A Matter of Life and Death
Thirteen-year-old Gricelda Zamora was like many children whose parents speak limited English: she helped translate for her family. When she got severe stomach pain, her parents took her to the hospital. Unfortunately, Gricelda was too sick to translate what the doctors were saying, and the hospital didn't provide an interpreter.
After watching her overnight, doctors told her Spanish-speaking parents, without a translator, to bring her back right away if she got worse, and otherwise to see a doctor in three days. However, what her parents understood was that they should wait three days to see the doctor.
After two days, with Gricelda getting much worse, they couldn't wait any longer and rushed her back to the emergency room. Doctors found she had a burst appendix. She was flown to a medical center in Phoenix, where she died a few hours later.
Gricelda's story isn't just sad—it shows what's at stake when hospitals can't bridge language gaps effectively.
Why Medical Translators Matter
When a patient and their doctor don't speak the same language, good care doesn't stop—it adapts. After talking with healthcare providers about caring for patients who speak different languages, one thing is clear: while medical translators are absolutely necessary, they create problems that healthcare teams struggle with every day.
Translator services in healthcare are both legally required and practically challenging. The Affordable Care Act requires healthcare organizations to provide qualified translators for patients with limited English (U.S. Department of Health and Human Services, 2020). This recognizes that good communication is essential for equal care. Hospitals are still working to develop systems that meet these requirements while delivering good care to all patients.
Let's look at what providers themselves are saying about these challenges.
1. The Waiting Game Disrupts Care
Picture this: A doctor has 15 minutes scheduled with a patient who needs a translator. After greeting the patient, they call the translation line... and wait. And wait.
"They're not always available, so we may be on hold for a while waiting for an interpreter to get online," shared a periodontist from California.
These delays create a ripple effect. One neurologist reported sometimes waiting up to 20 minutes to connect with a translator—that's longer than many appointment slots! With dozens of patients needing translation services daily, these delays add up to a lot of lost time.
The real cost isn't just efficiency—it's quality. When translator connections eat into appointment time, doctors rush through explanations, patients have less time to ask questions, and the thoroughness of care suffers.
2. Language Barrier Complicates Paperwork
Each translated session comes with extra paperwork. Doctors must document translator ID numbers, language used, and other details that add to their already heavy paperwork load.
The challenges go beyond paperwork to affect patient care directly. "That's also one of the challenges for us—giving patients instructions but having to write them in English because there's nobody there to type the patient plan in their language," explained a family physician from Oregon.
This creates a troubling disconnect. The patient receives verbal instructions in their language during the visit but takes home written materials in English. The gap between what's discussed and what's written becomes a recipe for confusion, missed medications, and care plan misunderstandings.
3. Translated Conversations Feel Choppy
Translator-assisted healthcare conversations create a "chunky" experience. The natural flow breaks down as doctors must pause frequently for translation, making it impossible to deliver complete explanations in one go. This constant stopping and starting disrupts the natural rhythm that helps build trust between doctors and patients.
Important emotional cues and context often get lost in these broken exchanges, potentially hurting care quality when subtle signs of confusion or concern go unnoticed. The result is a more mechanical interaction where both sides struggle to connect meaningfully through the necessary but disruptive translation process.
4. Technical Issues Make Communication Harder
"Suddenly we'll be in the middle of explaining a critical diagnosis and the call drops. We have to start over, dial back in, and hope we get the same interpreter," shared a frustrated oncologist from Michigan.
Technical problems like dropped calls, poor sound quality, and system failures create frustrating interruptions that hurt patient understanding. Doctors reported having to repeat sensitive information multiple times when connections fail, leading to patient anxiety and confusion.
5. Translator Quality Varies, Creating Uncertainty
Medical translation requires specialized knowledge that varies depending on the specialty. When it works well, it's seamless. When it doesn't, critical information gets lost.
"We have found that we don't necessarily trust every interpreter," admitted a cardiologist from Texas. Doctors reported big differences in translator quality—some have excellent medical knowledge while others struggle with terminology or professional boundaries.
This inconsistency creates a troubling reality: doctors can never be certain if their message is being accurately conveyed. A doctor who understands some Spanish mentioned having to correct translators who were "making up words" rather than accurately translating medical terms.
Without consistent quality, doctors often simplify their explanations, potentially sacrificing important details in the process.
6. The Human Connection Suffers
At its heart, healthcare is about human connection. The relationship between doctor and patient powers the healing process—and translation fundamentally changes this dynamic.
"You kind of lose some of that patient-to-provider connection," explained a neurologist from Michigan. The direct relationship becomes triangular, with doctors feeling removed from meaningful exchanges.
Even the physical setup creates barriers—tablets on wheeled stands or speakerphones create actual distance in moments when closeness matters most. The emotional connection that happens through shared smiles, concerned looks, or reassuring tones becomes diluted through the translation process.
Moving Forward: Practical Solutions to Medical Translation Challenges
Medical translation is tough, but we can make it better. Research shows that language barriers significantly impact healthcare outcomes (Diamond et al., 2019). Here's how we can fix some of the challenges healthcare providers face every day.
Reducing Wait Times
To cut down on wait times, hospitals can schedule translators ahead of time for patients who need them. They can also keep a list of staff who speak different languages on call. Grouping patients who speak the same language on the same day can help doctors use translator time better. For example, in the outpatient settings, having specific days for patients who speak the same language can make translator use more efficient. Setting aside specific hours when translators are always available can also help patients get care when they need it.
Improving Documentation
Creating ready-to-use forms in common languages helps doctors share instructions quickly. Translating consent forms and brochures means patients get important information in their own language, so they better understand their care plan and follow-up steps.
Enhancing Communication Flow
To help conversations flow better, doctors need tips on how to work with translators. Using pictures and diagrams helps when words get choppy. A quick chat between the doctor and translator before seeing the patient can set clear goals. Schedule 30-minute slots instead of 15-minute slots for patients needing translators, and mark these clearly in the scheduling system. This gives doctors time to explain things fully and check that patients really understand.
Addressing Technical Challenges
For optimizing remote interpreting applications, start with the basics - make sure the Wi-Fi connection is strong in all exam rooms, keep devices fully charged, and regularly update software on translation devices. Have simple backup options ready, like speakerphone translation if video fails. Place a quick troubleshooting guide in each exam room so anyone can fix common problems without waiting for IT help. Check all equipment at the start of each day to catch problems before patients arrive.
Improving Interpreter Quality
To get better translators, create ways for doctors to give feedback about translator quality. Making word lists for medical terms helps keep translations consistent. Having a "culture cheat sheet" with key customs and beliefs for common patient populations helps both translators and providers avoid misunderstandings and shows respect for patients' backgrounds.
Maintaining the Human Connection
To keep the human touch in care, using video instead of just phone calls helps people connect. Placing screens so doctors and patients can still make eye contact helps them bond. Simple gestures like offering a translated welcome sign at check-in or learning to say hello in a patient's language can make a big difference in how comfortable they feel.
We'd love to hear which of these ideas works best for you, or if you have other approaches that have helped in your practice. Your insights help us build better tools for talking across languages in healthcare.
About the author
Eyal Heldenberg brings 15 years of experience in speech recognition, AI, and B2B solutions to healthcare communication challenges. As an engineering and product leader focused on language accessibility in healthcare, he works to bridge communication gaps and improve outcomes for all patients, regardless of language background.
Resources
Chen, A.H., Youdelman, M.K. and Brooks, J. (2007) The legal framework for language access in healthcare settings: Title VI and beyond, Journal of general internal medicine. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC2150609/ (Accessed: 24 March 2025).
U.S. Department of Health and Human Services. (2020). HHS Finalizes Rule on Section 1557 Nondiscrimination Protections under the Affordable Care Act. Retrieved from https://www.hhs.gov/about/news/2020/06/12/hhs-finalizes-rule-section-1557-protecting-civil-rights-healthcare.html
Diamond, L. C., Jacobs, E. A., & Karliner, L. S. (2019). Systematic review of the impact of patient-provider language barriers on healthcare outcomes. Journal of General Internal Medicine, 34(8), 1591-1606. https://doi.org/10.1007/s11606-019-04847-5
