Healthcare providers are well-acquainted with the phenomenon of burnout. It's a systemic issue, exacerbated by a multitude of factors, such as administrative responsibilities, time constraints, high expectations, and a demanding work environment. However, one challenge often overlooked is the strain related to serving patients with Limited English Proficiency (LEP).
In our discussions with healthcare providers, we've identified several substantial challenges associated with language barriers:
1. Challenges related to Interpreter Services
The process of procuring interpreter services is often seen as a cumbersome workflow that heightens stress levels. Providers consistently reported delays in acquiring interpretation assistance whether via a telephone language line or a video translator service. Waiting times often depend on the language in question, with some interpreters becoming available within 1-2 minutes, while others may take 5-10 minutes or more. This is especially the case for less common languages or specific dialects, and during off-hours.
After the interpreter becomes available, additional time is consumed by procedural necessities, such as introductions, disclaimers, and other formalities. Moreover, healthcare providers are required to document the name and identification number of the interpreter in the Electronic Medical Record (EMR) as proof of involving an interpreter in the encounter, further contributing to the complexity and length of each appointment.
2. Time Pressure and Longer Encounters
The lengthy process of securing and working with an interpreter inevitably leads to longer patient encounters. Each exchange must pass through an interpretative filter, with every sentence translated twice — once for the patient and once for the provider. This, coupled with the occasional need for repetition due to misunderstandings, amplifies the length of each session. As a result, an average patient encounter, under normal conditions completed within a 15-minute slot, can extend to as much as 30-40 minutes when working with LEP patients.
3. Burden of Ensuring Accurate Communication
Effective communication forms the crux of healthcare provision. However, with language barriers, the fear of not having the message delivered as intended weighs heavy on providers. They find themselves unsure if their instructions were accurately understood or whether crucial details were lost, misinterpreted, or possibly "softened" during the translation.
Moreover, inconsistencies in translation quality can further deepen the unease. Providers have shared instances where interpreters, due to their expertise level or understanding of the context, were unable to accurately express the provider's instructions.
4. Navigating Cultural Differences
Diverse cultural beliefs and practices can pose another challenge in healthcare provision. Cultural differences can sometimes contradict medical advice, potentially resulting in non-compliance with the recommended course of treatment. Additionally, some cultural norms and taboos can inhibit full disclosure of symptoms or concerns that could be crucial for accurate diagnosis and treatment.
Recognizing these challenges, it becomes imperative to acknowledge a distinct form of burnout: the "LEP Burnout". This is a specific form of stress and fatigue that healthcare providers face when dealing with patients who have limited English proficiency.
Identifying LEP Burnout as a specific issue under the broader umbrella of healthcare provider burnout can guide us in finding targeted solutions. One such solution is the development of the first AI Medical Interpreter. This AI tool can alleviate some of the communication challenges, leading to clearer, more accurate, and more efficient interactions between providers and LEP patients, thereby helping to reduce instances of LEP Burnout.
