Lost in Medical Translation: PhD Student's Research Looks at Medical Interpreters and Their Effect on Prolonged Hospital Stays

Lost in Medical Translation: PhD Student's Research Looks at Medical Interpreters and Their Effect on Prolonged Hospital Stays

A USD SON PhD student has embarked on a research project for his dissertation that could help the healthcare community better understand problems resulting from translating a medical provider’s message to a patient in that patient's native tongue.

Byron Batz says a lot of the message gets “lost in translation” when physicians try to communicate to a non-English speaking patient through interpreters.  While research exists from the provider and patient points of view, there is little research from the translators’ point of view.  Batz will look at the issue through the eyes of the interpreter.

In his proposal to his dissertation committee, Batz noted the language barrier potentially puts the non-English speaking patient at risk for health disparities and inequities.  In fact, he says he has seen research that non-English speaking patients often have longer stays in the hospital than English-speakers with the same medical issue.

Batz, himself, is a level two qualified bilingual interpreter for Kaiser Permanente.

“They tell us that a successful interpreter is one that you don’t even know is there,” Batz said.  “They train us to interpret verbatim, but that’s almost impossible.”

Impossible for many reasons including the level at which the interpreter translates.  If it is a family member translating, the problem could be that the family member interpreter does not understand what the doctor is saying or sanitizes the doctor’s message to protect the ill loved one.  With professionals, the interpreter is getting the message from a medical provider, who typically speaks at a high level. The interpreter then takes that message, verbatim, and translates it into the patient’s native language. 

“Many interpreters are professional and sometimes it's very hard for them to switch that language from the medical level or college-level to a third- or fifth-grade level,” Batz said. “That’s required when we talk to our patients, that we speak at a third- or fifth-grade level. So professional interpreters and even translators, which are the ones that do the documents when they interpret or when they translate, I hear them talk and I'm thinking, who do you think you're talking to? A big number of these patients are not highly educated, and the interpreters are using these huge words.”

Another problem is dialect.  Spanish is one language, but Spanish-speakers from Spain speak in a different dialect than a Spanish-speaker from a Caribbean country, whose dialect is different from a Spanish-speaker from Mexico.

“So you have to be very aware as to who your audience is,” Batz said.  “If a doctor sends a message, the Spanish-speaking patient may not understand it if the translator uses certain words.  Sometimes you have to give that message to the patient more than once using different words and then you watch for the patient to react when they finally do understand.”

But doing that violates the basic tenants of interpreting because the message is not given verbatim.

“How much is being lost there,” Batz wonders. “The doctor gives the interpreter one sentence and the interpreter presents it to the patient in two sentences or three sentences. Are we, and again going back to the training, the training says you have to do that one sentence verbatim. But it's impossible, so I want to find out how the interpreters feel about breaking the rules. And when they break the rules, why do they break them? So it may be the training can be a little more adaptive. Maybe we can adapt that training to not be so rigid.”

Hear Byron Batz talk about the three different interpreter types he plans to research here.

begin quoteWhat’s being lost in that translation for these patients to stay longer in the hospital?
Lost in Medical Translation

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Carol Scimone
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