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Some at Hospitals Perform Double Duty : Interpreting: Under a 2-year-old state law, bilingual employees help doctors communicate with non-English-speakers.


NEWPORT BEACH — It was routine when switchboard operator Maria Magana was recently asked to leave her telephone exchange post at AMI Medical Center of Garden Grove to assist a doctor in the emergency room. As a bilingual employee she is frequently asked to translate for Spanish-speaking patients.

But the 25-year-old woman was distressed when she learned that the physician--who spoke no Spanish--wanted her to tell a patient that he had AIDS.

Magana, whose bilingual skills served her well in routine medical situations, said she told the doctor she just didn't feel comfortable trying to tell someone he had a life-threatening condition. "I just told the doctor, 'No! I can't!' " she said.

The doctor broadened his search and found a bilingual nurse to deliver the grim message.

In refusing the task, Magana did the right thing, said George Rimalower, president and founder of Interpreting Services International, a Van Nuys-based company that gleaned $1.5 million in revenue last year teaching bilingual hospital employees such as Magana how to serve as interpreters when doctor and patient don't speak the same language.

The surge in such training has been fueled by a 2-year-old state law, prompted by California's burgeoning immigrant population, that requires licensed acute care hospitals to provide interpreters if at least 5% of their patients cannot speak English.

"Hospitals are looking at interpretation services more closely," said Ed Foley, spokesman for the Orange County office of the Hospital Council of Southern California. "Ethnic communities are often market niches that a hospital can pursue to increase business." AMI, for example, is a 170-bed community hospital serving a population that is 12% Hispanic, 10.6% Korean and nearly 5% Vietnamese.

Because of budget pressures, however, relatively few hospitals have full-time interpreters. Instead, most simply hire bilingual people for other jobs and then press them into service as translators when necessary.

Hospitals find it beneficial to use bilingual employees as occasional translators because it's cheaper and the employees usually have some knowledge of medical terminology.

However, problems can occur if the employees aren't properly trained.

"Being bilingual does not necessarily mean you know how to interpret," Rimalower said. "There are certain critical guidelines an interpreter must follow, otherwise the non-English-speaking patient may not get the best possible care and the hospital may expose itself to potential liability if it can be proven improper care was provided because of language problems. If you take interpreting upon yourself you have to interpret verbatim what is being said. If you can't, just don't do it."

Courses such as Rimalower's teach hospital employees the rules of patient confidentiality, medical terminology, medical ethics and proper interpreting style.

To illustrate, Rimalower tells of an English-speaking doctor who wanted to tell a Russian-speaking patient that he had only a few weeks to live and should get his affairs in order. Ignoring the critical need to impart correct information, the interpreter--who felt sorry for the man--decided it would be kinder to tell him he was fine and shouldn't worry.

But compassion isn't always the best medicine. "We teach interpreters to basically act as a computer, translating one language into another" as precisely as possible so that there is no misunderstanding between doctor and patient, Rimalower said.

In a pinch, when a patient speaks a relatively uncommon language, such as Polish, many health care professionals rely on telephonic translation services offered for a fee by AT&T.

However, the telephone company can't provide as many services as people like Wendy Yoo, who serves as liaison to the Korean community and sometime translator at AMI. Yoo said she not only translates but helps patients through billing and insurance mazes and provides comfort in a crisis.

Recently a Korean woman came into the hospital screaming and crying because her 39-year-old son had died of cancer. "She kept saying, 'My son dies, why?' " said Yoo. The woman had not understood that her son had cancer and the hospital staff could not calm her because they could not understand her, said Yoo, who sat down with the woman and explained the cause of her son's death.

Even in large hospitals with a budget for full-time interpreters, problems can occur if an interpreter isn't careful.

At UCI Medical Center in Orange, the payroll includes 10 full-time Spanish interpreters, two Vietnamese interpreters and one Cambodian interpreter, according to Rosie Montoya, supervisor of the hospital's interpreters' services division. But earlier this month a patient from Mexico came into the hospital complaining that he had been pinched by a gato . A Brazilian-born interpreter, whose native tongue was Portuguese, correctly translated the word from Spanish to English as cat," Montoya said. However, gato also is a Mexican slang term for an automobile jack. Luckily, the translation mistake was detected before the patient was subjected to a painful course of rabies vaccinations.

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