Doctors often encounter language barriers in health care, whether their patients don't understand the language they're speaking or they're practicing in an area where they're not a native speaker. Luckily, there are many ways to work around language barriers and make sure the highest levels of care are still being provided.
Gerardo Guerra-Bonilla, MD, a family medicine physician at Dignity Health Medical Foundation - Woodland, shared some tips about the tools that are at a doctor's disposal, and how doctors can make their practices even friendlier to different cultures.
Doctors have a number of tools at their disposal, ranging from using Google Translate to having interpreters on hand to help. A good interpretation service is increasingly important. In California, Guerra-Bonilla explained, the population is about 30 percent Hispanic — but only about 5 percent of the providers are Hispanic.
For minor situations in which he and his patient can mostly understand each other, he may simply rely on Google Translate for the occasional word that isn't understood. The app is very convenient and fast, he said. But when language is a true challenge, his practice will use an over-the-phone translation service to get an interpreter's help, or even a tablet to video conference with an interpreter.
"You dial a number and within a couple minutes, you get a person on the line who can speak their language. In our clinic, we have a phone and a tablet for videoconferencing in every single hallway," Guerra-Bonilla said. "If you don't use a translator, there's potential for miscommunication and misunderstanding, and treating something that you really don't understand fully."
Sometimes patients will come with a family member who translates for them. While this seems convenient on the surface, doctors really need to avoid these situations if they can, Guerra-Bonilla said.
"The family member is unfamiliar with the medical language, and then they might also edit the patient's response," he explained. "And if you ask a personal question, they're less likely to share this personal information because they might be afraid of sharing it and later getting in trouble with the family member."
And you definitely don't want to let someone's minor child serve as a translator. "A mother may come to the hospital or clinic with her son because he speaks better English," Guerra-Bonilla said. "Sometimes they may use the child to translate, but that's a no-no. You can get in a lot of legal trouble if you end up in a situation where things go wrong because of a misunderstanding."
Providing an environment that's welcoming to people of all languages begins long before the doctor-patient interaction. It has to start with the people who are on the phone, making appointments, and extend all the way to prescriptions and follow-up calls, he said. When the patient understands every step, it creates a higher quality of care, better compliance to doctor suggestions and follow-ups, and decreased hospital visits. Even language-friendly insurance carriers are important, because patients also need to understand their bills.
But it's not just about being bilingual and translating medical terms. Doctor's offices should seek to truly understand the different cultures too, Guerra-Bonilla emphasized. "A bicultural environment helps a lot when trying to relate to the patient," he explained. "It's easier for them to open up and talk about more personal issues, like psychiatric problems, depression, or anxiety."
Ultimately, Guerra-Bonilla would like to see more doctors from other cultures entering the American medical field. Before his residency, he attended a program at UCLA that was focused on bringing on Hispanic doctors with medical degrees from Latin America and training them here. That way, they could enter a family medical practice in the U.S. and help bridge the cultural gap.
Ultimately, overcoming language barriers in health care is vital for any medical practice, and getting good interpreters is as easy as picking up a tablet or phone. Having good interpretation services readily available is not a luxury, but a necessity.
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