In many professions, effective communication is essential for a successful provider-consumer interaction. Particularly, healthcare providers rely on verbal and nonverbal communication as the primary tool for obtaining patients’ health history. Language and cultural barriers can lead to miscommunication, which can further lead to under- or over-diagnosis and inappropriate treatment.
Over the past few decades, the changing face of immigration in the United States has had an unprecedented impact on the healthcare system. Today, over 300 languages are spoken in the U.S., while political, economic and social changes worldwide continue to feed a constant stream of immigrants into the country. Their immediate and frequently urgent health care needs do not wait for linguistic adjustment or cultural assimilation.
Although interpreters have long been present in the administration of healthcare, in the past this function was performed mostly on an ad hoc basis. Providers would call upon whomever was immediately available: family members, non-medical hospital staff, and even other patients. It was a practice that ran a high risk of inadequate communication, resulting in misdiagnosis and inappropriate treatment that could, in a worst case scenario, result in the death of the patient. Such untrained individuals often had little or no understanding of medical concepts or terminology and much less understanding of the importance of accuracy and completeness in the messages they conveyed. This was through no fault of their own. As a result, erroneous messages were often transmitted, new information added, or critical information omitted, drastically changing the nature of the original message. These friends and family members may have unintentionally left out information to protect their relative because they felt embarrassed or may not have understood the information. At times it may be appropriate to accept offers of language assistance by family members or friends, but only for simple day-to-day communication.
Overcoming language barriers between the patient and health care provider is not an easy task. Both parties take meaning from cues based on a set of culturally determined beliefs and values. The cultural rules underlying how they respond to each other determine the course of their communication in the health care encounter. Differences in culture and primary language affect the direct provision of care. It is always best to use professional interpreters when seeking health care. Qualified interpreters are bilingual and can negotiate both cultures. They are trained and bound by a code of conduct that requires them to relate information accurately and maintain confidentiality.