How to Get the Right Medical Care When You Don’t Speak English

At many hospitals and medical centers in the U.S., patients have the right to a free professional interpreter. Here’s what you need to know.

If English isn’t your first language (or even your second or third), navigating the U.S. healthcare system can be tricky. Medical information can be hard enough to understand in your native tongue. Add a language barrier, plus the stress that comes with a health issue, and it’s easy for things to get lost in translation. 

“Oftentimes, patients speak some English and may even be able to get by with English in other settings,” says Leah Karliner, MD. Dr. Karliner is a professor of medicine at the University of California, San Francisco. “But when it comes down to a clinical conversation, it’s much different.” It’s a common concern: About 10% of all adults in the U.S. have trouble speaking English.

The good news: All hospitals and medical centers that get money from the U.S. government — for example, from Medicare — by law must provide professional interpreter services to any “limited English proficient” (LEP) patient. Those services must be free to the patient. That’s true even if the hospital can’t be reimbursed for them.

Still, that doesn’t guarantee that you’ll get an interpreter in person or that language barriers will be erased, says Dr. Karliner. Here are some steps you can take for a successful visit if your provider doesn’t speak your language. (Or, if you’re reading this for a friend who would benefit from an interpreter, you can share this key information with them.)

Contact your health plan to see if you’re eligible for Wellframe.

Ask for an interpreter ahead of time.

Do you have a doctor’s appointment or medical procedure coming up? Let your provider know as soon as possible that you need an interpreter. This gives them time to find one, which can take longer if your native language is uncommon, says Annette Ticoras, MD. Dr. Ticoras is the owner of Guided Patient Services, a patient advocacy group in Westerville, Ohio.

Don’t rely on friends or family.

Your instinct may be to lean on a loved one who speaks English to interpret for you. It’s understandable: Having someone you trust in the hospital room with you is comforting. But using them as an interpreter is never ideal for your health.

“They’re not trained to interpret medical information,” explains Dr. Karliner. “They may miss things. They may also be uncomfortable revealing personal information about the patient to the doctor. And if they’re busy interpreting, they can’t advocate for their loved one and ask questions.”

On the other hand, having a professional interpreter has been shown to encourage patients to use medical services. That can improve a patient’s outcome overall. The error rate for professional interpreters is also much lower than for someone who isn’t trained. And when errors are made, they’re less likely to be significant for the patient.

Opt for in-person or video over a phone call.

When a patient and interpreter can see each other, they can connect more easily on a personal level. “With both in-person and video, the patient and interpreter can look at each other and read body language,” explains Dr. Karliner.

Sometimes, though, a physician or hospital won’t have an interpreter on site or by video. It’s common during an emergency. In this case, any interpretation is much better than none, and certainly the phone is a good option, stresses Dr. Karliner. If the only choice is the phone, ask the physician and interpreter to talk in short sentences rather than full paragraphs. This goes for all types of interpretation, but especially over the phone. That way, it’s harder for any of you to miss crucial information.                                          

Repeat back information to both the interpreter and the provider.

This is called the “teach-back” method. It’s shown to help improve patient understanding. Patients who do this more likely will follow their doctor’s directions correctly and have a better health outcome as a result.

With this method, any miscommunications get addressed right away during the visit, Dr. Karliner explains. “It can be hard to advocate this way if you’re a patient. But all you need to say is, ‘Let me make sure I understand this correctly. Here is what I think you said,’” says Dr. Karliner.

Ask for an advocate.

If the doctor or hospital refuses to provide you with a medical interpreter, don’t back down. Legally, you have the right to request one, says Sandy Thigpen, BCPA. Thigpen is a patient advocate based in Huntington Beach, California.

Most hospitals have at least 1 patient advocate on staff. You can turn to them for help at any time during your hospital stay. “Ask to speak to the patient-relations person, either at the hospital or in the doctor’s practice,” says Thigpen. Or ask your employer or health plan if it offers a digital health management tool such as Wellframe. These easy-to-use apps can connect you with a care advocate through your health plan.

“Explain to them that because of the language barrier, you don’t have the information you need to make an informed decision.” And remember, you’re entitled to an interpreter, free of charge.

Contact your health plan to see if you’re eligible for Wellframe.

Sources:

  1. “When Patients and Providers Speak Different Languages.” Agency for Healthcare Research and Quality, Patient Safety Network, April 1, 2018, https://psnet.ahrq.gov/web-mm/when-patients-and-providers-speak-different-languages. Accessed August 18, 2021.
  2. Pathak S, Gregorich SE, Diamon LC, et al. “Patient Perspectives on the Quality of Professional Interpretation: Results from LASI Study.” Journal of General Internal Medicine, vol. 36, no. 8, January 29, 2021, pp: 2386-2392. 
  3. Yen PH, Leasure AR. “Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes.” Federal Practitioner, vol. 36, no. 6, Jun 2019, pp: 284-289.
  4. “Hospital Patient Advocates.” Cigna, February 11, 2021, https://www.cigna.com/individuals-families/health-wellness/hw/hospital-patient-advocates-abo4385. Accessed August 18, 2021.
  5. “Everything You Need to Know About Section 1557.” IU Group, https://interpretersunlimited.com/section-1557-affordable-care-act-faq/. Accessed September 12, 2021.
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