Language Access Still a Barrier In Equal Care For All

wheel chair sitting at the top of a staircase

The passage of the Affordable Care Act on March 23, 2010 might make it seem like great strides are being made to offer consistent, equal and affordable health care access to everyone across the U.S. It is pretty clear that the U.S. healthcare industry has much work to do before being able to rank among the best systems in the world.

Currently our healthcare industry accounts for almost half (44.3%) of the $6.45 trillion spent on health care globally. Among the many obstacles facing our nation’s healthcare system is the lack of consistent and efficient treatment for Limited English Proficiency (LEP) individuals. Diversity in the U.S. not going away anytime soon. According to the most recent Census report (Nov-2015) over 350 languages are spoken in American homes. The protector of LEP individuals’ rights was passed in 1964, in The Civil Rights Act which states that “No person in the United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” What this means for health care providers is that those who accept Medicare and Medicaid reimbursement for their services, have a legal obligation to provide an interpreter to LEP patients, or those with limited hearing, free of charge. This important piece of legislation helped create the framework necessary to allow non-English speaking individual’s access to health care in their native language, affording them the same healthcare experience every citizen deserves.


National Adoption Work Remains

Due to a lack of standards on a national level, wide-spread adoption for medical interpreters remains to be seen across the U.S. healthcare system. To date only three states (NJ, CA & WA) have enacted laws requiring health care professionals to receive training or continuous education to address language access and/or cultural competency. Unfortunately it is still common in many hospitals to utilize individuals who lack formal training as interpreters. Often times this role is hastily filled by an easily available bilingual employee, a patient’s family member or even children. Too often the assumption made within the healthcare environment that being bi-lingual equates to the same skill set of an interpreter, which is not the case. This is especially evident within the medical setting where the price of a miscommunication can mean the difference between life and death. Interpreting in a specific industry requires knowledge of that industry, including its terminology and etiquette among other factors. A legal interpreter typically does not double as a medical interpreter, since each field comes with its own respective set of knowledge bases. The fragmented setting and slow adoption of industry standards has led to less than acceptable treatment of LEP patients across the country. Sadly this issue has only managed to garner mainstream media attention in the rare tragic cases that could have been avoided with proper communication channels in place.


The 71 Million Dollar Word

In Florida an 18 year-old man was admitted to the hospital complaining of a headache. The young man was misdiagnosed as a result of a variety of miscommunications that occurred due to a lack of a medical interpreter being present. The error stemmed from the Spanish word “intoxicate,” which the patient’s family had used to describe his condition. This word is not the equivalent of the English word “intoxicated.” This mix-up combined with the symptoms he exhibited, led the medical staff to conclude that Willie Ramirez was suffering from a drug overdose. Sadly, the patient was actually suffering from a brain clot. Over the course of the next 48 hours the ensuing brain damage rendered the young Mr. Ramirez a quadriplegic. The lawsuit that followed resulted in a $71 million settlement being awarded to Mr. Ramirez’s family.


Long Road Ahead

This case illustrates how shortfalls in communication not only presents risks to an individual’s well-being, but also put hospitals and physicians in jeopardy. A well-trained interpreter can prevent unnecessary costs for the healthcare system (as well as patients) while ensuring higher treatment quality for LEP individuals. In addition a patient is more likely to come back for care if the medical provider did not understand his/her symptoms or if the patient could not accurately follow the health care instructions he/she was. The most common reasons the healthcare industry is slow to adopt the 51 year old act is a lack of knowledge of responsibilities on a federal level, not prioritizing and a lack of accountability as a result of inconsistent enforcement of the laws. One of the biggest breakthroughs for LEP individuals has been the emergence of new technologies that make access easier such as VRI or OPI options. With just a tablet, phone or laptop a patient can have an interpreter in arm’s reach in seconds. There is still much ground to cover to ensure equal access for all individuals, but with the gradual adoption by states, LEP patient rights advocacy groups and the continued emergence of industry disrupting technologies the industry is glacially moving in the right direction. If you want to learn more about language solutions feel free to contact us for a free consultation and more healthcare information. Whether you are exploring new services or looking to improve existing ones let us facilitate seamless communication on all levels.




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