Health Care Times

For The Health Care Industry Since 2013

Health Care Communication: Lost In Translation?

By: Christiana Nielsen November 8,2013 AZITROMICINA 250 MG PAQUETE DE DOSIS: TOMAR 2 TABLETAS POR VIA ORAL HOY, ENTONCES, TOMAR 1 COMPRIMIDO AL DIA DURANTE 4 DIAS. Entiendes? You probably have no idea what the sentences above read. The translation is: AZITHROMYCIN 250 MG DOSE PACK: TAKE 2 TABLETS BY MOUTH TODAY, THEN, TAKE 1 TABLET A DAY FOR 4 DAYS. Do you understand? For a non-Spanish speaker the instructions above would be difficult to translate when read and nearly impossible to understand verbally. This is an example of the many challenges immigrants face when trying to access American health care. Health literacy rates are extremely low in the United States; especially among those who do not speak the same language as their primary care provider. Health literacy is defined as an individuals ability to obtain, retain, and comprehend basic health information needed to make suitable health decisions. Limited health literacy hinders patients ability to access health resources, implement preventative care behaviors and comprehend important health messages. Americas history is deeply rooted in immigration, for decades immigrants from all over the world have come to the United States of American to start new lives. America is truly a mixing bowl of cultures and nationalities. To be American does not mean to speak English. Nearly 27 million Americans have limited English proficiency (LEP), which obscures their capability to barriers between patient and physician directly impinge on physicians ability to deliver quality and safe care for LEP patients. Language barriers often lead to misuse of medications, wrong diagnoses, and improper treatment plans, all of which can be harmful or fatal to the patient. These language barriers also diminish the relationship and trust between physician and patient; a patient can feel alienated and ignored. These issues have an effect on both a patients physical and mental health. Patients and health care providers must have access to competent language services to decrease avoidable risks to patient safety caused by unsuccessful communication. These services need to include interpreting of oral communications and translating written materials. A providers focus must be to ensure all forms of communication disseminated to the patient is fully understood for patient safety. Miscommunication between physician and patient is not uncommon and can easily cause medical travesties that negatively affect both parties involved. In 1980 language and culture barriers caused Willie Ramirez, an able bodied man, to become quadriplegic. Ramirez, suffering from head pain and dizziness, called emergency services and tried to describe his symptoms to medics using the Spanish word for dizzy, intoxicado. The medics understood him to be intoxicated and treated him as if they were treating a drunken patient. This language barrier masked his true ailment, a cerebral brain hemorrhage, which continued

for 2 days after Ramirez reached out for help. The hospitals failure to properly translate Ramirezs verbal messages caused him to lose the use of his arms and legs and severely affected his quality of life. This event took place nearly 35 years ago and similar events continue to occur in America each day. Some healthcare providers have made efforts to offer translation services to immigrant populations but even these services often times only aide those who speak Spanish. Many languages that make up a large portion of Americans first language such as Farsi, several Chinese dialects, German, and Polish, are not readily translated in the health care industry. Providers need to recognize the need of language services in order to ensure the health of their patients and to protect themselves from legal implications. Willie Ramirez sued the South Florida Hospital due to lack of translator and the damages caused. The lawsuit resulted in a settlement and Ramirez collected $71 million. This highlights the significant importance and dire need for language services in the health care arena. Effective translators would certainly improve health literacy rates marginally and will address issues of quality health care access. A health care providers lack of translators can negatively equate to losses in legal fees, punitive compensation, emotional distress from litigation, and loss of reputation. Many providers feel that cost associated with implementing language services is not worth safeguarding their patients health or their own practices. However, when cross analyzing cost effectiveness health care providers and insurers will find that the investment of language services greatly out-weigh the risk of loss due to legal cost. Providing language services radically increases non-English speakers health literacy by bridging the communication gap. This is tremendously noteworthy; individuals who have low health literacy are more likely to not have insurance, less likely to

receive preventative care, more likely to be rehospitalized, more likely to report their health as poor, and are more likely to acquire higher healthcare cost. These outcomes weigh heavy on the nation as a whole and add to the health care deficit. Rates of low literacy are disproportionately high among lower-income Americans who are financed through Medicare or Medicaid. Poor health literacy produces an increase of $50 to $73 billion in misdirected government healthcare expenditures annually (Somers & Mahadevan, 2010). In summary, inadequate health literacy rates in the United States adversely impacts the health status of the American people and the economy of the country. The ACA addresses health literacy broadly in Title V, Subtitle A. Effective communication and language barriers is mentioned within the section. This section is devoted to amending existing laws and creating new laws related to the health care workforce. The legislation touches on the issue of research distribution, medication labeling, patient- physician shared decision-making, and workforce development. Each of these suggestions emphasizes the need to improve healthcare professionals communication with patients and communities in order to improve the access to and quality of health care (Somers & Mahadevan, 2010). Language barriers need to be broken and the law needs to take stalwart action to address this prolific and serious concern. The law is currently not going far enough. Implementing new laws and enforcing current laws would protect both patient safety and health care provider practice. In conclusion, the health care industry often functions as if all patients have advanced health literacy levels, understand English and can be can vigilant supporters for themselves. This is not the case. In reality, there is a large divide in discourse between physician and patient. On state and national level, there is a push to improve the healthcare system through

various federal legislations, especially the Affordable Care Act. Language barriers hinders peoples ability to reap the benefits that health care reform offer. Without establishing new programs and initiatives to improve health care communication a mis-use of health care services and mis-appropriated funds will continue to occur. Targeting language barriers can reduce cost and improve the quality of care for many currently underserved non-English speaking Americans.

Resources Gorman, Anna. "Language, Knowledge Are Barriers For Immigrants Seeking Insurance In California." KHN: Kaiser Health News. N.p., 1 Oct. 2013. Web. Karlin, Rick. "Left with a Language Barrier to Health Care." Times Union. N.p., 04 May 2013. Web. 05 Nov. 2013. S.A. Somers and R. Mahadevan. Health Literacy Implications of the Affordable Care Act. Center for Health Care Strategies. November 2010 Ondash, E'Louise. "Overcoming Language Barriers Faced in Health Care." Nursing Feature Stories- Nursing Features and Profiles. N.p., 2008. Web. 05 Nov. 2013.