has three video-conference machines, each worth about $7,000 for just the machine itself.

The actual interpretion service costs from $3 to $4 a minute, but BMC might get a lower rate because of its high demand for the service.

BMC plans to install more of the video-conference machines in the hospital. In BMC's new in-patient building, which is currently under construction, 50 percent of the rooms should have the machines, Arocha revealed.

Wages of interpreters aren't so cheap, either.

A staff interpreter at BMC can start at $18 an hour. Regular contractors can make $75 per hour, and those interpreting hard-to-find African dialects can pocket about $150 per hour.

The five most-commonly-interpreted languages at BMC are, in ascending order: Spanish, Haitian Creole, Cape Verdean, Portuguese and Vietnamese.

Interpretation is also popular for patients who are deaf or hearing-impaired, who receive American Sign Language interpretation through on-site interpreters or by video conference.

Down the road at Beth Israel Deaconess Medical Center, another hospital in Boston, the need is slightly different. The top 10 languages are Spanish, Chinese, Russian, Cape Verdean, Portuguese, Haitian Creole, American Sign Language, Vietnamese, Farsi/Persian and Thai.

Beth Israel Deaconess, a Harvard teaching hospital, invests $2.5 million per year in staff interpreters and phone services.

The Connecticut Health Foundation estimates that Connecticut hospitals spend $4.7 million annually for interpretation for patients.

For Nataly Kelly, a national interpretation consultant whose book, Telephone Interpreting: A Comprehensive Guide to the Profession, will be published this fall, interpreting is all about public safety.

"If a patient speaks only Somali, and does not get diagnosed properly, he can have [and spread] a disease that poses a public health issue," she said.

For Kelly - who worked for five years for Language Line, a company that provides interpretation in 150 languages - most services to immigrants and refugees have been politicized.

"Many [non-immigrant Americans] think that if an immigrant does not learn English, he is a threat to our national identity. You can see that [kind of thinking] in movements for English only," she said.

Nonetheless, Kelly said, any recipient of federal funding is required by law to provide language assistance to foreign-born individuals, and hospitals top the list of institutions that get such resources.

Title VI of the Civil Rights Act of 1964 says: "If a recipient of federal assistance is found to have discriminated and voluntary compliance cannot be achieved, the federal agency providing the assistance should either initiate fund termination proceedings or refer the matter to the Department of Justice for appropriate legal action."

In addition, the demand for language services comes with a strict code of ethics for interpreters.

Federal and state laws prohibit minors from interpreting, and most hospitals don't accept interpretation assistance from family members or from patients' friends.

"It can traumatize a child to have to know about his parents' diseases. That's child abuse," said the BMC's Arocha.

Also, hospitals must abide by the Health Insurance Portability and Accountability Act, enacted by Congress in 1996, which guarantees confidentially for patients. Interpreters know that anything said in the hospital, stays in the hospital.

In Massachusetts, becoming a medical interpreter requires no specific certification, but hospitals set their own standards.

"If you have less than 40 hours of training, you shouldn't be interpreting, period," opined Nataly Kelly, who is also a senior analyst for Common Sense Advisory, an independent market research and consulting firm.

New Hampshire also requires no certification to become a medical interpreter.

However, New Hampshire resident Frederick Froes wanted some formal education anyway to better prepare himself to provide interpretation services.

Froes took a 54-hour course offered by the New Hampshire Minority Health Coalition, in Manchester, NH, which covered medical vocabulary and the humanitarian and cultural aspects of interpreting.

"I recall, in training, a case about an African woman who refused to take a prescribed medicine. She claimed that if it was of God's wish, she would be healed without any medicine. You know, the patient has the last word, but they [the course] taught us how to deal with it," said Froes, who is an operation room (OR) assistant for Southern New Hampshire Medical Center, in Nashua.

Froes, who is seldom required to interpret in the OR, believes that demand for language services will decrease in the future.

"The immigrant patient is assimilating more and more into the American culture. I doubt that the demand will keep its current high levels in the near future," he said.

Back in Boston, Oscar Arocha disagrees. He has witnessed the annual demand for interpretation at BMC jump from 10,000 service requests to 194,000 in the last 10 years.

"There's never enough interpreters in this hospital," he said.

But one thing is certain: Boston Medical Center has reduced the interpretation waiting-time for patients who can speak only an African dialect from 8 hours to mere seconds.

As CEO Elaine Ullian puts it, "[We] simply couldn't have a hospital if we didn't have interpreters helping on a daily basis."

Learn more about medical interpreting:

International Medical Interpreters Association: www.imiaweb.org [2]

National Council of Interpreting in Health Care: www.ncihc.org/mc/page.do [3]

California Healthcare Interpreting Association: www.chiaonline.org [4]

American Translators Association: www.atanet.org [5]

Check back soon with EthnicNewz.org for a one-on-one interview with national interpretation consultant Nataly Kelly.

source: EthnicNewz.org

Copyright 2008 New England Ethnic News, EthnicNewz.org. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without the express permission of the news source. Contact Newz for more information.

SEE ALSO:
Understanding Drug Labels When You Don't Read or Speak English [6]

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