Washington Post Examines Clinics’ Struggle To Treat Non-English Speaking Patients

The Washington Post health section today examines the challenges faced by federally funded medical facilities in treating patients who do not speak English. Federal officials and health advocates have interpreted Title VI of the Civil Rights Act of 1964, which prohibits discrimination based on national origin, among other things, to mean that medical facilities receiving federal funds must provide services to all patients equally. In August 2000, former President Clinton signed an executive order requiring all federally funded medical facilities to develop written policies on how they would serve patients who speak little or no English. Later that month, HHS released guidelines outlining medical facilities' responsibilities in offering language assistance, but those guidelines are rarely followed, the Post notes. "The requirement is a federal law. But the guidelines say what you should do, not what you must do if you want to be compliant," Robinsue Froehboese, principal deputy and acting director of the Department of Justice's Office of Civil Rights, said.

Many clinics have "made strides" toward compliance with the federal regulation by providing services for Spanish-speaking patients. However, communicating with other non-English-speaking patients has proven difficult for some facilities, and finding interpreters and the money to pay them can often be even more challenging, the Post reports. For many facilities, it "doesn't make sense" to hire an onsite interpreter for languages rarely spoken by patients. In cases where a patient speaks a language for which the facility does not have a translator, the patient and doctor generally rely on a family member to help or use a series of gestures to communicate. Not using a formal interpreter can put patients in danger of being misunderstood or misunderstanding medical advice and can compromise the quality of care they receive, the Post reports. HHS guidelines do not encourage use of family members as interpreters because such a practice could compromise a patient's privacy and the accuracy of interpretation (Park, Washington Post, 7/23).