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NEJM on Language Barriers to Health Care

NEJM on Language Barriers to Health Care

July 20, 2006

Terrific piece in this week's New England Journal of Medicine on language competency (or lack thereof) in US hospitals -- written by Dr. Glenn Flores of the Medical College of Wisconsin, and a former pediatrician at Boston Medical Center. Click here for free access to the article. Here's the start:

A 12-year-old Latino boy arrived at a Boston emergency department with dizziness anda headache. The patient, whom I'll call Raul, had limited proficiency in English; his mother spoke no English, and the attending physician spoke little Spanish. No medical interpreter was available, so Raul acted as his own interpreter. His mother described his symptoms:

"La semana pasada a el le dio mucho mareo y no tenía fiebre ni nada, y la familia por parte de papá todos padecen de diabetes." (Last week, he had a lot of dizziness, and he didn't have fever or anything, and his dad's family all suffer from diabetes.)

"Uh hum," replied the physician.

The mother went on. "A mí me da miedo porque el lo que estaba mareado, mareado, mareado y no tenía fiebre ni nada." (I'm scared because he's dizzy, dizzy, dizzy, and he didn't have fever or anything.)

Turning to Raul, the physician asked, "OK, so she's saying you look kind of yellow, is that what she's saying?"

Raul interpreted for his mother: "Es que si me vi amarillo?" (Is it that I looked yellow?)

"Estaba como mareado, como pálido" (You were like dizzy, like pale), his mother replied.

Raul turned back to the doctor. "Like I was like paralyzed, something like that," he said.

One study estimates that no interpreter was used in nearly half of visits to US emergency departments by folks with limited English proficiency. This is an important issue, and growing in importance every day.