Monday, October 14, 2013

Medical interpreting: merely a hiccup?

I recently read an article titled The death of healthcare interpreting in the Netherlands, which describes the decision from the Dutch government not to pay any longer for interpreting services in healthcare settings. The reason: officials believe it is the patient’s responsibility to be able to communicate in the official language.
One could remain unconcerned and believe that that would never happen here at home.  That would be wrong.  Let me tell you, something similar has happened very close to home; that is in Indianapolis, Indiana. This time, it was not a government decision but a hospital system decision.  As recent as last week, the interpreter service supervisor, and a good friend of mine, lost half her interpreting staff to hospital-wide layoffs. Unlike the Dutch government, this hospital will continue to pay for interpreting services, but not to the individual interpreters but a telephone interpreting agency. The hospital’s language access service had been carefully established and interpreters were carefully selected, trained and evaluated. They offered in-house workshops for interpreters, and were working to improve language services by bilingual providers who work without an interpreter with limited English proficient and deaf patients. All of this is almost gone!
 I don’t have anything against interpreting agencies; like everybody else, agencies are trying to earn a living.  I understand that, but two things about this situation bother me. First is the fact that interpreters get paid a fraction of what agencies charge their clients.  That is how agencies make their money.  I understand that as well.  But the second thing that bothers me is an even bigger problem. When a hospital, or a hospital system in this case, gives up responsibility for language access services to a third party, who assures that meaningful access to services are really being provided? Is the interpreter on the other side of the line a truly qualified professional? Is the interpreter adhering to the ethical canons of the medical profession? Is the interpreter’s rendition accurate? Who can provide an answer to all these questions?   Not the patient, not the provider, and not the agency.  Let’s keep in mind, the interpreter is, by and large, the only party in a medical encounter who knows what is going on. Let’s also keep in mind that telephone interpreters work from home in most cases. Who checks on the quality of their work?  Agencies, in the best of cases, do random checks of the interpreter’s rendition. If nobody else but the interpreter knows what is going on during a medical encounter, who will complain about a poor rendition or the message not getting across?  Of course, one can argue that interpreters are interpreters whether they work for an agency or a hospital. It is worth noting, however, that wages for interpreters in the medical/health care field are overall lower than wages for interpreters in legal settings. If interpreters are paid agency wages, then their rates can become significantly lower.  Not very enticing for a good interpreter! So, who are the agencies getting as interpreters?
While I understand that the economy is doing poorly in general, I do not understand that a service as important as access to services would be awarded to a third party without oversight for quality control by the medical provider. Are medical interpreters doomed to work for ‘the middle man’ at a fraction of what the ‘middle man’ gets for the services the interpreter provides, while at the same time the quality of services is not assured? I find this idea rather disturbing.

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