title: Medical interpreters: improvements to address access, equity, and quality of care for limited-English-proficient patients.
abstract: Limited-English-proficient (LEP) patients in the United States experience a variety of health care disparities associated with language barriers, including reduced clinical encounter time and substandard medical treatment compared with their English-speaking counterparts. In most current U.S. health care settings, interpretation services are provided by personnel ranging from employed professional interpreters to untrained, ad hoc interpreters such as friends, family, or medical staff. Studies have demonstrated that untrained individuals commit many interpretation errors that may critically compromise patient safety and ultimately prove to be life-threatening. Despite documented risks, the U.S. health care system lacks a required standardized certification for medical interpreters. The authors propose that the standardization of medical interpreter training and certification would substantially reduce the barriers to equitable care experienced by LEP patients in the U.S. health care system, including the occurrence of preventable clinical errors. Recent efforts of the U.S. federal court system are cited as a successful and realistic example of how these goals may be achieved. As guided by the evolution of the federal court interpreting certification program, subsequent research will be required to demonstrate the improvements and challenges that would result from national certification standards and policy for medical interpreters. Research should examine cost-effectiveness and ensure that certified interpreting services are appropriately used by health care practitioners. Ongoing commitment is required from lawmakers, health care providers, and researchers to remove barriers to care and to demand that equity remain a consistent goal of our health care system.
authors: Dr. VanderWielen is an instructor at the University of Colorado School of Medicine, Department of Family Medicine, Denver, Colorado. Dr. Enurah is an internal medicine intern at the University Of Colorado School Of Medicine, Denver, Colorado. Dr. Rho is a family medicine/internal medicine intern at Eastern Virginia Medical School, Norfolk, Virginia. Dr. Nagarkatti-Gude is a psychiatry intern at Oregon Health and Science University, Portland, Oregon. Ms. Michelsen-King is a federally certified Spanish court interpreter and master test specialist of federal and state consortium Spanish interpreter certification examinations, and collateral instructor of medical and court Spanish interpreting, Virginia Commonwealth University School of World Studies, Richmond, Virginia. Dr. Crossman is associate professor of family medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia. Dr. Vanderbilt is director of assessment and evaluation, Virginia Commonwealth University School of Medicine Center on Health Disparities, Richmond, Virginia.
authors: Lynn M
authors: LM
authors: VanderWielen
authors: Alexander S
authors: AS
authors: Enurah
authors: Helen Y
authors: HY
authors: Rho
authors: David R
authors: DR
authors: Nagarkatti-Gude
authors: Patricia
authors: P
authors: Michelsen-King
authors: Steven H
authors: SH
authors: Crossman
authors: Allison A
authors: AA
authors: Vanderbilt
mesh_terms: D002568:Certification; D003144:Communication Barriers; D006282:Health Personnel / Q000592:standards*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D014175:Translating; D014481:United States