The United States has one of the most developed and unique healthcare systems in the world. Health care is provided by several organizations in the country and the facilities are primarily owned and operated by big businesses in the private sector.
Improper communication between patient and their doctor due to limited knowledge of English, the primary spoken language in the US, can prove to be costly for healthcare providers as well as payers because of a reduced use by patients of preventive care, a higher risk of misdiagnosis, poor patient compliance, increased incidences of diagnostic testing, as well as a higher rate of admissions to the hospital or to the emergency room. Despite the fact that federal law in the US requires a provision of bilingual healthcare professionals as well as interpretation services, most healthcare providers are not complying with the law as the cost goes up significantly.
Today, we take a look at some of the most common languages that medical patients in the US speak and the importance of having a well-qualified medical interpreter present at these hospitals for providing the correct assistance and to ensure that nothing gets lost in translation.
Language Barriers in the US
Over 55% of the community hospitals in the US are non-profit, while the rest is split equally between government-owned and for-profit businesses. Over the years, the US has come to be known as a ‘melting pot of cultures and nationalities’, as put by erstwhile President Jimmy Carter. The country is made up of different people, different cultures, different beliefs, and of course, different languages.
A report from the Census Bureau in 2015 found that there are nearly 350 languages spoken within the country. This, of course, means that many of these 350 languages get represented at hospitals when patients come in for a checkup.
Furthermore, a Census in 2000 found that nearly 50 million citizens of the US or residents of the country between the ages of 5 years and above, were speaking a language other than English at home. The percentage of people having limited proficiency in English stood at 34.8% in 1980. This climbed sharply to 8.1% in 2000. It is expected to be even higher today.
Studies have shown that people who have a limited English proficiency (LEP) are having difficulty in getting access to proper healthcare systems and are less likely to be using services aimed at preventive health care such as screening for cancer, vaccinations, dental and eye examinations, etc. Researchers have found that LEP individuals are less likely to visit the doctor and even more unlikely to opt for preventive services.
Common Languages amongst Medical Patients in the US
Research has shown that apart from English being the most common language spoken in the US, the majority of patients who visit healthcare facilities are Spanish speakers. It is estimated that even though the number of native Spanish speakers are substantially lesser than English speakers, Spanish, nevertheless, has become one of the fastest growing spoken languages in the country. In fact, there are actually more Spanish speakers in the US, then even in Spain itself. Thereby, it makes sense that after English, most patients are found communicating in Spanish.
What’s even more surprising is that the second position is occupied by an Asian language – Chinese. Chinese is, in fact, the second most common foreign language which medical patients communicate in within the US. Chinese also includes Cantonese and Mandarin, as well as any other variety of the language. Chinese speakers make a huge majority of the patients who visit hospitals, particularly in California, New York City, and Texas.
French follows a close third to Chinese, including Louisiana Creole French, a hybrid of the African and French languages. Hospitals in New Orleans, in particular, have reported a large number of patients coming in who are fluent in French and are not proficient in English. In fact, French continues to be one of the major languages still spoken by a vast majority in the state of Louisiana.
incluido el francés criollo de Luisiana, un híbrido de las lenguas africana y francesa. Los hospitales en Nueva Orleans, en particular, han informado que un gran número de pacientes que ingresan son fluidos en francés y no dominan el inglés. De hecho, el francés sigue siendo uno de los principales idiomas que aún se habla por una gran mayoría en el estado de Louisiana.
The Need for Qualified Medical Interpreters
One of the biggest challenges that face healthcare services in keeping medical interpreters is the financial burden they would have to bear. There is no financial resource provided to healthcare facilities that allow them to adequately provide language interpretation services. Even third-party payers such as Medicaid, do not reimburse hospitals for interpreters. These services need to be provided within the existing budget of the hospitals itself. While some healthcare providers are arranging for medical interpreters and funding them themselves, most, though, ignore this pressing need.
Research, however, now indicates that the cost of providing interpreters will actually get offset as this means lesser testing when not required, shorter visits by the patients, as well as a better compliance with after treatment and follow-up guidelines. Studies have shown that as compared to fluent English speakers and LEP patients who did not have an interpreter, LEP patients with an interpreter actually had the shortest duration of stay in an emergency department.
It is, but understandable, that it is not at all feasible for each hospital or clinic to provide a professionally trained medical interpreter for so many potential languages. However, what can be achieved is that technological advancements be used to increase the availability of medical interpreter services.
Technologies such as telephonic interpretation services or video conferencing are now being used worldwide by healthcare facilities to provide access to interpreters for several languages, not just the commonly spoken ones. Telephonic interpretation also allows doctors to easily have access to interpretation when faced with a patient besides them who does not speak English. An added benefit of video conferencing is that not only does it provide a quick access to telephonic interpretation for any language, it also allows for visual communication, which may make many patients feel much more comfortable owing to the face-to-face interpretation experience.
Therefore, with the use of technological developments such as telephonic interpretations, it is possible for healthcare facilities in the US to bring down the cost of interpretation services, while also providing medical interpreters to those patients who are less proficient in English. The use of these technologies will not only bring down the overall cost, but it will also increase the effectiveness of doctor to patient communication, and also make healthcare services accessible to one and all, even those who are not capable of speaking fluently in English.