Spotlight On: Medical Interpreters in Cancer Care

November 18, 2014

If you’ve been diagnosed with cancer, you will interact with a number of different members of the health care team at various times during treatment. When you walk into a doctor’s office, hospital, or cancer center, you may encounter nurses, physician assistants, social workers, doctors—the list goes on. In this series, we talk with some of these health care professionals to learn more about their jobs and the role they play in providing high-quality cancer care.

Talking with the doctor isn’t always easy, especially when it comes to cancer. Feelings like fear, shock, and anxiety, as well as the medical jargon health care professionals may use, often get in the way. And when English isn’t your first language, establishing open, effective communication with the health care team is even harder. However, there are language services available. In fact, hospitals that participate in federal programs like Medicaid and Medicare are required by law to provide patients with free language services, including access to interpreters either in person or over the phone. 

To better understand how medical interpreters help patients and families communicate with their doctors, I talked with Debra H. Haynes, MPH, Hispanic Outreach Program Coordinator at Inova Life with Cancer, and the Interpreter Services team for the Inova Health System in Virginia. This team includes Alejandro Muzio, Language Services Manager; George Donald, Medical Interpreter at Inova Fairfax Hospital; and Mariano Siles, Medical Interpreter at Inova Mount Vernon Hospital.

Q: What role does a medical interpreter play in the health care team?

Interpreter Services Team (IST): Our role is to serve as a seamless bridge of communication. Without a medical interpreter, the paths of communication between an English-speaking provider and a limited-English-speaking patient is simply inadequate, incredibly time consuming, and prone to poor outcomes. The medical interpreter transmits everything said accurately and completely. We encourage the patient-provider relationship. We resolve cultural misunderstandings.  Occasionally, we advocate for the patient.

Debra Haynes (DH):  We seek to provide the highest quality of service to ensure that the patient and the provider are able to make the health decisions necessary for the best outcome for the patient. We also bring a sense of security to patients because they can feel like they are able to understand what is being said to them and have a way to respond and participate in their personal health care decisions.

Q: What are the most important things you do on a daily basis?

IST: We do the same thing all health providers do—take care of patients—except that we do it in an indirect way. We are there to make a medical visit possible by removing barriers, both linguistic and cultural. Interpreting is complex and incredibly subtle, requiring know-how far beyond “just speaking a language” if one is to perform consistently and at a high level. Some of us worked in other aspects of the health care field before. Some as providers: RNs, CNAs, medics. Now we are interpreters. But the end-result is the same—we help make a difference in people’s lives. And we take great pride in the work we do.

DH: When I am interpreting for a patient, I seek to make the patient and the provider feel like they are truly communicating and I am only the avenue by which they are doing so. I seek to make sure that they are talking to each other and not to me.  I want them to build a working bond between them so they can work together for the best possible outcome.

Q: What are the best or most rewarding parts of your job?

IST: To interpret a session with optimal word choices, fidelity of meaning, and clearness of production in both languages. Then seeing the end result of our work; seeing the patient get better, get discharged having received excellent and compassionate care, and recognizing we were a big part of that success. Every encounter is a story with challenges and rewards. The job renews itself with each new encounter.

DH: As a medical interpreter, my being able to provide the sense of security for the patient as they are able to effectively communicate with their health care provider and thus being empowered in their own health care decisions is extremely rewarding.

Q: What should patients and their families know about medical interpreters and their role in cancer care?

IST: Patients and families have a right to good, competent interpreters, and the medical staff should always offer this service to them at each visit. We are here for them, to make sure there is clarity and to make sure they get the most out of their medical visit.

DH: We are here to facilitate their effective communication with their health care providers. We also provide a sense of security because we usually understand something of their culture as well, which encourages the patient and their family to trust that we are being accurate in what we are communicating to their provider. In addition, we have training to make sure that we are communicating as accurately as possible what is actually being said, not what we feel or perceive. We also are very discreet and are bound by HIPPA (a federal privacy law) so patients and families should not fear that the information that is exchanged in the course of the appointment or in a medical setting will be told to anyone else. We maintain the privacy of the patient and their families.

Q: Do you have any tips to help patients and their caregivers better use or access your services?

DH: If a patient is concerned about being able to communicate effectively, they should request our services. We are trained to provide this service for the patient at no cost to the patient, and it can give them the peace of mind, that if they are hesitant about their language skills, we can make sure that they are able to communicate their concerns, questions, and fears.

IST: Ask as many questions as necessary while the interpreter is present. Make sure everything is clear before the session ends. Interpreters cannot repeat or explain anything said after the fact, when the provider is no longer there.  

Debra, Alejandro, George, and Mariano talk more about their role in the cancer care team in this podcast.