When patients and doctors don't speak the same language, healthcare gets tricky. We've talked with many patients who struggle to get care because English isn't their first language. They tell us that while interpreters help, how providers use these services really matters.
Research shows this too. A study by Diamond and colleagues in 2019 found that patients who don't speak English well face more medical errors, follow treatment plans less often, and feel less satisfied when translation services aren't set up properly.
Here's what we've learned from real patients.
The Patient Journey: Six Real Challenges
1. The Waiting Game
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Maria's story stands out to us. A Spanish speaker from Ecuador, she told us: "I checked in at urgent care with severe pain but couldn't explain my symptoms until an interpreter arrived two hours later."
This happens too often. Patients wait without being able to explain what hurts or understand what's happening next. Meanwhile, they worry and their health problems might get worse.
Practical Approaches That Make a Difference: Having a tablet ready for video interpretation at check-in can cut wait times. Even a simple translated welcome card makes patients feel seen while waiting. Asking about language needs when making appointments gives everyone time to prepare. When staff wear badges with interpreter contact info, they can get help faster when needed.
2. Lost in Translation: Medical Terms
"The interpreter used a word for my condition I didn't understand," Carlos told us after his cardiology appointment. "In my country, we use a different term. I nodded yes because I felt embarrassed to ask again."
Medical words are tough even for native English speakers. When translated, these terms can become even more confusing. Many patients tell us they pretend to understand rather than asking for clearer explanations.
Practical Approaches That Make a Difference: Using everyday words instead of medical jargon makes a big difference. Drawing simple pictures often shows what words can't explain. Having patients repeat back what they understood gives everyone a chance to fix misunderstandings. A simple guide with common medical terms and their plain-language alternatives helps providers explain complex conditions clearly.
3. Navigating the Technology Divide
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Many hospitals now use video or tablets for interpretation. This creates a new problem: some patients don't know how to use the technology.
We recently spoke with Elena, an elderly Russian speaker, who shared: "The nurse handed me this tablet with a person on the screen. I didn't know how to use it or even that I was supposed to speak to them. I kept trying to touch the screen to make it work."
Older patients or those who haven't used much technology can feel confused by these new tools, especially when they're already stressed about their health.
Practical Approaches That Make a Difference: Training staff to properly introduce video interpretation systems to patients helps prevent confusion. Creating clear protocols for who is responsible for setting up interpretation technology ensures it happens consistently. Establishing backup phone interpretation procedures gives options when video systems aren't working well.
4. When Language Has Layers
"The interpreter spoke Spanish, but not my Spanish," Juanita from rural Guatemala told us. "I left more confused than when I arrived."
Spanish in Mexico differs from Spanish in Argentina. Arabic has many different forms. When interpreters speak the wrong version of a language, patients may become confused about their diagnosis, medicine instructions, or treatment plans.
Practical Approaches That Make a Difference: Asking "What country are you from?" helps match patients with the right dialect. Speaking in shorter sentences with pauses gives the interpreter time to translate accurately. Writing down dialect preferences in patient charts helps provide insight for the interpreter to translate effectively. Letting patients know they can request a different interpreter if they're struggling to understand gives them control over their care.
5. The Trust Factor
Ibrahim noticed something concerning: "The doctor would speak for two minutes, but the interpreter would translate in just a few seconds. I knew I wasn't getting the full message."
Patients worry they're missing important details, that medical terms aren't being explained right, or that interpreters are adding their own thoughts.
Practical Approaches That Make a Difference: Starting with "I'll pause after each important point" sets clear expectations. Watching facial expressions helps catch confusion early. Visual aids bridge gaps when words aren't enough. Writing down key numbers and medication names creates a reference point everyone can understand. Asking interpreters to translate everything rather than summarize ensures nothing gets lost.
6. The Family Interpreter Dilemma
We often hear of family members – even young children – being asked to interpret complex medical information. While it might seem easier, this causes serious problems.
Children don't know medical terms in either language. Family relationships change when children become information gatekeepers. Patients often hide sensitive information to protect family members. Both the patient and family member can feel upset by difficult medical news.
Practical Approaches That Make a Difference: Having a ready phrase like "We always use professional interpreters for medical information" helps staff politely decline family offers to interpret. For sensitive appointments, scheduling during quieter times helps maintain privacy.
Looking Forward
These solutions hint at the impact and importance healthcare providers place on the U.S. Department of Health and Human Services' (2020) guidelines on Section 1557 Nondiscrimination Protections, which emphasize healthcare providers' responsibility to ensure meaningful access to care for patients with limited English proficiency. By addressing these six challenges, providers can get closer to aligning their care with the ideal of every patient getting the same quality no matter what language they speak.
We'd love to hear what's worked in your hospital or clinic!
References
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. Link
U.S. Department of Health and Human Services. (2020). HHS Finalizes Rule on Section 1557 Nondiscrimination Protections under the Affordable Care Act. Retrieved from Link
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.Eyal was recently involved in research on how technology can improve medical translation accuracy and has facilitated discussions with doctors and healthcare providers across the United States to better understand real-world interpretation challenges. His work aligns with current healthcare regulations and is informed by the latest research on patient-provider language barriers.
