Emory Healthcare provides free language interpretation services to ensure all patients, regardless of language barriers, receive compassionate and comprehensive care.
“The central element of caring for a patient is communication, and when the patient and provider do not speak a common language, this can be a challenge,” says David A. Frank, MD, PhD, FACP, hematologist-oncologist at Winship Cancer Institute of Emory University and director of the Division of Hematology and a professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine.
As a patient, it’s essential that you can understand and communicate with your health care team, whether you’re getting treatment for cancer or going for a routine physical. But what if English isn’t your primary language?
Without interpretation services, language barriers between patients and physicians would prevent patients from receiving proper care. For this reason, Emory Healthcare provides language interpretation services, free of charge, to anyone with a communication barrier—whether they’re the patient, a family member or a part of the patient’s support system.
“You're talking about a human being who does not have a fair chance to understand what is happening to get the comfort and the compassion that they need,” says Oscar De Leon, manager of interpretation services at Emory Healthcare. “It's bad enough for you to feel so sick that you have to be in the hospital. It's a completely different issue to be in a place where nobody understands what you're saying.”
The 1964 Civil Rights Act stipulated that people have “meaningful access” to trained medical interpreters and translation services they need to make informed decisions about their care. But “it goes beyond just following the law,” says De Leon. “It’s the right thing to do.”
The complexity of language for cancer settings
It takes years of training, certification and continuing coursework to be a medical interpreter—and even more work to stay current. Often interpreters consult with the doctor and read about the treatment so they can translate as comprehensively as possible. Many interpreters attend conferences and discuss terminology with other interpreters. Still, a lot of training comes from the job.
“Cancer research and care is constantly evolving, bringing new treatment options to patients,” says De Leon. “It’s not uncommon for an interpreter to hear a new term during an interpretation exchange and pause to ask the physician for clarification.”
Helping patients navigate complex medical diagnoses is what Emory medical interpreter Sandra Underwood does best. Having previously worked as an optometrist in Colombia, she has a background in health care that helped prepare her for working with Spanish-speaking patients. She notes that cancer involves a whole new language for any patient. In the field of cancer research, the needle is constantly moving in terms of treatment and care options for patients.
In her nine years at Emory, Underwood has worked with young patients who are around the same age as her own children and others who do not have family or a support system to help them through the process. In every situation, she and her colleagues make sure they treat all patients with the utmost compassion and understanding.
“Our role here is to be the bridge and facilitate communication between the providers and the patients,” says Underwood. “We help emphasize how important the patient is in the treatment decisions and finding their own autonomy in deciding what they want their treatment and care to be,” says Underwood.
According to Underwood, the biggest challenge is having to deliver a diagnosis of cancer or other serious disease to a patient. Every patient is different and will take their diagnosis differently. It’s important to be able to stay focused, neutral and accurately deliver the message without emotions getting involved. “Sometimes I find myself feeling guilty because it’s my voice that will be delivering the news,” she says. “Even though the doctor is speaking, it’s my voice they will remember.”
Emory physicians allow Underwood to talk more in depth with patients and help them understand the importance of all the tests in making a diagnosis and, for example, possibly needing a biopsy. Having a familiar voice in the patient’s own language to explain the same things the doctor says, but in words the patient can understand, helps them to feel more confident in their plan.
“Our interpreters are both technically proficient and sensitive to nuance, and they allow one to have a seamless dialogue with a patient,” Frank says. “This allows us to provide the same high level of care to every human being who walks through our door."
Sharing this one-to-one connection has a tremendous impact on the patient, the interpreter and the doctor. “We (the clinicians and interpreters) are a team,” Underwood says. “We work together to make sure the patient is heard and understands everything being said. It’s not just about patient understanding. It’s also about all of us understanding the patient and what they’re feeling.”
Interpretation Services at Emory
Emory Healthcare patients can access on-site interpreters who speak Spanish, Korean and Vietnamese, as well as more than 200 languages using an app or a blue phone to speak to a translator online.
“Whenever possible, we try to have an in-person interpreter to provide that personal touch,” De Leon says. “But when it’s 3 o’clock in the morning and an emergency, we’re very thankful to have technology that can connect patients with someone who speaks their language at any hour of the day.”
While technology is a great asset to help patients receive meaningful care at all hours, having access to an on-site interpreter allows for reading body language and visual cues, especially if the patient is uncomfortable.
Medical interpreters cover cases in all Emory Healthcare clinics and help patients feel comfortable in their care. Interpreters often start their job as early as 5:30 a.m. to prepare for surgery alongside the surgical team, making sure they are up to date on any terminology that needs to be explained. To further support the patient’s comfort, Emory Interpretation Services tries to match the same interpreter with the patient for follow-up care.