| Treating The Multilingual Patient |
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Crystal Reeves
Communications between health care workers and patients can be difficult even with a common language. When the patient is from a non-English speaking culture or for whom English is a second language, discussions can be confusing. One of the biggest risks is that the patient will hear something other than what was actually said.
Even if you and your patient do not speak the same language you can improve communications by making some simple adaptations to your word choice and pacing.
Tips on Word Choice
1. Use words that are simple, common English. “There are several ideas to consider regarding this problem.”
2. Choose the most simple, direct, grammatical form possible. “I do not understand.” “Please repeat” or “I’m sorry. What did you say?”
3. Avoid jargon (scientific or technical vocabulary words used within a particular subject matter), slang (informal language used by a group of people), idiomatic expressions (a group of words that, together, have a special meaning that has nothing to do with the meaning of each word in the expression; for example, “It’s raining cats and dogs.”) and acronyms (an abbreviation used as a word; for example, DNR for Do Not Resuscitate).
4. Use direct language. “Please answer every question on the form.”
5. Assess the patient’s understanding of English. Ask them for a copy of their insurance card upon entering the office. If they are not able to understand this simple request, chances are they will not be able to understand medical directives either.
Tips on Pacing
1. Organize your thoughts. Before you begin to speak, arrange the contents of your message. Decide what the most important point is and focus on the essential information.
2. Break messages down into manageable pieces. Use short sentences. Complete one thought before moving on to the next item.
3. Speak slowly. Most of us know that speaking more slowly helps a listener with limited English abilities. Making this change takes practice and you will need more time with the patient if you are going to slow the pace of your conversation.
4. Enunciate each word. In normal speech, many sounds or complete syllables are run together or omitted. For example, “What do you want to do today?” may be pronounced “whaduhyu wanna do duday?” Pronouncing words carefully will help your patient understand what you are saying.
5. Allow pauses between sentences or after questions. Pauses provide time for mental translation for patients with limited English abilities.
Use of Interpreters
Sometimes, in an effort to communicate with the non-English speaking patient, practices will use interpreters to provide translation. However, one of the problems with using interpreters is that the individual providing the translation has no training in medical interpretation. Other practices may hire more bilingual staff members or ask the patient’s children, volunteer and even bystanders to act as interpreters. It is a mistake to assume that because someone speaks the same language, he or she will be able to act as an interpreter.
Therefore, Choose interpreters carefully. It is always best to use trained interpreters. When possible, choose interpreters who are willing and experienced, and who have proven interpretation abilities.
“Treating the Multilingual Patient” Long Island College Hospital Employee Handout
“Communicating with Diverse Cultures in Today’s Health Care Environment” Louise Range, Carolinas Physicians Network
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