Many immigrants to the United States
may be getting inadequate medical care because of language
barriers between patients and medical professionals. But some health facilities
are working to add more multilingual staff and reduce errors based on
More than 22 million people who live in the United States don't speak
or understand English very well. And that can be deadly. In a study
published in the New England Journal of Medicine, Dr. Glenn Flores
highlights some cases where language barriers prevented patients from
communicating with health care providers -- with serious consequences.
recalls one incident in which English-speaking paramedics thought a
Spanish-speaking man was suffering from a drug overdose. "He was in the
hospital basically for two days being worked up for drug abuse," Flores
says. "They finally did a head C-T scan and realized he had had a major
bleed into his brain, probably originating from the rupture of an artery
in his brain. He ended up being quadriplegic
and he got a $71
million settlement award from the hospital."
Flores, a professor at the Medical College of Wisconsin says that
despite examples like that, the majority of U.S. health care facilities
still do not have trained interpreters on site. But he acknowledges that
increasing numbers of health care workers are bilingual, and that more
clinics and hospitals do make sure their staff and patients understand
The Tinno families get into the waiting room at the Sixteenth Street Community Health
Center in Milwaukee, Wisconsin. Some 40%, or about 7000 of the
patients who were seen there last year spoke little or no English.
Fortunately for them, of the 30 doctors and nurses at the clinic, 28 also
After greeting several
members of the Caseas family,doctor Ricas examines their young daughter
Gabrielle. Doctor Ricas says being able to speak to Mrs. Caseas in her native Spanish means
he can discuss Gabrielle's condition - and treatment - in much greater depth.
"It's always good to ask a few extra questions," he explains, "like why this
is important for you and what have you heard and what do other people say
about this? Sometimes that helps you understand what their real concerns
are. But it's difficult to get into that detail if you don't speak the
The Sixteenth Street Clinic is expanding. So its directors
are in the process of hiring more staff who are bilingual now, or
who commit to learning Spanish. Clinic vice-president, Dr. Julie Schuller,
says new hires are told that by speaking to patients in their own
language, they can provide the highest quality care. "By providing high
quality care, we are avoiding errors, we are avoiding malpractice suits,"
she says. "The main focus for us is the high quality. What [follows] from
that [i.e. avoiding errors] is important too, but we're focused on
providing the best quality we can provide."
Schuller says it's frustrating to go into medical facilities and see
patients who are not being understood. So she urges other hospitals and
clinics to look into adding interpreters to their staff, or at least to
make use of translator hotlines that can be called day or night.
But Dana Richardson of the Wisconsin Hospital Association says many
facilities are worried about the additional cost. "What we have seen in
the state of Wisconsin overall is an increasing number of minority-ethnic
groups coming in, and so it's becoming a greater cost for the health
community to provide these services." Richardson says translator hotlines
can cost at least $50 per hour. She says while hospitals recognize the
value of having a multi-lingual flexibility, most simply cannot afford it.
The author of the language barrier study, Glenn Flores, suggests that
U.S. medical schools could require their students to take medical Spanish,
Chinese or other appropriate language. But for now, the number of immigrants is
outpacing the health care industry's ability to provide adequate care in a
language they can understand.