ANNAPOLIS – A growing language barrier is challenging Maryland hospitals to work harder to communicate with patients who don’t speak English.
Doctors rely on patients to communicate their symptoms before they can reach an accurate diagnosis. But if the patient and doctor speak different languages, the chance of receiving quality health care could be compromised, according to a recent study by the Robert Wood Johnson Foundation.
The survey said one in five patients have put off seeing a doctor because of language barriers with English-speaking doctors.
“When you are taking care of patients you need to communicate in a language that both can understand,” said Dr. Marcos Pupkin, director of obstetrics and gynecology at Mercy Medical Center in Baltimore.
The primary problem for health care providers is the patient’s inability to fully understand prescribed treatment, medical advice and the ramifications of the disease they may be suffering. The No. 1 complaint from patients is that they cannot fully explain their symptoms or ask questions, according to the survey.
“They love it when I come into the room and speak Spanish, they look like God just walked in,” Pupkin said of his Hispanic patients.
Hispanics represent 4.3 percent of Maryland’s population, an 80 percent increase since 1990. About 7 percent of Maryland’s Spanish-speaking population speaks no English, according to the U.S. Bureau of the Census.
Over the past several years Maryland hospitals have implemented programs to address the language barrier between patients and doctors.
Mercy Medical Center offers numerous resources to non-English speaking patients, including “flag cards” depicting flags from more than 50 countries. The cards help the patient identify his or her primary language.
Mercy, like most Maryland hospitals, provides translators to help with oral communication or interpreters who can translate written material.
Many Maryland hospitals also use AT&T’s language line service, capable of translating more than 140 languages. Nurses and doctors may also take classes in cultural diversity and medical Spanish.
“We are trying things to see if they work. At Mercy, we’ve got a serious mission and we want to treat everyone with respect and the same quality care,” said Sister Aine O’Connor, assistant to the president for mission for Mercy Health Services.
Johns Hopkins Medical Center in Baltimore attracts patients from all over the world and often encounters language barriers.
“We are able to serve almost any language because we have connections with outside personnel,” said Harris Benny, operations director at Johns Hopkins International.
Johns Hopkins provides translators and interpreters and, unlike some hospitals, requires them to have a substantial medical background.
“We have one individual who speaks seven languages, and can help with 30 to 35 languages on the spot,” Benny said.
Johns Hopkins Medical Center puts emphasis on cultural competence as well as vast knowledge of a particular language, said Benny.
“A hugely important topic is cultural competence — not only linguistic competence, but being able to understand the culture,” said Emilio Williams, managing director for the Americas at Johns Hopkins International. “Anybody can call an interpreter, but our interpreters must be bilingual and trained in the culture.”
Hopkins also uses an international call center.
“We can access an interpreter in as short as two minutes and could get someone on site in a reasonable amount of time,” said Benny. “I think some institutions simply call on staff who speak a language, but we don’t stop there.”
Many hospitals use existing staff, but some institutions hire employees to specifically focus on interpretation or translation.
Maria Currano, a Maryland graduate, was hired two years ago with no medical background as a translator and interpreter for Prince George’s Hospital.
“There is a very big improvement in care when you can communicate with a patient in their own language,” Currano said.
On average, Currano receives 20 calls a day to help translate for doctors and nurses.
“Their face brightens and they feel much more at ease when they realize that now they have someone to communicate with,” she said. “But the ideal situation is being able to have the hospital staff able to directly to communicate with their patients.”
If patients don’t feel comfortable, they may keep their symptoms quiet or worry they are bothering their doctor, said Currano.
Anne Arundel Medical Center caters not only to patients in its hospital but also to an outreach clinic, where more than 40 percent of the clients speak only Spanish.
The clinic, in Annapolis’ Stanton Center, provides all literature in Spanish, and bilingual staff is available to help patients and doctors understand each other.
“It still takes a lot longer to see a patient because of language barriers,” said Outreach Service Coordinator Faye Hunt-Anderson. “We try to make sure that the doctor understands the patient and the patient understands the doctor so that we can close that gap and make sure each party knows what’s going on.”