Amy Olen, PhD; Paulina S. Lim, MS; Charles “Barry” Rothschild, MD
Research has documented the prevalence of health disparities between non-English speakers and English speakers in the United States. To address disparities, medical interpreters bridge the language gap between medical treating teams and patients and their families receiving medical services. Studies demonstrate the positive impacts of language access services on reducing language-related health disparities. However, little is known about encounter-level factors that promote or inhibit equitable language access in interpreted medical encounters (IME).
In this presentation, we draw from qualitative interviews with 13 medical interpreters and 37 providers (physicians, nurse practitioners) in a medium-size pediatric hospital in the United States to explore perspectives on behaviors and attitudes that facilitate, or create barriers to, effective communication and language access in IME.
Interpreters noted they feel like outsiders with regard to medical care teams and believe that providers experience negative emotions related to the additional time commitment required for IME. Interpreters often perceive microaggressions toward patients and families and reported “absorbing” these provider attitudes to protect patients and families. Physician perspectives largely corroborated that they feel IME are “tricky,” “time-consuming,” and “frustrating.” Further, physicians identified inequity of information sharing for IME, acknowledging both less frequent communications and large boluses of information to “take advantage of the fact that the interpreter is there.” A minority of providers saw IME as an opportunity to improve cultural understanding and equity of care.
The interview data suggests that language use biases regarding IME and within IME prevent equitable language access despite language services provision. Simply providing interpreting services is insufficient for attaining equitable, inclusive health communication and healthcare provision, and positive health outcomes. We identify opportunities for interpreters and in-hospital language services allies (e.g., physicians, psychologists), to advocate for and educate treating teams on language access equity and inclusion, not only in language services provision, but also within and during IME themselves.
Keywords: Language Access, Equitable Language Access, Inclusive Language Access, Interpreted Medical Encounters, Medical Interpreting.