Wednesday, March 31, 2010

Is Our Industry Disconnected from Clients?

There is a disconnect--a divide. The difference between what we know and what our clients know is vast and the gulf that lies between us is insurmountable alone.

This is how I felt walking away from the Harvard Social Enterprise Conference. Held February 28th, its global health track featured leaders from international pharmaceutical companies, the Pentagon, the Obama administration--even George W’s daughter sat a panel under her Global Health Corps role. These, supposedly, were the world’s greatest minds on global health and social enterprise, with Harvard‘s reputation fully stacked behind them. But when it came to language services, they didn‘t know jack.

Here’s what made me realize this:

I was sitting in the back row listening to a panel made up of Barbara Bush, the director of the International Health Specialist Program for the Pentagon (Lt Col Mylene Huynh), Merck’s director of global affairs (Kris Natarajan), Management Services for Health‘s CEO (Jono Quick), and two professors from the Harvard School of Public Health (Drs Jessica Cohen and Till Barnighausen). The topic was “Breaking the Silos: Collaborations That Impact Complex Global Health Issues.” According to the program summary, the session’s goal was to bring together people and information from different fields, all with the goal of improving global health.

When it came time for Q&A, I raised my hand. “People don’t heal if they don’t understand,” I said. “The rest of the world does not speak English.” I then asked what we could do as a language industry to help connect with the global health one.

There was a long pause. Too long. Then Lt Col Huynh from the Pentagon spoke. Bilinguals and heritage speakers need to learn medical terminology. Sure, I thought, that’s a given. The military, she claimed, does not have systems in place to teach medical linguists medical language terms. Okay. Fair enough. She’s acknowledged their need and is speaking out. That, we can address; lessons, we can do.

But then Harvard’s Dr Barnighausen spoke up. And his response made me wonder what I’ve been doing with the last four years of my life, what our industry has been doing the last ten. He told a story about the one time he had worked with a “translator.” He asked the “translator” to ask the patient if his stomach hurt. The “translator” and the patient had a long back and forth conversation before the “translator” said, “No.” Dr Barnighausen’s reaction was to stop working with translators (which is good, as he needs interpreters instead) because “they’re all like that.”

I wanted to weep. I sincerely and utterly wanted to weep. The moderator went on to the next question while I sat there in shock. The camera Harvard was using to record it all (Harvard, conveniently enough, was unable to locate the video upon request) panned away from me and back toward the panel as they continued, but I didn‘t hear a word. I was too in shock. This “expert,” this Dr Barnighausen, wasn’t an expert on language‘s crucial role in health care at all.

This was Harvard. These people were supposed to know what they were doing.

After the session, I ran to the front to try and catch Dr Barnighausen. If, for some reason, our entire industry, the multiple associations that we have, the whole of both certification movements, had not been able to reach him, I would. But I didn‘t. The moderator carted him away before we had the chance to talk. I did get to speak with Lt Col Huynh, though. I told her how glad I was she articulated her answer so clearly, how much I appreciated the information. I told her how much Dr Barnighausen’s remarks had pained me, then what she said pained me even more. “But he’s right. They’re all like that.”

I immediately started gushing about the National Council on Interpreting in Health Care, its code of ethics, the certification for medical interpreters expected this fall. “You mean there are ethics?” she said, “This is a profession?”

This woman works for the Pentagon. She is in charge of our entire military’s medical efforts.

Clearly, there is a disconnect. It is wide and vast and sprawling.

As a language industry we are working hard--harder than ever before--to develop interpreting as a profession. We have more trade associations than ever before, more conferences than in years past, more training opportunities than before. But do they help? And, if so, whom?

There is a disconnect. When representatives of our own government, professors at the country’s purported top school--when our nation’s leaders have never heard of us--when they stand aghast at the sheer principle of our having ethics--when they think we’re all bilingual quacks who summarize--what are we doing wrong? Who are our efforts for?

Conference after conference, session after session, we talk, but to each other. We must talk to the client. We must talk to those who need to listen. Instead of teaching Bridging the Gap, we should be bridging the gap between us and our clients.

But how? In the past, this has fallen on the freelancer, on the LSP, on the person selling the services. That’s why we call it client education. But the LSP can not tackle this great gap by itself. The language industry is being squeezed. Rates are falling, client demands are going up. If the LSP refocuses its effort to focus on client education, the burning of resources will mean there is no LSP left. We need our associations to help us. Clients do not always believe freelancers or LSP’s because they assume we have something to sell. But if the associations would work together to sell clients on our industry, there’s no telling who or how many people we could help.

We must close the disconnect. We must stop thinking intrinsically and think externally. Educational PSA’s on YouTube, an NCIHC booth at global health conferences. Our associations must market this industry just as we LSP’s market our services. There should be no excuse for our nation’s leaders to know so little. Again, there should be no excuse for our nation’s leaders to know so little!

Where are we going wrong? How can we take this talking together and make it working together to educate the client? How do we bridge the disconnect?


Douglas Green said...

Terena -

Thank you for your post.

The reality is that interpreting services are viewed as risk mitigating costs for indigent patient populations that cannot and will not pay their bills.

The recipient of language services is viewed as an abuser of the system who takes and gives nothing back and is someone from a poor third world country who takes advantage of one of the world's finest health systems (cough cough). You will find the recipient of language services in the overworked, understaffed, outdated, run down ER of a county hospital and not in the polished ivory towers of academia. Fame and glory are found in magazine articles and cutting edge science not in pushing cattle through charity given care.

I have found several areas helpful when 'educating' the client;

1. Making sure the client understands the size of the population that requires language services. In Texas this is about 7M people, pretty close to the size of NYC. Not insignificant.

2. Communicating in real numbers the dollar amount lost annually by not providing the service - which is staggering. 73B a year is lost due to poor communication in Healthcare. In Texas 30% of our population speaks a language other than English and we represent 10% of National Healthcare expenditures. Doing rough and loose math it is safe to say that in Texas we lose about 2.2B a year due to poor communication with LEPs. What percent of HC expenditures does your Hospital represent?

3. Provide them a way out. Did you know that when LEPs receive language assistance they are more likely to have a primary care physician, less likely to use the ER, and are more likely to follow Dr's orders than their English speaking patients? WOW. Can you hear me now? They are more likely to use the system as it was intended to be utilized than their English speaking counterparts.

Now Mr. Client, not only have I just showed you how to save a ton of money from all the cash you are hemorrhaging, but I also showed you how to redirect the patient flow in your hospital so that you can actually begin to manage your encounters, staff, and resources.

It is long past time to take the gloves off and quit prancing around the numbers because some ignorant doctor might bite your head off. Trust me. Your clients will be glad you did.

Doug Green
Director of Outreach for the Texas Association of Healthcare Interpreters and Translators

Chief Advocate for Saving Healthcare in Texas
Translation Source

PS. If you need these stats send me an email to and I will forward to you.

Mónica Algazi said...

Preoccupying scene indeed. Yet there are exceptions. There are people in the health care industry who are fully aware of the need for qualified linguists, not just bilingual quacks.
Naturally, to do so you have to understand, and in order to understand, a reasonable IQ is a must...

M ó n i c a A l g a z i
Sworn Spanish Translator
ATA certified

Mark said...

Great article and it was interesting to hear about your experience at Harvard. I recently spoke with a woman who has a community based paper focusing on Hispanics in her area. She uses a "cheap translating program" to translate her writing, because it is "good enough for them". When I translated in the US, this seemed to be the summary for most people. Do it "just good enough" but the patient and their understanding was not so important. Keep up the good work helping those who deserve a better understanding of what they are experiencing with their health.

Mark Wakefield

Ilse said...


THANK YOU, and WOW. I had no idea.
I certainly view things from a different angle now. I have always taken pride in doing an excellent job interpreting, but now I have to work just as diligently at educating.
I was recently offered the opportunity to write an educational piece for the Journal of Court Reporters --I agreed to think about it, but after reading your blog I have a new motivation to do it ASAP.
Eventually, we will also need to address the need to educate the LEP's, so that the general population will have a basic understanding of how to make communication through an interpreter more accurate, efficient and cost effective.

Rosanna said...

Dear Terena, with your permission,I'll send the link of your post to the Italian Intepreters and Translators I belong to. In these days, we, as association, are having a kind of pause to think and give ideas to the associates what we, as a group, shall do and change in order to make all the world understand that translating or interpreting, for whatever sector of the industry, is A PROFESSION!! and a profession that requires time, efforts, continuos studying and updating, not a job that you can do while cleaning the house or cooking the meals,that's the idea that has come out in an article of the young enterpreneurs representative in ITALY!! So I do agree that it is time for all associations all over the world to join together and show the world how important is our job in all fields.It is known how big corporates would give their blood to have a good machine translation and save millions of dollars but as human translation cannot be substituted, for now, they have obtained a decrease of rates, instead. How is it possible that the job of a translator is valuated less than the lowest labor (with all my respect for those workers)? The market has changed a lot. More and more clients address themselves directly to freelancers and require higher and higher expertise from them. If before the agency or the LSP was delivering a translation that has been proofread and revised, now in most cases these last two passages are left to the translator. The processes of the translation industry itself should be made known to the world so the client knows what to ask for and to expect from the eventual LSP. A world conference would suit? A connection of intents and a regulatory paper valid worldwide?

Ekaterina Tarasova said...

OMG I thought that situation is bad in our country and I couldn't imagine that it might be possible in highly developed countries. Thank you, Terena, for sharing it with the community...It explains a lot...

Once I was urgently called to the hospital in Minsk where one of our staff workers was taken (ER department). It was impossible for him to convey to the personnel at the hospital what’s wrong (he was a native American and his Russian was much to be desired). Moreover, he suffered from pain which made the situation even worse. So my help was very useful and just in time and it was acknowledged by the patient and by physicians and nurses. I bet that honorable Harvard professor would change his mind regarding ‘translators’ if he happened to be in the same situation.

I agree that there are poor interpreters (as well as poor physicians). Nevertheless we need both services, linguistic and medical one.

Terena Bell - In Every Language said...

Thank you, EVERYONE, for your comments! And, Rosana, feel free to share this with your group. The more people who understand the work we have to do, the better!

Manuel Duran said...

Ms. Bell:

You are not alone in perceiving this dilemma. I was a certified interpreter for 20 years and I saw many horrible things.

1. In most industrial accident medical settings, the doctors and their personnel could care less what the interpreter is saying. They just want to get through the exam and get paid.

2. Most persons who receive "interpreter services" are totally unaware that they have the right to understand what the interpreter and the doctor or other medical personnel are saying. These patients think that they cannot ask questions if they do not understand. Even if they ask questions, the interpreter does not have enough sense to relay the question to the medical personnel. Even if the interpreter were to relay this information, see 1.

3. California has a "Medical Interpreter Certification". All you have to do to pass and get certified is to know some anatomy and a few diseases and medical devices.
There is no preparation regarding patient relations.

4. In hospitals where things may be a little better, there is such a shortage of qualified interpreters that it is as if interpreters were non-existent.

5. I read your blog. If the medical personnel cares so little about patients, the politicians and office holders care even less. They pay lip service to whatever people want to hear, so they can keep their office.

Is there a solution?

Yes, but not a national, state, or local level.

The solution is at a personal level. The interpreter must care, must be knowledgeable regarding patient rights, and must be willing to put his/her neck on the line.

You might want to get in touch with Holly Mikkelson from the Monterey Institute of Languages, or with Dr. Dueñas (Roseann?) from Tucson University. Perhaps through people like them a wider awareness can be accomplished. Holly is in Spreckles, California. They are both in Google. They are very knowledgeable and like to shake up things.

The outlook at present is dismal. If more people like you, who are shocked at this, were to advocate better interpreter services, not as a service, but as an expectation, an obligation by medical personnel, there is a chance of improving the status quo.

In the judicial setting, judges in California have to go through training in the use of interpreters. I do not think there is any requirement for doctors, nurses, hospital staff or any other medical staff to have this kind of training.

Perhaps interpreting agencies can develop some guidelines for their interpreters in the medical setting. I would be glad to contribute in something like this.

Danielle said...

Hey, Terena -

That blog post was really good. I am SOOOOO disappointed that "our nation’s leaders...know so little". I heartily agree with your statement, "We must stop thinking intrinsically and think externally." I don't have a ton of time, but I will try to help you/us do what we can - you can call on me!

:) Danielle

Joana said...

Don't get me started on this topic, it's a major concern of mine also, especially as I live in the city where global health has been described as the "hottest new industry."!!!! It's a structural and political problem that you are seeing.

Part of the problem is the huge, often unspoken, political scenario
underlying why we still must justify the need for language access for resident of our country, fueled by the racism, anti-immigrant bias and classism that still permeate our society and are being exacerbated in the current economic downturn. Global health, on the other hand, has a certain cachet among many who may have never have experienced and/or concerned themselves with , equity issues here at home., and see nothing wrong with the global corporatization of every aspect of human activity.

I myself am also involved in global health advocacy work , and keep going by seeking out others who share the human-centered philosophy of life. It's a struggle. Feel free to contact me off list to discuss further.


Sasha Federiuk said...

Terena, I loved the blog entry you wrote. I'm glad that it was posted on the NCIHC website for members' review. I know how frustrating it is to feel that our profession is unappreciated and misunderstood. Client education is an ongoing struggle and you and I both know that with NCIHC's future involvement in the formation of a National Certification for interpreters in health care, we will receive more recognition as a true profession. Cheers!

Anonymous said...

Great article-I truly appreciate your dedication and commitment, as evidenced by your travel and participation as a language professional in worldwide venues related to the LSP profession.

A Spanish proverb says, the older you get, the greater and deeper your perspective and you see what drives decisions and the bottom line for most countries, industries, professions and individuals is money. In our current economic pandemic, costs are being cut (except for CEO salaries and honoraria for the privileged classes) to the bone. A dollar unspent can be then directed to bonuses or, in a more honest context, used for survival. Our position as LSPs is further compromised by an unvoiced but omnipresent truism that foreign language ability is a service that is to be provided at no cost just because.

I'll cite a couple of local (i.e., Louisville) examples. At UPS, where I have worked part-time for 12+ years, the company policy is not to pay for foreign language capability. Nevertheless, management puts considerable effort into identifying employees with FL ability, determining which language(s) and the degree of fluency, then placing these employees' names on a ready reference list to be used as "foreign language resource persons". Many times I have pursued the issue of not compensating employees with fl ability, The conversation routinely goes like this: Me - "UPS does not compensate for FL ability?" Them - "Correct." Me - "Why not?" Them - "Because FL ability is not required." Me - "Why is FL ability not required?" Them - "Because it is not needed?" Me - "If FL ability is not needed, why does UPS identify employees with FL ability, identify the specific foreign language(s) and level of proficiency, and publish a list with the employees' names, telephone extensions for circulation as resource persons to all employees?" Them - silence.

Anonymous said...

The second example occurred several years back when a Hispanic male was apprehended by the Louisville Police Department for what I recall was a relatively minor offense and incarcerated for an extended period because he was unable to speak English and the presiding judge refused to pay for an interpreter. The judge further expressed the opinion that an interpreter should receive a rate of pay at the low end of the scale.

I just finished reading Thomas Friedman's "The World Is Flat" which speaks of the flattening effect of the triple convergence and explains how outsourcing (read translation) became a way of life after 2004. Interestingly enough, this was about the time my telephone stopped ringing for translation. And for good reason-it takes no longer to email text for translation to India or Central or South America than across town. Translation agencies and companies routinely use electronic transmission to outsource translation and reduce costs to improve the bottom line. I suspect translation outsourcing has a collateral effect of depressing fees for interpreting. After all, foreign language work is foreign language work, and many people fail to distinguish (as you so well pointed out) the difference between translation & interpretation.

To return to my original point, when foreign language ability is perceived as a service to be provided without cost, then anyone who provides it is considered an adequate practitioner, even when (s)he is marginally qualified. I don't recall ever being asked by the person requesting interpretation if I knew anything about the field for which interpretation was requested. This brings me to another point. Most FLPs are genuinely interested in people, other cultures and the interrelationship thereof. For this reason, it's understandable we would become involved in pro bono projects. Which, in turn, allows us to shoot ourselves in the (financial and professional) foot. Because THEY then conclude, "Why should we be expected to pay for FL ability when FLPs work for free?" As the British say, "it's a sticky wicket."

We are caught in a double bind. While I have no problem WHATSOEVER helping out Paco and Juanita or Dieudonne and Aisha with community language issues, I see no reason why I should not be fairly compensated for work performed as a FL Professional.

My own experience has provided me with a niche market that will probably be around for quite awhile to come-interpretation mandated by law (read CYA for the public school system, legal matters, etc-hospitals would seem also a logical venue) and interpretation/translation for technical applications. When a plant production line shuts down because a key component needs to be repaired and the field engineer or mechanic sent by the foreign home office doesn't speak English, then my services as interpreter become part of general overhead. Similarly, translation for consumer goods (usually requiring some technical ability) is a good field, particularly when the client appreciates the "warm and fuzzy" feeling of having someone "nearby" and always available in case of emergencies. In the above examples, my involvement is perceived as adding value, and not as an (unnecessary) expense. Responding to your blog, Doug Green in Texas makes this point quite well. We FLPs need to promote ourselves as agents to diminish costs, not add to them. All business and agencies pay greater attention to Profit Centers than to Cost Centers.

Marla Schulman said...

For what it's worth, I do believe the situation isn't as bleak as you may feel at the moment - you've got it right that we need to expend less energy talking to each other and more time talking to our clients, but us even talking to each other is quite new in the evolution of our industry and so the steps are in place to get to where you say we need to go. Also, at the leadership level of the ALC we are working diligently with the leadership of many other industry associations to create the cooperation needed for us to reach out as one voice to the public, and we're making further strides there than we ever have before.

These things don't happen overnight but they are now happening at a faster pace than ever before in the past.


Martha E. Galindo said...

Scary experience indeed. Even when we recognize the lack of maturity as an industry in the US, compared to Europe for example, a lot of work needs to be done.

We educate clients one at a time. I always remember an attorney many years ago in Pennsylvania who was shocked for the price of the translation of a document. And said, ”my transcriptionist only charges xyz, why are your services much more expensive?... and the simplest answer for such an ignorant comparison of apples and oranges was, “your transcriptionist is doing it in one language. Recognizing which word to write in another language has a price”. Thank God, I have not had many of those examples.

From a business point of view I try to focus on the clients sophisticated enough to recognize the value of our work. No time now for the rest. They will learn their lessons the hard way.

Bertha Garber said...

Unbelievable. We definitely need to speak up and make people aware of the need of interpreters.

Thanks for sharing.

Cyndy Hernandez said...

FABULOUS article - well said and very timely - Thanks for sharing - I will follow her blog. I have felt her "pain" so many times. She is so right when she stresses the public awareness point....

Cynthia S. Hernandez
Court Certified Interpreter/Interpreter Trainer
ATA Certified Translator (Spanish>English)

Andrea Henry Sims said...

Very true and definitely a stressor for a lot of us in the field. Even when our work is appreciated, we are still very misunderstood as professionals and as a field. Case in point: I had interpreted for several years for the same provider in surgery and when I happened to mention that our field was working towards a national certification process, she couldn’t suppress her surprise. She smirked and then laughed out loud, “You guys actually NEED certification?!!” Whew. What a way to start the day. I realized at that moment (as it converged with other similar memories archived in the deep recesses of my mind) that even those that use us regularly and seem to appreciate the work we do, just do not understand what it takes to do it and do it well.

Having said that, I know we are not alone. Other fields deal with the same issues (e.g. registered nurse midwives, nurse practitioners and physician assistants, etc) and I am encouraged by their progress.

Andrea Henry Sims
Spanish-English Interpreter
Children’s Healthcare of Atlanta

Jill said...

Good suggestions. The industry really should band together.

rebeccathelinguist said...

Accolades, to you, Terena, for such an excellent article. I have always appreciated your sincere interest in helping others to appreciate our profession.
Thank you for speaking up and out!

Natasha Curtis said...

Good article, Terena!

Philippe said...

Dear Terena,

Thanks for this amazing posting. I'm baffled by the ignorance level of these supposedly "important people".
From my long experience it just confirm that administrations and large companies are still cuting translation costs to a minimum. With all related risks for public health and well-being...
Remember buying you first japanese stereo or motorcycle back in the 70's? And its low-cost owner's manual?
As a professional translater in the field of orthodontics, I have the tremendous advantage to be the only competent one (no, I don't get any natural modesty). And I got my customers used to a high per-word-rate, refusing to over-discount my service (the message is clear: "you want it much cheaper? Please call someone else").
I believe we (as a profession) should be unmovable in stating the quality of our services and our rates.

Thanks again for your posting.


Philippe Mollard
Orthodontic translator
Paris, France

Catherine Guilliaumet said...

Dear Terena,

What to say in my not too good English? First of all, of course I am horrified by the exchange you had at this Harvard Conference. Of course, I find the reaction of both these VIPs supposed to be in charge of the Health policy absolutely scandalous, but it reveals their shameful, or even culpable, ignorance.
At the end of your article, you should substitute "our nationS leaders" for "our nation's leaders", because this a global disconnect.
With your permission, I shall mention your artivle/blog on the list Medical_Translation for Professionals.
As for the solutions ? Educate, educate ! All means acceptable.
Thank you for drawing our attention on this nonsense.

Anonymous said...

Shouldn't the "education" of the client be the job of an enterprise like the ATA? As long as the ATA treats its translators like cattle and its real clients (Corporations, government agencies, and such important people as those pontificating at the Harvard meeting) like cowboys, then the translation "profession" will not come down from the trees.
I, for one, advocate that the ATA mandates all its agencies and corporate clients to hire only certified translators as a condition of membership, or that the ATA works towards making the translation profession a "licensed profession", as engineers, doctors, builders, electricians, etc. are.
Sadly, though, it does not look like this is anywhere in the foreseeable future.
Joseph Hitti

Maria said...


Great Post! Interesting, informative, sad and shameful. Maybe we do need some serious lobbying. If nowadays people in high positions don’t know the difference between a translator and an interpreter, it means that we LSP, translators, interpreters and trade organizations are doing something wrong, or better said we are not doing something totally right. I guess we have to keep trying. Those of us who are serious about our “profession” need to allign so that we can be recognized, respected and rewarded for what we do.

Tony said...

Nossa senhora...
I'm truly incredulous that people working in such an important field, on such a grand scale, in so wide a network, in so many countries, with people who speak so many languages have never encountered a professional interpreter.
It really is disturbing.
Another sad fact that demonstrates the sheer lack of knowledge on the part of medical professionals of the importance and impact of our profession is the fact that so many hospitals today in the US, if they use an interpreter all (instead of patient's "bilingual" 5 year old kid, or some crap like that), they use interpretation over the telephone. I can't imagine being in a country where I didn't speak the language and having to speak over the telephone to communicate with health professionals. I find the concept revolting.
At the same time, these people in the health field, well, they, too, have a responsibility here. They should have done the homework to find real, professional interpreters, instead of just grabbing the nearest Tom, Dick or Harry who was purportedly "bilingual". They should be as ashamed as we are that they know nothing of our profession. Seriously.

Marie-France Schreiber said...

None of this is really that surprising! It was painful to read your blog, and I stopped short because I have heard it all before in Corporate America. I sometimes wonder why I am in this profession. We don't even do a decent job of teaching languages in our schools. I really don't know what it is going to take to get respect for what we do. But, I can't wait to read the comments and add to the discussion.

Liz Lyons said...

I think some of this is due to the overall lack of interest, on the part of many people in the US, in ethnic cultures and their general inability to understand non-English languages. Perhaps this is an unintended heir to the Monroe Doctrine. It goes along with a rather insular prejudice that is clearly seen from a distance, i.e., when one lives abroad. None of this surprises me, as a result.

Anonymous said...

You are right on target to change a culture!

--@Eiber_Translate (from Twitter)

Boletus said...

Top people are usually political appointees and they cannot be expected not to know much about anything. The fact that some, in fact many of them, are quite knowledgeable, is a miracle. At the lower level, hospitals, courts, corporations and our other clients do hire professional interpreters as well as translators. Otherwise, how would any of us make a living?

Anna Augustin said...

Dear Terena,

I read your blog posting dated March 31, and took the
liberty of sending it to the OFA, White House Website in the
hope someone will take notice.

Faced with similar problems as to the seriousness of my
profession, I really needed your posting to remind me that
yes, I did do 5 years at university to get where I am and yes, I expect people to recognize that.


Anna Augustin
Paris France

Suzanne Salimbene said...

As a cultural & linguistic competency writer and trainer since 1993, I have been so excited by the wonderful steps medical interpreters have been making and join you in your disappointment at the "disconnect" you witnessed at the conference to which you refer.

However, I must admit, that as one who now lives outside the US and has become extremely interested in making better known, the need for cultural and linguistic competency in the rapidly growing medical tourism industry, I find that both your term "global healthcare" and the total lack of interest that has been displayed by members of this list-serve regarding the need for language access and cultural competency to American and all others globally who seek care outside their own countries and medical systems. While most of these medical tourists are 'paying clients", don't they also deserve care given in a language they can understand and in a manner that is appropriate to their cultures? Right now countries such as Mexico, Costa Rica, Turkey, Dubai, India, Korea, etc. are promoting medical tourism to both Europe and North America. They rightly promote the quality of the medical knowledge and their modern facilities, but say nothing about their ability to provide language access and cultural appropriateness to patients from other countries.. As far as I have been able to find out, Mexico, the country in which I now reside, doesn't even have any professional interpreters--let alone medical interpreters!

No, as Terena pointed out in her blog, the U.S. isn't the center of the world, and not everybody speaks English! While we must keep up our fight to improve cultural and linguistic competence in the U.S., we also need to think more globally. Don't you think that the more than one million six hundred thousand US citizens who are expected to seek healthcare outside the US just in 2010 and the millions from other countries seeking healthcare outside their countries deserve to be able to communicate with their caregivers and receive care that meets their cultural needs and expectations? I see this lack of interest as a "disconnect" too.

Suzanne Salimbene, Ph.D.
Inter-Face International

Linda Golley said...

I read your blog. Jeez, that is awful. I almost went to the conference on my own. Now I am so glad I did not spend that large amount of money for such a frustrating experience.

I recommend sending your blog to the attention of the conference organizers, with a note asking them to include material on NCIHC and language support with the conference materials that they post now that the conference is over.

Hang in there, lady! Keep up the good fight, but also take joy in the fact there is a listserv of all of us working on the same stuff!

Linda Golley, Manager
Interpreter Services, UWMC

Greg Faherty: said...


I am a marketing communications professional and I am currently working with a language services company, and one of the owners sent me a link to this article. I believe that I can help. In short what this industry needs is a strategy and plan to communicate the benefits and attributes of professional language services. A previously poster made the point that "Did you know that when LEPs receive language assistance they are more likely to have a primary care physician, less likely to use the ER, and are more likely to follow Dr's orders than their English speaking patients?" This kind of message is powerful but if you have to spread the word one client facing engagement at a time you have a long, uphill battle ahead of you. I have experience helping businesses communicate to other businesses so drop me a line if you would like to discuss this further. Good luck to you all!

Kimberlee Thorne-Waintraub said...

Terena tells it like it is. Until these leaders are in a situation where they can't understand a foreign language, it seems like they won't see how important it is to understand and be understood...

na C. Marin said...

I'm a native Spanish and have lived in the USA for 34 years. I've worked as a Spanish Medical Interpreter for the past 10 + years in MA and in RI. I currently work with facing Cancer - I love my profession as a Medical Interpreter. I've lived the disconnect and feel the pain Tereana expressed in her blog and agree with her it 100%.

Language and Medical Interpreting in the health field and in the USA is a key to better patient care, services and outcomes. This message needs to be embedded in higher government official's minds and perspectives. It sadness to realize the confusion still exits on translator vs. interpreters.

Thanks so much,

Ana C. Marin
Cancer Patient Navigator
American Cancer Society
Beth Israel Deaconess Medical Center

Anonymous said...

Great post. Can’t wait to read the next ones :).

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Anonymous said...

This is a fantastic view of the situation, I don’t think I’ve quite seen it from that perspective before.

Dennis L. Ziegelmeier said...

I have two observations. As translators, it is best to not need to be translated. Stop using acronymns.

The "Medical Profession" has become only "Big Business". Why not take your Profession to the majority that needs it. U.S. Small Business. It is an $8 Trillion Industry of which over half are Home Based Businesses. You want the "masses" to understand you? Show them How your Profession Works For Them.

Figure out where you want to be and concentrate on being there.

Three people I have come to respect have already said it.

"The significant problems we face cannot be solved
at the same level of thinking we were at when we created them."
Albert Einstein

"Don't let Way be Way."
Bruce Lee

"Keep a grateful journal. Every night, list five things that happened this
day that you are grateful for. What it will begin to do is change your
perspective of your day and your life. If you can learn to focus on what you
have, you will always see that the universe is abundant; you will have more.
If you concentrate on what you don't have, you will never have enough."
- - Oprah Winfrey - -

Share your Joy. It will spread like Wild Fire.

Dennis L. Ziegelmeier
JAMI and Associates, Inc.
A Self-Enabled Veteran-Owned Business (SEVOB)
PO Box 720879
Orlando, FL 32872
(407) 495-5835