The demand for trained interpreters to help doctors and patients communicate is growing.


By Kirsti Marohn and Stephanie Dickrell, USA TODAY


Going to the doctor can be an uncomfortable and intimidating experience. But imagine if you couldn't communicate with your doctor or nurse to describe your symptoms or explain your medical history.

As the nation becomes more diverse, demand for trained, skilled interpreters to help doctors and patients communicate — and avoid potentially deadly misunderstandings — is growing.

Health care regulations require medical providers who receive federal funding to provide interpreters. There's also growing research on the effects of bad communication on patient safety, said Izabel Arocha, executive director of the International Medical Interpreters Association.

"There's just been a huge increase in awareness that has changed these practices," Arocha said.

However, there aren't always enough medical interpreters to go around, said Rosemond Owens, health literacy and cultural competency specialist at CentraCare Health System in central Minnesota. CentraCare contracts for interpreters from three organizations including The Bridge−World Language Center. Top languages in demand in central Minnesota are Spanish and Somali.

"We don't have to look too far for what needs there are," said the Bridge's CFO and trainer Jan Almarza. "The needs just hit you in the face."

There's a difference between interpreters and translators. Interpreters convert spoken words from one language to another, while translators convert written documents.

Not all bilingual people are interpreters, Almarza said. While bilingual employees or the patient's family members are sometimes tapped to interpret, it's a practice experts say should be avoided.

Programs around the nation that train and certify interpreters in medical terminology, ethics and cultural differences are seeing rising enrollment.

Training for The Bridge's program takes about 40 hours and outlines best practices and ethical guidelines as set by the National Council on Interpreting in Health Care. There are also oral and written tests to verify people really understand what they claim to know.

Certified interpreter Adalberto Villalobos was among the first to go through the Bridge's training program in 2010. A native of Costa Rica, Villalobos had recently been laid off after working 16 years at the same company and was looking for a career change.

"I simply fell in love with it," he said. Naturally curious, Villalobos spends a lot of time learning about medical conditions and treatments and has even observed surgeries to improve his knowledge.

Villalobos said it's important but sometimes challenging to maintain professional distance while on the job. He sits to the side of but a little behind the patient and keeps his head down. He must remain impartial, even if the doctor is delivering bad news.

"When I put my interpreter hat on, I'm a machine," he said.

Still, Villalobos feels good knowing that he's helping people. He's interpreted for children, mental health patients and even a woman giving birth when no female interpreters were available.

"There's never a dull moment," he said.

The National Board of Certification for Medical Interpreters has about 500 certified interpreters, said Tina Peña, board president. The program is offered in Spanish and is expanding to Mandarin, Russian and possibly African languages, said Peña, who is also an instructor at Tulsa Community College.

More hospitals and clinics are realizing the need to use trained interpreters, Peña said. In some cases, hospitals have had to pay to settle lawsuits because of errors attributed to language barriers, she said.

Peña teaches her students not only about medical terminology and privacy laws but also familiarizes them with home remedies popular in Hispanic cultures, such as passing an egg over a sick person to chase away evil spirits.

"She is like a cultural broker, and will explain quickly to the doctor what happened," Peña said.

At the University of Georgia's Center for Continuing Education, a 40-hour Spanish medical interpreter certificate program offered three times a year is usually full and sometimes has a waiting list, said Shirley Chesley, program developer. The center recently added a Korean program.

Students learn medical terminology and practice typical scenarios, Chesley said. The program also spends a lot of time on ethics, she said.

"You can't get empathetic with your client," Chesley said. "You have to be very precise and do exactly what's required at that particular moment."

In some cities with a large non English-speaking population, hospitals have added their own interpreters on staff.

At UC Davis Medical Center in Sacramento, Calif., 30%-35% of patients have limited proficiency in English, said Elena Morrow, manager of interpretive services. The hospital has 41 staff members who interpret 16 different languages, she said.

Spanish is the most popular language, followed by Russian, Ukrainian, Hmong and Mien. The interpreters handle about 37,000 encounters every year, Morrow said.

"We do see the demand is quite steady and increasing little by little every year," she said.

The salaries interpreters earn vary depending on whether they work on their own or for a hospital or an agency, what part of the country they are in and what language they speak, said Joy Connell, president of the National Council on Interpreting in Health Care.

There are even some interpreters who can work in more than two languages. Those interpreters are in high demand, Connell said.

The U.S. Bureau of Labor Statistics reports interpreters and translators in hospitals earn a national average of $21.43 an hour and $44,570 a year.

Technology is helping health care providers meet the demand for interpreters. Using phone or video conferencing allows hospitals and clinics – including those in rural areas – to provide interpreters for patients, even if they speak a rare language.

Video systems are growing in popularity, Arocha said, because "it allows for that very quick access, but it also allows for the face-to-face interaction."

"There are situations where you can't just rely on audio," she said.

Marohn and Dickrell also report for the St. Cloud (Minn.) Times