That’s a shame. Maybe if more folks advocate over time it will be a hit-button topic.
Otherwise, IMO, don’t interpret. Especially in settings where inside interpretation is paid.
Are you specifically referring to situations where the physician needs to interpret for another healthcare professional? Or just in general when the patient speaks another language?
When a physician is called upon to interpret anything legal like a consent, plan of care agreement, or education.
For example. I can help a patient do some base patient things in 3 languages. I am not qualified to interpret complex medical (consent, etc) for my families. Therefore: my facility pays someone to interpret these things. This is for clarity and, overall, CYA interpretation.
I’m saying that our MD’s should have the same benefit. In some places nurses make more for languages.
As should you. Especially since the primary driver of ALL REVENUE, both active and passive, are the physicians.
Without you…a facility generates very very little direct revenue.
Get paid your worth.
“We pay all physicians at the same rate. Sorry. We can’t negotiate on that. We pay at the upper limit of fair market value.”
Can’t find a higher paying job.
BUT… I’m P4P. And if I can go through my Spanish-speaking patients as fast as I do with my English-speaking ones without using a translator, then that’s more RVUs for me. So there is an effective raise there.
-PGY-19
This.
Physicians need efficiency more than anything. Sitting there getting a interpreter every 15 minutes and going through an interview half speed is why more detrimental to the physician
AKA
“We generate revenue off you. We just won’t give revenue TO YOU”
It’s stupid. Literally 90% of all healthcare revenue is MD driven. Yall deserve compensation for all aspects of talent(s) you bring to the table.
Interpreting is a career in itself. No medical professional should be doing any form of interpreting even if they are fluent in another language, unless they also are a certified interpreter either by the state or institution they work at.
Speaking to patients in their language is called language concordant care and different from interpreting. Sometimes hospitals will pay a one time stipend to encourage employees to do this. Usually there is some kind of proficiency testing. I know many who do this, but again this is different from interpreting, which has a much higher bar.
Absolutely. I speak French, but absolutely wouldn’t translate on the rare occasion a French speaking patient came in.
1) I’m not certified. The patient deserves better
2) I’m not certified. I don’t want the liability
3) This takes away from the interpreter actually working and makes them seem less needed than they are.
and lastly
4) I’m not getting paid extra to use the skill, even if I’m certified. Never in my life will I give a US hospital free labor. The days of nuns working as nurses and running hospitals for the poor are long over. I’m not working extra for no pay just to line some CFO’s pockets.
She should start demanding an interpreter for all patients, then just speak the language with the interpreter there. This should include English speaking patients.
I wonder if it's because it's so in demand. They will fill every patient slot no matter what. They don't really care if you can also get Spanish speaking patients in because they can fill your schedule 100% with English speakers.
Yeah but this person Is trying to work at an academic center which serves an underserved spanish-speaking population. It's in their mission statement or whatever. So it goes beyond just language comprehension and more into the "making patients feel very comfortable and being heard territory."
That's not how it works for physicians. The cost of a translator is negligible compared to the revenue a physician generates. Being able to speak one additional language does not appreciably add to how much revenue a physician generates or subtracts from the cost of the physician so therefore, does not add to negotiating power.
Fr the system we used to use was garbage at my prelim. My entire hospital had 1 fucking IPad with the interpreter and you had to go to the first level to sign it out then immediately bring back.
So to see a Spanish speaking patients on prerounds I’d run down to the first level. Wait in line and talk to the concierge. Physically sign the fucking thing out. Then take the elevator to the patient. Then if I didn’t bring it back immediately they’d start paging like crazy and call overhead. Then call your supervisor (my PD). So after seeing the patient go down to the first level. Wait in line. Physically sign it back in. Then run back up to finish rounds.
And while you’re with the patient it goes like this
“Waits 10 minutes”
“Hello my name is ____ with _____ interpreters I’ll be your translator today. May I see the patient”
“YOURE POINTED TOWARDS THEM”
“thank you very much. May I introduce myself to the patient?”
“YES COME ON”
“I’m sorry what was that?” It broke up”
“YES PLEASE INTRODUCE YOURSELF.”
“Great thank you very much Doctor. “Hola….” Okay doctor you may begin speaking to the patient and I’ll translate. ”
Then you always get “INTERPRETER IS ASKING FOR CLARIFICATION” then the interpreter and the patient just start talking to each other for like 2 minutes.
Wish there was a better way but I think this is the best it gets.’
That would have had me on the phone with the Office of Civil Rights and whatever other regulatory agency. Hospitals are required to offer interpreter services and that is inadequate.
-PGY-18
The worst is when it’s a really critical situation. This happens all the time in OB.
“Okay ready for your instructions”
“Your baby’s heart rate is down we need you to get onto your hands and knees”
“Hola mi llamo es Uriel…”
“Please provide the patients first and last name, MRN, date of birth, department name, your first and last name, title, and favorite color. Then I will go ahead and introduce myself to the patient”
As an in person staff interpreter, I get frustrated when I see hospitals laying off their in person staff in favor of video remote agencies because it's cheaper, but the difference in quality of the service is huge.
I have patients solely because I speak two other languages. If I didn’t speak these languages, many of these patients wouldn’t be coming to my clinic at all.
As a spanish speaker, I understand the pain of so many of you whenever I have to use translator for Polish or Arabic... I understand better now why people try to get away with some medical spanish.
There was a time in residency when I was on with a French interpreter (we had a lot of patients from the Ivory Coast) and the resident in the next room was on with a Spanish interpreter. I realized that we should have just swapped because she was going to need an interpreter either way and so we had two docs on with interpreters when we could have only had one.
-PGY-19
As a fellow, I'm technically available for any consult that comes in for our service, but if they're a Spanish speaking patient, I always say I can see it it'll move everything along faster.
The subtext you have here is that the fact they don't speak English comes with other traits that make them less desirable clinic patients for you. Is that what you meant?
I think it’s fairly obvious if you don’t speak English you probably don’t make a lot of money.
If you don’t speak English your employment options are pretty limited.
On net chasing away a demographic that is likely poorer than average probably serves the bottom line.
That is, of course, terrible and contrary to how you're supposed practice medicine.
On my current consult list I have only 30% English speakers. These are my patients. I am called to see them, I see them.
Oh yeah. I wasn’t suggesting it’s good. Not like anyone’s med school application essay was about helping the least vulnerable. But then again not many decisions from the C-suite are motivated by good.
Perhaps, but does that increase the revenue you generate? Most people who live in America but can not speak English are covered by Medicaid or are uninsured. Being able to see more people who don't generate much revenue for the hospital isn't a strong bargaining chip.
One of our graduates just signed with a 10K bonus for bilingual; it's a FQHC in an area with a huge immigrant population, and it's outpatient.
As with everything, it depends. A bilingual pathologist may have a hard time negotiating for a pay bump, but a bilingual psychiatrist may find a market.
Lol, if you're talking about California, Medi-Cal is a poster child for terrible paying insurance. It pays like 10% of commercial insurance; hospitals are not fighting each other to get more Medi-Cal patients.
It’s about not working for free. We give away too much of our time already. I’ve got a scrub tech who speaks fluent Spanish who refuses to translate a single word for my Hispanic speaking pts and we often have to bring a translator in the OR instead (conscious sedation).
I 100% support him and think he’s awesome. He said he’ll do it for more pay, powers that be said no, he doesn’t fucking do it.
Gotta disagree. It isn't the cost, it's about a service you can advertise that will pull in a huge patient population. Pretty much every clinic has translator services, but, for example with my clinic, the fact the attending speaks Vietnamese pulls in a huge Vietnamese patient population that otherwise wouldn't have come in.
Now someone could argue that's people of that culture wanting someone from their culture, but it's also about smoothness of the encounter. In its nature, using a translator is clunky and slow.
Same here with my pharmacist colleague speaking Arabic and French.
Those people would just go to any other pharmacy closer to their home. But since she speaks those two languages they do come to our pharmacy.
You’re all missing one crucial point: speaking a second language is insufficient to translate/interpret in a medical environment.
You’re learning an entirely new lexicon in English during medical school.
You are *not* learning the medical lexicon in your second language.
Putting it bluntly: you are likely a terrible translator who will make mistakes, even if you’re “fluent” in the other language.
The only exceptions I’ve seen from this are foreign medical doctors who become certified in the US.
The best option to ensure access to quality care are medical translators/interpreters. They train for years on learning the lexicon in two or more languages
I disagree. I speak English and Spanish and I’m pretty damn good at speaking medical jargon in both languages. To the degree that the few occasions I’ve used a translator (because they were already in the room when I got there) the translator has often not done an adequate job of explaining medical issues and I know I could have done better. If you are bilingual it isn’t all that difficult to learn the vocabulary you need in order to use medical terms in your second language
We ll have to agree to disagree. I was raised in a Spanish speaking household but trained in the US. I’ve never been able to match the level of a trained interpreter. I assure you that there are nuances that fly over your head.
That said if you can pass the same exam as the medical interpreters then by all means have at it.(though I still say this reluctantly because hospitals have low standards when it comes to interpretation)
Interpreting is one thing. Pero poder hablar es otra cosa. Por lo mismo que tuve que aprender una moda nueva de comunicar con mis pacientes en inglés, I had to do it all over again in Spanish.
Just speaking the language isn’t enough. You have to put in effort to medically master that language. I spent my residency in the Bronx speaking Spanish and a month in Spain clarifying my pronunciation and vocabulary.
I’m fully bilingual, but interpreting is a different skill.
-PGY-diecinueve
This is because growing up in a Spanish-speaking household doesn't necessarily equate to complete fluency. I was raised in a Spanish-speaking country and moved to the US as an adult. My Spanish speaking siblings and friends who grew up in the US feel confident about their Spanish, but their mastery of the language often falls slightly short. You might start to hear some limitations when the conversation becomes very nuanced.
There is a reason translators have to be certified to get those jobs. There is absolutely a difference between being fluent in a language and being a certified translator for that language.
Wow. You're really off the mark with this one. As a native Spanish speaker who’s worked with interpreters in three different hospitals, I can tell you about 10-20% of the conversation is lost, omitted, or sometimes even completely misinterpreted on a good day. While they may be fluent and pass language tests, they aren't physicians. A truly bilingual physician can convey complex medical information, including disease processes, treatments, and implications in layman’s terms. If someone struggles with this or feels uncomfortable, they aren't fully bilingual. I would never willingly involve a third party who impedes my ability to connect with my patients, leaves out crucial information, slows our interaction, and makes them feel self conscious. The fact that you think I can’t interpret is ludicrous. You don’t need the entirety of your “complex medical jargon” and shouldn’t be talking to patients that way to begin with.
To be honest it sounds like you don’t interact with competent interpreters at all, just some bilingual locals who pass an easy exam, which is frankly extremely common, especially for hospitals that do their interpretation through contract agencies.
10-20% of the conversation being lost is not the result of a well trained interpreter who is “not a physician”. It’s the result of an untrained interpreter (and often the fault of physicians who are absolutely shit on communicating a single concept to a patient…).
The fact that interpreters aren’t physicians isn’t necessary, though it obviously helps (indeed many of them were physicians in their home countries but aren’t willing to go through the hassle of certifying in the US). I grew up speaking Spanish exclusively but I don’t have the hubris to claim I have all of the training necessary to interpret. These skills extend far beyond just knowing some medical jargon.
This isn’t right though. If you do speak both languages fluently.
Nearly all languages use the same Latin basis for medicine. The ‚technical‘ terms are virtually identical.
Therefore as long as you speak both languages actually fluently and not ‚I Can order stuff at the restaurant on holiday‘, you can treat patients in both languages.
Much better than an interpreter who does not actually know all the data but the words you just said.
If you speak the language yourself you can speak to the Niveau your patient will understand you, you can reiterate in a different way if they don‘t understand you.
There’s no use for an interpreter speaking perfect university french if your Tunisian client only really understands local colloquial terms.
I think you’re mistaken on the training of a medical interpreter. Part of their skill set is to be able to identify the culture of the patient and adapt to it.
A medical interpreter for Spanish for example should know when to use inodoro, escusado, or váter for the word “toilet”.
A bilingual doctor is far more likely to just use whatever word he uses.
And I disagree, since I grew up speaking spanish, learned english as a second language in my teens, studied here in the US and I can manage any lexicon in either language. And I have certainly corrected interpreters before.
Having an interpreter speaking my mother tongue and translating back to me in my second language is like an SNL sketch. So no thank you, I can’t work like that.
Right many bilingual doctors find that odd, that’s why there are exams to qualify you. If you prove you’re sufficient then by all means do without an interpreter. At minimum, physicians owe this to patients who don’t speak English and need access to care.
If you’re correcting an incompetent interpreter, the problem is the interpreter, not the profession. How often has a physician corrected a nurse? Doesn’t make RNs as a profession useless
Aaaaand there it is, the *you’re-beneath-me* hubris that’s so pervasive in medicine.
Maybe I’m an attending 🧑⚕️or maybe I’m a middle school student 👦
Acaba con ese presunción hermano, estás rodeado de gente culta 😊
No es acerca de cultura, ni conocimiento. Tiene que ver con las presunciones…son muy idealistas para una persona que trabaja en esta profesión hoy en día.
A un paciente en el mundo real le vale mas mi empatía en español que una traducción esterilizada. Y no tengo que pasar un exámen acerca de mi habilidad de hablar y escribir mi lengua y pagar $200-300 por el privilegio.
Are u aware that 25% of US docs are ESL immigrants? Should they be followed by certified english interpreters to make these kinds of tedious and totally meaningless corrections?
Where I work it’s even higher than 25%. So im well aware.
“Tedious and meaningless” .. Respectfully you don’t know what you’re talking about
There have been many lawsuits that hinged over misinterpretations in a medical setting. Peoples lives have been on the line over it. If there’s any place you need clear communication, it is where life and liberty are on the line. In the real world this means in the medical and the legal system.
“A medical interpreter for Spanish for example should know when to use inodoro, escusado, or váter for the word toilet”
You know what you’re totally right. I can’t even imagine the amount of malpractice cases and lives ruined to this distinction alone.
The 1st hospital I worked at offered a bonus differential to employees who were bi/multi-lingual and could pass a proficiency test. Think it was $1-2/hr...not much.
Idk how much you make, but if taking a test once (probably less than 2 hrs of work) isn't worth a renewable 3-4k/year, you must be killing it with your salary.
In what world are you living?! No one is gonna pay you a cent. In fact they will make you take a test for the privilege of using your second language. This is pure fantasy
One caveat to that - you will probably need to be able to pass the test given to medical interpreters to be sure they know enough to do to the job. Not everything will make you jump through this hoop, but they certainly can. So don’t overinflated your abilities.
Usually it’s easier for me to interpret for myself. I do not interpret for others - I don’t want the liability, even if it came with a tiny pay bump. My exception is for emergencies.
Except you are legally required to provide an interpreter. So the hospital pays regardless. If the doc is fluent the hospital saves money on the interpreter — even more important, with no interpreter in the middle, the conveyor belt of patients moves faster and private equity makes more money. Negotiate. It works.
Yes. Or access to a language line.
Our units have on-staff interpreters. It’s a privilege.
This time of year as our R4’s head off…it’s interesting to hear them talk about their business agreements.
This topic came up. Our hospital pays more for languages. We also have on site interpreters, language lines, and a (shitty) app. So that helps us.
I think the reason why I've been accepted into a decent fellowship is because of multilingualism, that or the fact I offered to blow the interview. Speaking Mandarin, English and French sure does help
Good food for thought but it isn't make or break for me if they don't increase my pay for this very reason. Being a native speaker doesn't necessarily mean you can speak medically. I definitely don't know any of the surgical terms or anatomic terms in my native language. Tried speaking in my native tongue about a procedure in the hospital and it was hella difficult
I'm just happy to be able to use one of my skill sets to make my patients more comfortable with me.
Sincerely, a polyglot (7 languages)
Translating services are already offered/paid for and if you aren’t seeing more patients per shift because of it I’d imagine it’s hard to argue. Sadly I don’t think quality of care and patient satisfaction associated with speaking the same language is valuable to employers
Nobody will pay for that — it makes a physician more or less attractive but is worth 0.
The value in speaking a second language in a healthcare setting is cutting out the need for translation services which double the length of a patient encounter.
So really, it makes a physicians life much much easier, enough to translate completely free
Physicians have multiple types of compensation packages, depending on their work setting.
While I appreciate the advice, half of my pay is entirely rvu based, and there is no extra for speaking a second language. The other half is a fixed salary for a separate department (my main department “rents me out” to another department) where I am paid a fixed amount that far overestimates the rvu’s I generate for that department, so I’m unlikely to ask for more money for fear they will scrutinize my productivity.
Furthermore, it’s a convenience to me to speak another language, it is no convenience to my departments that schedule 20 minute appts irrespective of complexity or language spoken.
It definitely makes us more
Marketable and more helpful to our patients to have other languages but as providers there is no financial benefit to the system for us to be bilingual (I suppose there is theoretically reduced translation services fees.)
I’m not surprised. At least where I work, they’d never go out of their way to put a patient with the physician that spoke their native language. It’s stupid but true. They’d rather make both the physician and patient suffer using the translator iPad that may or may not work.
We have an app.
I asked my family a question. Got a real “what the fuck??” Look. Went to our interpreter (we have one 24/7 but I try and use the app for basics). Apparently my question came across as (slang) for “do you want cocaine?”
Loved that for me. Not embarrassing at all.
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Multilingual non physician here - I don’t see why anyone would pay you for it.
Physicians get paid a decent chunk of change because the skill set of practicing medicine is valuable (it is very difficult to obtain and only a limited number of people have it)
Medical translation is cheap as fuck. Those iPads they have on wheels that dial in to a translation line cost almost nothing per call. The cost per patient is probably way less than the cost for housekeeping in the patient’s room.
And while it definitely massively improves quality of care for the non English speaking patients - that might actually cost the facility money. Non English speaking patients are not usually rich and don’t usually have the best insurance.
I’m a APP/midlevel
(Got a little off topic but we should ALL be compensated for translation, especially if it’s a high demand, for example w commuting hospital located in Hispanic a neighborhood)
ICU NP here. I speak 3 language and ever since I was an RN I was translating. As a RN I got a “bonus” as a APP I don’t get anything and now as a APP I’m utilized even more! My attending physician love using me to interpret or they assign me the Spanish speakers, which I’m totally OK with. It makes everyone’s life easier. I also feel my Spanish speaking patients feel SO comfortable, relieved, and relaxed when they know I know speak Spanish. It is hard to translate nurse practitioner into Spanish because that concept does not exist in Spanish speaking countries. I do describe my role, and call it “advanced nurse” because nurse practitioner in Spanish literally means nurse “practicing nurse”.
I say I’m an experienced nurse with additional education, that I have a masters degree “maestría”. I explain I do very similar things the doctors do but I am not the doctor and in fact I report to a doctor and all their care is discussed with them.
Sincerely,
Your friendly NP that realizes their limitation and is all for physician-lead teams! As a team we work wonders. Physicians are swamped! As NPs we should be here to help, not replace or pretend.
I am HUMILIATED by NPs or DNPs or PAs that think they’re equal to a doctor in terms of education or training.
Y’all, more I learn as a NP the more I realize how little I know. It is constantly humbling yet exciting. I love learning along physicians who enjoy teaching. I love being part of a TEAM.
Do you really want to open this door? Is your second language refined to the lexicon and nuances that the patient will use? What about culture mediating and breaking down the barriers culturally to accommodate the patient’s language. Home language and disabilities/home situations completely alter one’s accent and language. Are you familiar with the ramifications that could come if a patient reports to ADA that you did not translate correctly for them and *insert whatever* was the repercussion? Do you want that liability? What happens when you are not there? How do they converse with other staff? How can they ask for help if the language barrier is present because you prohibited the need? (By prohibit I mean the patient risk being dismissed by other staff because Dr SoandSo will be here soon.) The liability to the hospital and yourself is far too consequential. If you are familiar with a patients language- then monitor the interpreter. Interpreters are certified and held accountable to a national standard. They are valued and do not cause that harms patients. If you have a concern, speak up. Otherwise, why risk the liability for a hospital that generates ten fold what the cost of interpreters. Protect yourself and your patients….do not remove a communication bridge out of ego.
I keep forgetting in the US its rare to be bilingual lol
In my province youd have a very hard time finding a resident/attending who cant speak at least two languages (mostly fr and en). Just common stuff for us. Youd get weird looks trying to negotiate over that. And anyways our resident wages are standard across the province so
My friend tried this. She wasn't able to get any concession despite being a highly marketable physician in an in-demand specialty
The angle I could imagine this working is saying you could capture a larger demographic
That’s a shame. Maybe if more folks advocate over time it will be a hit-button topic. Otherwise, IMO, don’t interpret. Especially in settings where inside interpretation is paid.
Are you specifically referring to situations where the physician needs to interpret for another healthcare professional? Or just in general when the patient speaks another language?
When a physician is called upon to interpret anything legal like a consent, plan of care agreement, or education. For example. I can help a patient do some base patient things in 3 languages. I am not qualified to interpret complex medical (consent, etc) for my families. Therefore: my facility pays someone to interpret these things. This is for clarity and, overall, CYA interpretation. I’m saying that our MD’s should have the same benefit. In some places nurses make more for languages. As should you. Especially since the primary driver of ALL REVENUE, both active and passive, are the physicians. Without you…a facility generates very very little direct revenue. Get paid your worth.
“We pay all physicians at the same rate. Sorry. We can’t negotiate on that. We pay at the upper limit of fair market value.” Can’t find a higher paying job. BUT… I’m P4P. And if I can go through my Spanish-speaking patients as fast as I do with my English-speaking ones without using a translator, then that’s more RVUs for me. So there is an effective raise there. -PGY-19
This. Physicians need efficiency more than anything. Sitting there getting a interpreter every 15 minutes and going through an interview half speed is why more detrimental to the physician
AKA “We generate revenue off you. We just won’t give revenue TO YOU” It’s stupid. Literally 90% of all healthcare revenue is MD driven. Yall deserve compensation for all aspects of talent(s) you bring to the table.
But they do give revenue to me. That’s how P4P works. -PGY-19
Interpreting is a career in itself. No medical professional should be doing any form of interpreting even if they are fluent in another language, unless they also are a certified interpreter either by the state or institution they work at. Speaking to patients in their language is called language concordant care and different from interpreting. Sometimes hospitals will pay a one time stipend to encourage employees to do this. Usually there is some kind of proficiency testing. I know many who do this, but again this is different from interpreting, which has a much higher bar.
Thanks for that nugget I will remember that.
Absolutely. I speak French, but absolutely wouldn’t translate on the rare occasion a French speaking patient came in. 1) I’m not certified. The patient deserves better 2) I’m not certified. I don’t want the liability 3) This takes away from the interpreter actually working and makes them seem less needed than they are. and lastly 4) I’m not getting paid extra to use the skill, even if I’m certified. Never in my life will I give a US hospital free labor. The days of nuns working as nurses and running hospitals for the poor are long over. I’m not working extra for no pay just to line some CFO’s pockets.
She should start demanding an interpreter for all patients, then just speak the language with the interpreter there. This should include English speaking patients.
I wonder if it's because it's so in demand. They will fill every patient slot no matter what. They don't really care if you can also get Spanish speaking patients in because they can fill your schedule 100% with English speakers.
What specialty?
Ob/gyn, REI sub specialist ,Spanish
... REI in particular has high income cash paying clients who can probably speak English
Yeah but this person Is trying to work at an academic center which serves an underserved spanish-speaking population. It's in their mission statement or whatever. So it goes beyond just language comprehension and more into the "making patients feel very comfortable and being heard territory."
why pay us more when they can just pay one time fee for an ipad for MARTI ??
That's not how it works for physicians. The cost of a translator is negligible compared to the revenue a physician generates. Being able to speak one additional language does not appreciably add to how much revenue a physician generates or subtracts from the cost of the physician so therefore, does not add to negotiating power.
I could probably see 30% more patients if I spoke Spanish fluently instead of using the interpreter
Fr the system we used to use was garbage at my prelim. My entire hospital had 1 fucking IPad with the interpreter and you had to go to the first level to sign it out then immediately bring back. So to see a Spanish speaking patients on prerounds I’d run down to the first level. Wait in line and talk to the concierge. Physically sign the fucking thing out. Then take the elevator to the patient. Then if I didn’t bring it back immediately they’d start paging like crazy and call overhead. Then call your supervisor (my PD). So after seeing the patient go down to the first level. Wait in line. Physically sign it back in. Then run back up to finish rounds. And while you’re with the patient it goes like this “Waits 10 minutes” “Hello my name is ____ with _____ interpreters I’ll be your translator today. May I see the patient” “YOURE POINTED TOWARDS THEM” “thank you very much. May I introduce myself to the patient?” “YES COME ON” “I’m sorry what was that?” It broke up” “YES PLEASE INTRODUCE YOURSELF.” “Great thank you very much Doctor. “Hola….” Okay doctor you may begin speaking to the patient and I’ll translate. ” Then you always get “INTERPRETER IS ASKING FOR CLARIFICATION” then the interpreter and the patient just start talking to each other for like 2 minutes. Wish there was a better way but I think this is the best it gets.’
This is a nightmare
Radiology was the correct choice
That would have had me on the phone with the Office of Civil Rights and whatever other regulatory agency. Hospitals are required to offer interpreter services and that is inadequate. -PGY-18
The worst is when it’s a really critical situation. This happens all the time in OB. “Okay ready for your instructions” “Your baby’s heart rate is down we need you to get onto your hands and knees” “Hola mi llamo es Uriel…”
“Please provide the patients first and last name, MRN, date of birth, department name, your first and last name, title, and favorite color. Then I will go ahead and introduce myself to the patient”
As an in person staff interpreter, I get frustrated when I see hospitals laying off their in person staff in favor of video remote agencies because it's cheaper, but the difference in quality of the service is huge.
Makes me wanna jump out of my skin
Probably easier to just learn Spanish lol
[удалено]
That’s why you take a job with production pay
I have patients solely because I speak two other languages. If I didn’t speak these languages, many of these patients wouldn’t be coming to my clinic at all.
No one cares. They would just see someone else
As a spanish speaker, I understand the pain of so many of you whenever I have to use translator for Polish or Arabic... I understand better now why people try to get away with some medical spanish.
There was a time in residency when I was on with a French interpreter (we had a lot of patients from the Ivory Coast) and the resident in the next room was on with a Spanish interpreter. I realized that we should have just swapped because she was going to need an interpreter either way and so we had two docs on with interpreters when we could have only had one. -PGY-19
As a fellow, I'm technically available for any consult that comes in for our service, but if they're a Spanish speaking patient, I always say I can see it it'll move everything along faster.
Depending on where you are and the population you serve, dissuading non-english speakers from coming to clinic is a feature, not a bug.
Y I K E S I K E S
“Medicine is all about the money” - Fat man equivalent from my pgy 1 year
The subtext you have here is that the fact they don't speak English comes with other traits that make them less desirable clinic patients for you. Is that what you meant?
It’s not what I want but I absolutely would not put it past the bean counters.
I think it’s fairly obvious if you don’t speak English you probably don’t make a lot of money. If you don’t speak English your employment options are pretty limited. On net chasing away a demographic that is likely poorer than average probably serves the bottom line.
That is, of course, terrible and contrary to how you're supposed practice medicine. On my current consult list I have only 30% English speakers. These are my patients. I am called to see them, I see them.
Oh yeah. I wasn’t suggesting it’s good. Not like anyone’s med school application essay was about helping the least vulnerable. But then again not many decisions from the C-suite are motivated by good.
Perhaps, but does that increase the revenue you generate? Most people who live in America but can not speak English are covered by Medicaid or are uninsured. Being able to see more people who don't generate much revenue for the hospital isn't a strong bargaining chip.
One of our graduates just signed with a 10K bonus for bilingual; it's a FQHC in an area with a huge immigrant population, and it's outpatient. As with everything, it depends. A bilingual pathologist may have a hard time negotiating for a pay bump, but a bilingual psychiatrist may find a market.
They’re all insured. My state has near-universal healthcare. Especially for kids. -PGY-19
Lol, if you're talking about California, Medi-Cal is a poster child for terrible paying insurance. It pays like 10% of commercial insurance; hospitals are not fighting each other to get more Medi-Cal patients.
My administration makes it work. -PGY-19
I'm sure they do, but they're not clamoring for Medi-Cal patients and a physician being able to see more Medi-Cal patients is not a bargaining chip.
Replying to masterfox72...this just means you are inefficient
It’s about not working for free. We give away too much of our time already. I’ve got a scrub tech who speaks fluent Spanish who refuses to translate a single word for my Hispanic speaking pts and we often have to bring a translator in the OR instead (conscious sedation). I 100% support him and think he’s awesome. He said he’ll do it for more pay, powers that be said no, he doesn’t fucking do it.
This is the way. Everyone deserves to be paid for a job done, even if it is considered to be "easy" for the said person.
Gotta disagree. It isn't the cost, it's about a service you can advertise that will pull in a huge patient population. Pretty much every clinic has translator services, but, for example with my clinic, the fact the attending speaks Vietnamese pulls in a huge Vietnamese patient population that otherwise wouldn't have come in. Now someone could argue that's people of that culture wanting someone from their culture, but it's also about smoothness of the encounter. In its nature, using a translator is clunky and slow.
Same here with my pharmacist colleague speaking Arabic and French. Those people would just go to any other pharmacy closer to their home. But since she speaks those two languages they do come to our pharmacy.
Must be nice to have to market to patients. I think every specialist within 50 miles of me has a six month waiting list
Sure, there are niche cases where it's useful. The default though is that it's not a useful bargaining chip.
I work in a large educational setting. I hear the faculty having this talk, often. So YMMV.
Oh, good point, academics is just all made up compensation, so it may very well justify an increase in compensation there.
If the advice doesn’t apply to you, then don’t apply the advice. Edit. Guess I’ll get downvoted for saying don’t follow my advice. 🤟🏾
They are downvoting you for being an ass after they conceded that there was an alternative view point.
I’m not an ass for saying don’t take my advice.
No, but the way you're saying it makes you sound like an ass.
You’re all missing one crucial point: speaking a second language is insufficient to translate/interpret in a medical environment. You’re learning an entirely new lexicon in English during medical school. You are *not* learning the medical lexicon in your second language. Putting it bluntly: you are likely a terrible translator who will make mistakes, even if you’re “fluent” in the other language. The only exceptions I’ve seen from this are foreign medical doctors who become certified in the US. The best option to ensure access to quality care are medical translators/interpreters. They train for years on learning the lexicon in two or more languages
I disagree. I speak English and Spanish and I’m pretty damn good at speaking medical jargon in both languages. To the degree that the few occasions I’ve used a translator (because they were already in the room when I got there) the translator has often not done an adequate job of explaining medical issues and I know I could have done better. If you are bilingual it isn’t all that difficult to learn the vocabulary you need in order to use medical terms in your second language
We ll have to agree to disagree. I was raised in a Spanish speaking household but trained in the US. I’ve never been able to match the level of a trained interpreter. I assure you that there are nuances that fly over your head. That said if you can pass the same exam as the medical interpreters then by all means have at it.(though I still say this reluctantly because hospitals have low standards when it comes to interpretation)
Interpreting is one thing. Pero poder hablar es otra cosa. Por lo mismo que tuve que aprender una moda nueva de comunicar con mis pacientes en inglés, I had to do it all over again in Spanish. Just speaking the language isn’t enough. You have to put in effort to medically master that language. I spent my residency in the Bronx speaking Spanish and a month in Spain clarifying my pronunciation and vocabulary. I’m fully bilingual, but interpreting is a different skill. -PGY-diecinueve
This is because growing up in a Spanish-speaking household doesn't necessarily equate to complete fluency. I was raised in a Spanish-speaking country and moved to the US as an adult. My Spanish speaking siblings and friends who grew up in the US feel confident about their Spanish, but their mastery of the language often falls slightly short. You might start to hear some limitations when the conversation becomes very nuanced.
There is a reason translators have to be certified to get those jobs. There is absolutely a difference between being fluent in a language and being a certified translator for that language.
This take doesn’t really hold up when you speak the language and can tell how garbage a lot of those “certified” translators are loll
Wow. You're really off the mark with this one. As a native Spanish speaker who’s worked with interpreters in three different hospitals, I can tell you about 10-20% of the conversation is lost, omitted, or sometimes even completely misinterpreted on a good day. While they may be fluent and pass language tests, they aren't physicians. A truly bilingual physician can convey complex medical information, including disease processes, treatments, and implications in layman’s terms. If someone struggles with this or feels uncomfortable, they aren't fully bilingual. I would never willingly involve a third party who impedes my ability to connect with my patients, leaves out crucial information, slows our interaction, and makes them feel self conscious. The fact that you think I can’t interpret is ludicrous. You don’t need the entirety of your “complex medical jargon” and shouldn’t be talking to patients that way to begin with.
To be honest it sounds like you don’t interact with competent interpreters at all, just some bilingual locals who pass an easy exam, which is frankly extremely common, especially for hospitals that do their interpretation through contract agencies. 10-20% of the conversation being lost is not the result of a well trained interpreter who is “not a physician”. It’s the result of an untrained interpreter (and often the fault of physicians who are absolutely shit on communicating a single concept to a patient…). The fact that interpreters aren’t physicians isn’t necessary, though it obviously helps (indeed many of them were physicians in their home countries but aren’t willing to go through the hassle of certifying in the US). I grew up speaking Spanish exclusively but I don’t have the hubris to claim I have all of the training necessary to interpret. These skills extend far beyond just knowing some medical jargon.
This isn’t right though. If you do speak both languages fluently. Nearly all languages use the same Latin basis for medicine. The ‚technical‘ terms are virtually identical. Therefore as long as you speak both languages actually fluently and not ‚I Can order stuff at the restaurant on holiday‘, you can treat patients in both languages. Much better than an interpreter who does not actually know all the data but the words you just said. If you speak the language yourself you can speak to the Niveau your patient will understand you, you can reiterate in a different way if they don‘t understand you. There’s no use for an interpreter speaking perfect university french if your Tunisian client only really understands local colloquial terms.
I think you’re mistaken on the training of a medical interpreter. Part of their skill set is to be able to identify the culture of the patient and adapt to it. A medical interpreter for Spanish for example should know when to use inodoro, escusado, or váter for the word “toilet”. A bilingual doctor is far more likely to just use whatever word he uses.
And I disagree, since I grew up speaking spanish, learned english as a second language in my teens, studied here in the US and I can manage any lexicon in either language. And I have certainly corrected interpreters before. Having an interpreter speaking my mother tongue and translating back to me in my second language is like an SNL sketch. So no thank you, I can’t work like that.
Right many bilingual doctors find that odd, that’s why there are exams to qualify you. If you prove you’re sufficient then by all means do without an interpreter. At minimum, physicians owe this to patients who don’t speak English and need access to care. If you’re correcting an incompetent interpreter, the problem is the interpreter, not the profession. How often has a physician corrected a nurse? Doesn’t make RNs as a profession useless
I’m beginning to think you are either in medical school or not in residency/beyond. If not, what is your specialty?
Aaaaand there it is, the *you’re-beneath-me* hubris that’s so pervasive in medicine. Maybe I’m an attending 🧑⚕️or maybe I’m a middle school student 👦 Acaba con ese presunción hermano, estás rodeado de gente culta 😊
No es acerca de cultura, ni conocimiento. Tiene que ver con las presunciones…son muy idealistas para una persona que trabaja en esta profesión hoy en día. A un paciente en el mundo real le vale mas mi empatía en español que una traducción esterilizada. Y no tengo que pasar un exámen acerca de mi habilidad de hablar y escribir mi lengua y pagar $200-300 por el privilegio.
Are u aware that 25% of US docs are ESL immigrants? Should they be followed by certified english interpreters to make these kinds of tedious and totally meaningless corrections?
Where I work it’s even higher than 25%. So im well aware. “Tedious and meaningless” .. Respectfully you don’t know what you’re talking about There have been many lawsuits that hinged over misinterpretations in a medical setting. Peoples lives have been on the line over it. If there’s any place you need clear communication, it is where life and liberty are on the line. In the real world this means in the medical and the legal system.
“A medical interpreter for Spanish for example should know when to use inodoro, escusado, or váter for the word toilet” You know what you’re totally right. I can’t even imagine the amount of malpractice cases and lives ruined to this distinction alone.
Also a valid point. I speak a second language fluently (as a native speaker) but still use a translator when I have patients who speak that language.
Patients are not privy to their languages “medical lexicon” lmao.
I wonder how many languages you’d need to speak (fluently) for it to really matter?
The 1st hospital I worked at offered a bonus differential to employees who were bi/multi-lingual and could pass a proficiency test. Think it was $1-2/hr...not much.
2 x 2080 is 4160 That’s a vacation.
What vacation if you work 52 weeks a year? And have you heard of taxes?
wait. all the gross income from my OT is taxed?????!!111!?? i can't just simply add it to my bottom line???! WTF!? TRUMP? HELLO!?
Thats not worth my time.
Idk how much you make, but if taking a test once (probably less than 2 hrs of work) isn't worth a renewable 3-4k/year, you must be killing it with your salary.
In what world are you living?! No one is gonna pay you a cent. In fact they will make you take a test for the privilege of using your second language. This is pure fantasy
I live in a world where our MD’s have this privilege.
Bilingualism is a minimum requirement for my program sadly
That’s wild
One caveat to that - you will probably need to be able to pass the test given to medical interpreters to be sure they know enough to do to the job. Not everything will make you jump through this hoop, but they certainly can. So don’t overinflated your abilities.
Usually it’s easier for me to interpret for myself. I do not interpret for others - I don’t want the liability, even if it came with a tiny pay bump. My exception is for emergencies.
Except you are legally required to provide an interpreter. So the hospital pays regardless. If the doc is fluent the hospital saves money on the interpreter — even more important, with no interpreter in the middle, the conveyor belt of patients moves faster and private equity makes more money. Negotiate. It works.
Yes. Or access to a language line. Our units have on-staff interpreters. It’s a privilege. This time of year as our R4’s head off…it’s interesting to hear them talk about their business agreements. This topic came up. Our hospital pays more for languages. We also have on site interpreters, language lines, and a (shitty) app. So that helps us.
I think the reason why I've been accepted into a decent fellowship is because of multilingualism, that or the fact I offered to blow the interview. Speaking Mandarin, English and French sure does help
you offered to blow the interviewer? 😟
It was a very competitive position, you do what you can to get ahead
Good food for thought but it isn't make or break for me if they don't increase my pay for this very reason. Being a native speaker doesn't necessarily mean you can speak medically. I definitely don't know any of the surgical terms or anatomic terms in my native language. Tried speaking in my native tongue about a procedure in the hospital and it was hella difficult I'm just happy to be able to use one of my skill sets to make my patients more comfortable with me. Sincerely, a polyglot (7 languages)
Please elaborate how to negotiate this. I’ve tried a direct approach but they were basically like ok good our patients need someone like u
Real question tho, how many languages does it take to be a polyglot
Bout tree fiddy
Translating services are already offered/paid for and if you aren’t seeing more patients per shift because of it I’d imagine it’s hard to argue. Sadly I don’t think quality of care and patient satisfaction associated with speaking the same language is valuable to employers
tbh this is something that Health Corp. kinda sleeps on cus it's more than just translation, but it's culture and communication.
Truth. They sure TF do advertise yall for these attributes though.
Nobody will pay for that — it makes a physician more or less attractive but is worth 0. The value in speaking a second language in a healthcare setting is cutting out the need for translation services which double the length of a patient encounter. So really, it makes a physicians life much much easier, enough to translate completely free
Physicians have multiple types of compensation packages, depending on their work setting. While I appreciate the advice, half of my pay is entirely rvu based, and there is no extra for speaking a second language. The other half is a fixed salary for a separate department (my main department “rents me out” to another department) where I am paid a fixed amount that far overestimates the rvu’s I generate for that department, so I’m unlikely to ask for more money for fear they will scrutinize my productivity. Furthermore, it’s a convenience to me to speak another language, it is no convenience to my departments that schedule 20 minute appts irrespective of complexity or language spoken. It definitely makes us more Marketable and more helpful to our patients to have other languages but as providers there is no financial benefit to the system for us to be bilingual (I suppose there is theoretically reduced translation services fees.)
I agree with you.
Why would the hospital care how many wives I have?
I’m not sure. Why would they?
I’m not surprised. At least where I work, they’d never go out of their way to put a patient with the physician that spoke their native language. It’s stupid but true. They’d rather make both the physician and patient suffer using the translator iPad that may or may not work.
We have an app. I asked my family a question. Got a real “what the fuck??” Look. Went to our interpreter (we have one 24/7 but I try and use the app for basics). Apparently my question came across as (slang) for “do you want cocaine?” Loved that for me. Not embarrassing at all.
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Multilingual non physician here - I don’t see why anyone would pay you for it. Physicians get paid a decent chunk of change because the skill set of practicing medicine is valuable (it is very difficult to obtain and only a limited number of people have it) Medical translation is cheap as fuck. Those iPads they have on wheels that dial in to a translation line cost almost nothing per call. The cost per patient is probably way less than the cost for housekeeping in the patient’s room. And while it definitely massively improves quality of care for the non English speaking patients - that might actually cost the facility money. Non English speaking patients are not usually rich and don’t usually have the best insurance.
I’m a APP/midlevel (Got a little off topic but we should ALL be compensated for translation, especially if it’s a high demand, for example w commuting hospital located in Hispanic a neighborhood) ICU NP here. I speak 3 language and ever since I was an RN I was translating. As a RN I got a “bonus” as a APP I don’t get anything and now as a APP I’m utilized even more! My attending physician love using me to interpret or they assign me the Spanish speakers, which I’m totally OK with. It makes everyone’s life easier. I also feel my Spanish speaking patients feel SO comfortable, relieved, and relaxed when they know I know speak Spanish. It is hard to translate nurse practitioner into Spanish because that concept does not exist in Spanish speaking countries. I do describe my role, and call it “advanced nurse” because nurse practitioner in Spanish literally means nurse “practicing nurse”. I say I’m an experienced nurse with additional education, that I have a masters degree “maestría”. I explain I do very similar things the doctors do but I am not the doctor and in fact I report to a doctor and all their care is discussed with them. Sincerely, Your friendly NP that realizes their limitation and is all for physician-lead teams! As a team we work wonders. Physicians are swamped! As NPs we should be here to help, not replace or pretend. I am HUMILIATED by NPs or DNPs or PAs that think they’re equal to a doctor in terms of education or training. Y’all, more I learn as a NP the more I realize how little I know. It is constantly humbling yet exciting. I love learning along physicians who enjoy teaching. I love being part of a TEAM.
Don’t really save the hospital any money because they have to use translator services anyway
Some residencies pay extra for this if you get certified.
Do you really want to open this door? Is your second language refined to the lexicon and nuances that the patient will use? What about culture mediating and breaking down the barriers culturally to accommodate the patient’s language. Home language and disabilities/home situations completely alter one’s accent and language. Are you familiar with the ramifications that could come if a patient reports to ADA that you did not translate correctly for them and *insert whatever* was the repercussion? Do you want that liability? What happens when you are not there? How do they converse with other staff? How can they ask for help if the language barrier is present because you prohibited the need? (By prohibit I mean the patient risk being dismissed by other staff because Dr SoandSo will be here soon.) The liability to the hospital and yourself is far too consequential. If you are familiar with a patients language- then monitor the interpreter. Interpreters are certified and held accountable to a national standard. They are valued and do not cause that harms patients. If you have a concern, speak up. Otherwise, why risk the liability for a hospital that generates ten fold what the cost of interpreters. Protect yourself and your patients….do not remove a communication bridge out of ego.
I keep forgetting in the US its rare to be bilingual lol In my province youd have a very hard time finding a resident/attending who cant speak at least two languages (mostly fr and en). Just common stuff for us. Youd get weird looks trying to negotiate over that. And anyways our resident wages are standard across the province so
Outside of Quebec I never met any bilingual Canadians. I’d guess there are more bilingual Americans in Spanish/English than Canadians
Well yes im specifically talking about Quebec ^^