5 Clear reasons that being bilingual isn’t enough to interpret in healthcare

We instinctively know that bilingualism doesn’t mean that an individual is qualified to interpret in a medical setting, but what are the specific reasons?

It’s unfortunately way too common of a scenario that the closest bilingual individual available is called upon to help communicate important information to a patient because the trained interpreter isn’t available at the moment. This is commonly referred to ad-hoc interpreting or using an ad-hoc interpreter. We all know that it’s not a good idea to use a patient’s family member, housekeeping staff or a bilingual-ish co-worker to translate… but it can oftentimes seem innocent enough.

It’s not okay to use unqualified and unapproved interpreters. Ad-hoc interpreting is risky for the patient. Interpreting is a true professional skill that most bilinguals don’t possess. Here are 5 clear reasons to resist the temptation of using the closest bilingual and wait for a professional interpreter:

1. Interpreters are a conduit of information between the provider and the patient. As a bilingual person, you have flexibility to communicate a given message in a variety of ways and convey the same meaning. However, according to the National Standards of Practice for interpreting in healthcare, there is no flexibility with how something is said when you’re acting as an interpreter. The interpreter must communicate a given message precisely how the speaker does. This doesn’t mean that the interpreter has to provide a literal translation, but it does mean that they can’t adjust the message in any way, even if it’s to make it more polite, less crass, etc. Untrained interpreters aren’t accustomed to this linguistic restriction, and likely aren’t skilled enough to mirror exactly what the individual is saying.
2. Interpreters are required to match the register of the speaker. Register is a fancy word for complexity of speech. If a speaker is using low register (“uneducated” language), the interpreter needs to interpret the message with similarly low register words in the target language. If the speaker is using high register (more professionally sounding words), the interpreter must match that register during their interpretation. Untrained interpreters rarely possess the linguistic range to match the register of the speaker, and may not understand the subtle differences in selecting a lower vs higher register word. Why does register matter? The care provider gathers important information and makes subconscious assumptions about the patient based on the words they use. If a provider hears low register words, they’ll likely respond with lower register speech. Conversely, if a provider hears high register speech from a patient, they adjust their messaging to match. If an interpreter is changing the register of speech between patient and provider, neither the provider nor the patient get the full picture of the other party’s message as it was originally intended.
3. Interpreters are required to match the tone of the speaker. How important is tone in communication? Ask any spouse if tone matters and they’ll tell you it’s not the words that were said, it was “how” they said it 😂. Tone transmits the emotion of a message and is often communicated through inflection, volume and pace in speech. An interpreter needs to stay true to the tone of the speaker in order to convey the emotion behind the message. Similar to register, the emotion of a message gives the provider and the patient crucial information about the importance of a given topic to the speaker.
4. Qualified interpreters have a wide range of medical terminology. A bilingual person can communicate effectively on their own with a limited range of vocabulary, but it’s impossible to be a true conduit (#1 above) and match register (#2 above) without a wide range of medical terminology. We all tend to take the past of least resistance in life. This is true for bilingual individuals as well. Let’s take “heartburn” as an example. If you aren’t professional linguist, you’re probably satisfied to know one term for heartburn. Maybe that’s acidez. Acidez is a great word, but what about all of its other synonyms like: acedía, agruras, reflujo? It’s a simple example, but if the individual interpreting doesn’t have a wide enough range of vocabulary, the provider and the patient are for sure going to miss out on at least part of the message that’s being communicated.
5. Quality interpreting requires professional-level skills of memory and focus. Besides the linguistic points 1-4 above, let’s not forget that a medical interpreter is performing consecutive interpreting. This means that a speaker will say their piece and then wait for it to be interpreted. Your interpreter needs a special ability to focus on the speaker in addition to an amazing short term memory so that they don’t omit or add any information to the message. They need to remember details of a 15 – 45 second message and convey it fully after the speaker has finished. Most people don’t possess this level of focus or short-term memory naturally; it’s a skill that needs to be intentionally developed and practiced. If you’re relying on a ad-hoc interpreters for your Spanish speaking encounters, you can be sure that important information is being omitted.

Interpreting in healthcare is not something you can take for granted. Most bilingual individuals are not sufficiently trained and prepared to provide quality interpretations.

Healthcare interpreting is a skill that needs to be learned, practiced and refined. Bilingual clinic and hospital staff can become responsible interpreters with some training. Check out our 20hr Introduction to Interpreting in Healthcare course get the training needed to provide responsible interpretations.

Want to get certified to speak Medical Spanish to your patients? If you’re a bilingual provider, you may be wondering if you speak enough Spanish already … you need to get certified!

You may be fluent enough to speak Spanish responsibly already and not need the services of a healthcare interpreter. If you’re wondering about your own Spanish skills, head over to Certifiedspanish.com to create a free account and take as many free