PORTLAND 鈥� Interpreting from one language to another is a tricky business, and when it comes to interpreting between a doctor and patient, the stakes are even聽higher.
Consider the story of 18-year-old baseball player .
Ramirez was taken to a South Florida hospital in a coma, says Oregon certified medical interpreter Helen Eby. 鈥淗is family apparently used the word 鈥榠ntoxicado鈥� to talk about this person,鈥� she says. 鈥淲ell, 鈥榠ntoxicado鈥� in Spanish just means that you ingested something. It could be food, it could be a drug, it could be anything that has made you聽sick.鈥�
Patient Isidro Hernandes communicates with Dr. Angela Alday through Spanish interpreter Armando Jimenez. (Photo by Tuality Healthcare/Jeff Schilling)
But, Eby continues, 鈥渢he interpreter interpreted this as 鈥榠ntoxicated鈥� so the doctor immediately made a diagnosis of drug overdose. They had him in the hospital for two days before they figured out they should call in a neurologist and found that he had a couple of hematomas in his brain. The guy ended up聽quadriplegic.鈥�
Eby says doctors and hospitals also often turn to a family member for help, but that can be problematic, too.
鈥淵ou know, you鈥檝e got a 10-year-old in a gynecology appointment. Is this where you would normally take a 10-year-old?鈥� she says.聽 鈥淣ot likely. Or have a child, an adult child even, interpret a parent鈥檚 cancer diagnosis. That鈥檚 got to be highly traumatic.鈥�
Thirteen years ago, the state of Oregon recognized the problem and required doctors and hospitals to start using interpreters. The Affordable Care Act also broadens what hospitals and insurers are required to translate for people who don鈥檛 speak English.
But even more than a decade after the state law has been on the books, it still poses challenges in Oregon. Many hospitals and doctors turned to a phone service, where they can quickly get help in several languages.
But the people who work for those language services often aren鈥檛 certified medical interpreters, and that can lead to difficulties.
Isidro Hernandes is 48 and lives in Cornelius, in Oregon鈥檚 fertile Willamette Valley. Recently, he was a patient at Hillsboro鈥檚聽.
The 48-year-old landscaper was at work when he started to feel a tightness in his chest. He鈥檚 feeling better now that his heart problems are being addressed, but speaking through interpreter Armando Jinenez, Hernandes says he prefers in-person interpreters to those on the phone.
鈥淎 lot of times the over-the-phone interpreter can鈥檛 see what you鈥檙e doing, can鈥檛 describe or relay that message. And sometimes they might have errors or mistakes in communications,鈥� Jinenez relays in English for Hernandes.
Tuality Hospital has been using a phone service to provide qualified interpreters, but the director of corporate communications, Gerry Ewing, says they鈥檙e planning to use more in-person聽interpreters.
鈥淲e鈥檙e trying to reflect the demographics of our community, which is changing rapidly,鈥� he聽says.聽 鈥淲ashington County is around 25 percent Hispanic, so we need to reflect that in the services we provide our聽patients.鈥�
Hernandes鈥� doctor, Angela Alday, says that five to 20 percent of her patients require an interpreter. She said the hospital encourages her to use a phone service when necessary, which she does. But she says sometimes, when dealing with a touchy issue, she will use a family聽member.
鈥淥ne problem that I run into with the translator phone is a lot of our elderly patients seem to be kind of confused by it,鈥� Alday聽says. 鈥淵ou know some of them don鈥檛 hear very well so that can be a problem. And then, particularly if the patient has dementia, sometimes using the telephone translator is confusing. They don鈥檛 know what鈥檚 going on. But I feel like if there鈥檚 a family member standing there beside them, then they understand more what鈥檚聽happening.鈥�
She鈥檚 pleased the hospital is planning to use more in-person interpreters in the聽future.
Oregon has about 3,500 medical interpreters. But Eby says only 32 are certified and another 64 qualified, 鈥淪o you have a three percent chance of getting a qualified or certified interpreter in Oregon right now,鈥� she聽says. 鈥淭hat鈥檚 pretty low, in my聽opinion.鈥�
It takes a long time and costs a lot of money to become certified, she adds. And after a person goes through all that training, they find they can make more money and have a more stable lifestyle in another career, like translation for court reporting. That鈥檚 because medical interpreters tend to be consultants and don鈥檛 get paid to travel. The hours can also be sparse and sporadic.
But Eby remains hopeful. Now that the Affordable Care Act is , such a reduction in errors could save them significant聽sums.
A 2012 by the聽American College of Emergency Physicians looked at interpreter聽errors. It found that the error rate was significantly lower for professional interpreters than for ad hoc interpreters 鈥� 12 percent as opposed to 22 percent. And for professionals with more than 100 hours of training, errors dropped to 2聽percent.
plans to increase training and add 150 new interpreters in the next two years.