In The Hospital, A Bad Translation Can Destroy A Life
RENEE MONTAGNE, HOST:
In the year since the Affordable Care Act went into effect, millions of people have gotten health insurance for the first time, and that includes a large number who speak very little or no English.
Obamacare does expand translation services, translations that hospitals and insurers now must make available. As it happens, Oregon began tackling that challenge 13 years ago when it began requiring that translators be provided within the health care system for patients who need them. But as Christian Foden-Vencil reports, it's been a difficult thing to implement.
KRISTIAN FODEN-VENCIL, BYLINE: Interpreting from one language to another is a tricky business. But when it comes to interpreting between a doctor and patient, the stakes are high. Helen Eby, the president of the Oregon Society of Translators and Interpreters, tells the story of an 18-year-old baseball player, Willie Ramirez, who turned up at a Florida hospital unable to speak.
HELEN EBY: His family apparently used the word intoxicado to talk about this person. Well, intoxicado in Spanish just means that you ingested something. It could be food; it could be a drug; it could be anything. But the interpreter interpreted this as intoxicated, so the doctor immediately made a diagnosis of drug overdose.
FODEN-VENCIL: A couple of days later, they figured out he was really bleeding from his brain, and Ramirez eventually ended up in a wheelchair. Eby says doctors and hospitals often turn to a family member for help, but that can be problematic.
EBY: You know, you've got a 10-year-old in a gynecology appointment. Is this where you would normally take a 10-year-old? Not likely - or have a child - an adult child, even - interpret a parent's cancer diagnosis? That's got to be highly traumatic.
FODEN-VENCIL: Thirteen years ago, the state of Oregon recognized the problem and required doctors and hospitals to start using interpreters. What happened is doctors turned to language services available from private companies over the phone. But, says Eby, the people who work for those language services often aren't certified medical interpreters, and that can lead to problems.
Isidro Hernandes is lying in a bed in Tuality hospital in Oregon's fertile Willamette Valley. The 48-year-old landscaper was at work when he started to feel a tightness in his chest. He's feeling better now, but speaking through interpreter Armando Jimenez, Hernandes says he prefers in-person interpreters to the phone.
ISIDRO HERNANDES: (Through translator) A lot of times, the over-the-phone interpreter can't see what you're doing, can't describe or relay that message. And sometimes they might have errors or mistakes in communication.
FODEN-VENCIL: Hernandes's doctor, Angela Alday, says up to 1 in 5 of her patients requires an interpreter, and she usually uses the phone. But sometimes she still turns to a family member.
ANGELA ALDAY: One problem that I run into with the translator phone is that a lot of our elderly patients seem to be kind of confused by it. You know, some of them don't hear very well, so that can be a problem with the phone translator. And then particularly if the patient has dementia, sometimes using the telephone translator is confusing. They don't understand what's going on. But I feel like, you know, if there's a family member standing there beside them, then they understand more what's happening.
FODEN-VENCIL: In an effort to meet the requirements of Oregon's interpreter law, and now the Affordable Care Act, Alday's hospital is training staff to do the job, says hospital spokesman Gerry Ewing.
GERRY EWING: We're trying to reflect the demographics of our community. Washington County is around 25 percent Hispanic, so, you know, we need to reflect that in the services we provide those patients.
FODEN-VENCIL: He says the hospital's also translated many of its medical discharge documents into Spanish. Still, Helen Eby of the Oregon Society of Translators and Interpreters says after 13 years, the state only has about 3,500 people doing the job. And only about 100 of those have the right qualifications.
EBY: So you have a 3 percent chance of getting a qualified or certified interpreter in Oregon right now.
FODEN-VENCIL: She says it takes a long time and costs a lot of money to become certified. And after somebody goes through all that, they find they can earn more and have a more stable lifestyle in another career, like court reporting. But Eby remains hopeful. She says now the Affordable Care Act is penalizing hospitals for readmissions, reducing medical errors should become a priority. One study found the error rate for professional interpreters is much lower than for ad hoc interpreters - 2 percent as opposed to 22 percent. But what's the state doing about the shortage? The Oregon Office of Equity and Inclusion says it's trying to increase training and add 150 new interpreters over the next couple of years. For NPR News, I'm Christian Foden-Vencil in Portland.
MONTAGNE: This story is part of a reporting partnership with NPR, Oregon Public Broadcasting and Kaiser Health News. Transcript provided by NPR, Copyright NPR.