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Lost In Translation: Medical Interpreters May Influence Health Decisions

Thanks to KevinMD for highlighting this fascinating blog post by Pallimed. A recent study in the journal Chest showcases the inaccuracies inherent in translating medical conversations. According to the small study, as many as 50% of the statements made by physicians were altered in some way by the designated interpreters. Generally the certified medical interpreters attempted to editorialize or soften the physician’s language. Here is one specific example:

Doctor: I don’t know. Um, this is a very rapidly progressing cancer.

Interpreter (translating): He doesn’t know because it starts gradually.

Although this study had a very small sample size, in my experience it rings true. I speak three languages (English, French and Spanish) however my proficiency in the last two doesn’t quite reach fluency. Although I can comprehend what people are saying, I make some grammatical errors and demonstrate somewhat limited vocabulary in my responses. For this reason, I welcome interpreter services when they’re available, and when they’re not – I proceed with self-translation for convenience and speed.

This puts me in an interesting position – I can understand the difference between what I say in English and how the interpreter translates it. In most interactions I’ve asked the interpreter to rephrase at least one concept to the patient as I note some inaccuracies in editorialization or softening of concepts. The kinds of translational “errors” include things like:

Dr. Val: We need to use IV antibiotics to treat your skin infection because we don’t want it to spread. If we don’t treat it, the infection could enter your bloodstream and cause serious problems, including organ damage, and even death.

Interpreter: The doctor is going to give you some strong medicine through your IV to treat your skin inflammation.

I agree with the conclusions drawn by the study authors – it’s helpful to speak with the interpreters prior to the patient interaction, and stress the importance of translating the exact meaning of your words. Also, physicians should speak in slow, short sentences to increase the chances of accurate translations.

And patients? Don’t hesitate to ask clarifying questions if anything about your condition or treatment plan is unclear to you. Invite a bilingual friend or family member to the meeting if possible, and realize that the quality of interpretation varies. Make sure you understand the risks and benefits of any procedure or medication before you accept or decline it. When you’re in the hospital you certainly don’t want any aspect of your care to be lost in translation.

*See my interview with Access Hollywood reporter, Maria Menounos, about how her dad’s diabetes care was influenced by a language barrier.*This post originally appeared on Dr. Val’s blog at

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One Response to “Lost In Translation: Medical Interpreters May Influence Health Decisions”

  1. CRHD says:

    Very topical blog post Dr. Val. Our reseach center is currently working on a NIH funded study looking at interpreters as advocates. That is to say, with training can an interpreter help improve the delivery of health care.

    I’ll be sure to keep you up to date.

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