Article Content

Because of language barriers and insufficient medical translation, millions of U.S. residents who don't speak English well receive inadequate-and sometimes tragically inappropriate-health care. Writing in The New England Journal of Medicine, Glenn Flores, MD, an expert in multicultural health care, offered several examples:

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

* A patient seeking care for feeling sick to his stomach was wrongfully treated for drug abuse. The treatment delay resulted in the rupture of a brain aneurysm, quadriplegia, and a $71 million malpractice settlement.


* An ad hoc interpreter told the mother of a child with otitis media to put oral amoxicillin in the child's ears.


* A physician misinterpreted a mother's explanation of how her daughter had hurt herself when falling off her tricycle. Believing the child had been abused, he called social services and the child was removed from her home.



According to U.S. Census Bureau estimates, nearly 50 million U.S. residents speak a language other than English at home, and another 22 million speak English poorly. When these patients need health care, they find medical translators in short supply. One study found that no interpreter was present in 46% of emergency department (ED) cases involving patients who speak English poorly. Only 23% of U.S. teaching hospitals offer clinicians any training in working with translators, and in most cases the training is optional.


Citing government figures, Flores says that offering appropriate language services for ED, inpatient, outpatient, and dental visits would cost only $4.04 more per physician visit. He concludes that "this seems like a small price to pay to ensure safe, high-quality health care for 49.6 million Americans."


Source: Language barriers to health care in the United States, The New England Journal of Medicine, G Flores, July 20, 2006.