Patients with poor English are under-served in Canada
Not all hospitals in Canada have interpreter services.
According to Dr. Sheila Raval, a researcher at the University of Toronto, lack of access to interpreter services can lead to unsafe medical care due to missed symptoms, misdiagnoses and medical errors. Providing language services should be a priority, she says.
According to Dr. Raval, patients with a chronic illness and poor English are more likely to return to the emergency room or be readmitted to the hospital within 30 to 90 days because they did not understand the hospital discharge document and medication instructions — compared to those who speak the language and were discharged with similar health problems.
The study is based on data from 9,881 patients discharged from two hospitals with acute conditions, pneumonia and hip fracture, and chronic heart failure and chronic obstructive pulmonary disease, between January 2008 and March 2016.
Of the 9,881 patients, 2,336 had poor English, of whom 36% spoke Portuguese, 23% spoke Italian, and 14% spoke Cantonese or Mandarin Chinese.
According to Dr. Rawal, patients at the two hospitals where the study was conducted have 24-hour access to telephone interpreter services in different languages. In-person interpreting is also available during office hours, but must be booked in advance.
"The quality of medical care or the level of access to interpreter services, in my opinion, should not depend on which hospital you end up in for your illness," Raval says. — The way it is now, depending on which hospital you go to in our city, in our province or across the country, you will have different levels of access to professional interpreting services. And I think in a multi-lingual country, institutions need to meet the language needs of patients and their families.
Sometimes the doctor's words are translated by the patient's family members. However, as previous studies have shown, they are less accurate in translating medical terms and may miss some of the information if the doctor's prognosis is disappointing.
According to Kiran Mulley, director of language services at the BC Provincial Health Services Authority, patients in and around Vancouver's hospitals and federally funded long-term care facilities have access to translation in 180 languages, the main ones being Cantonese, Mandarin and Punjabi. Interpreter services are available in person and by phone without an appointment.
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The authorities are also gradually introducing various programs. Last year, the health authority launched a pilot project to provide telephone services in family doctor's offices. Another pilot for video remote interpretation for sign language patients has already been launched and will soon begin operating in isolated parts of B.C.
