Glenn Flores, M.D., professor of paediatrics, epidemiology and health policy at the Medical College of Wisconsin highlights the many deleterious and sometimes tragic effects of language barriers on health and health care for these patients. Lack of effective communication also contributes to the high cost of healthcare.

His perspective article includes examples of tragic consequences of miscommunication between the physician and ad hoc medical interpreters for patients with limited English proficiency: The misinterpretation of a single word led to a patient’s delayed care, preventable quadriplegia and a $71 million malpractice settlement. The patient was wrongfully treated for drug abuse when he actually was complaining that he felt sick to his stomach. The delay in treatment resulted in rupture of a brain aneurysm.

An ad hoc interpreter told the mother of a seven-year old girl to put an oral antibiotic in the girl’s ear to treat her middle ear infection. A resident physician who interpreted a Spanish speaking mother’s explanation that her daughter had “hit herself” when she fell off her tricycle assumed the fracture had resulted from abuse, and called the social services department who had the mother sign over custody of her two children.

“As these cases illustrate, it can be dangerous to have children, family members and friends provide medical interpretation,” points out Flores. Yet many patients who need medical interpreters have no access to them. According to one study, there was no interpreter used in 46 percent of emergency-department cases involving patients with limited English proficiency.

Flores’s review shows that patients who face such barriers find it more difficult to access care, and are less likely to have a usual source of medical care. They receive fewer preventive services and are at increased risk of nonadherence to medication.

MEDICA.de; Source: Medical College of Wisconsin