Pediatricians Rarely Provide Translation Services for Patients with Little English Proficiency

Most pediatricians use untrained interpreters to communicate with families who are not proficient in English, according to the results of a nationwide survey of doctors led by researchers at Johns Hopkins University. Nearly two-thirds of the pediatricians surveyed said they relied on the patient’s bilingual family member to relay health information. Pediatricians in rural areas or in states with higher proportions of non-English proficient populations were the least likely to use professional translation services. The study is published in the April 2007 issue of Pediatrics.

“Our results show that language services for patients with limited English proficiency are clearly inadequate, especially in smaller rural communities,” said lead author Dennis Z. Kuo, MD, MHS, a general pediatrics fellow at the Johns Hopkins School of Medicine and graduate of the Johns Hopkins Bloomberg School of Public Health. “This is really an overlooked problem, given all that we know about the adverse health outcomes that can arise from miscommunication between physicians and their patients.”

The study was based on the results of a survey of 1,829 physicians from the American Academy of Pediatrics. Of the physicians surveyed, 70 percent reported using the patient’s bilingual family member to relay health information, 58 percent reported using bilingual staff for assistance. Only 40 percent reported using professional interpreters, and 35 percent offered translated written materials in the office. In this study, limited English proficiency were defined as those for whom English was not the primary language and who spoke English less than “very well.”

Pediatricians in states with large numbers of Spanish-speaking patients were less likely to use professional interpreters. Instead, they reported greater reliance on bilingual staff members to relay information. In addition, doctors in states where translation services were covered by health insurance were more likely to use professional interpreters.

“There is an urgent need to promote appropriate language services through the use of interpreters, translated written materials, provider training and third-party reimbursement,” said Cynthia S. Minkovitz, MD, MPP, senior author of the study and associate professor in the Department of Population, Family and Reproductive Health at the Bloomberg School. Failure to address these issues, the authors note, will contribute to worse health status, compromised patient safety, decreased patient satisfaction and increased costs of health care services.

The study was supported by the American Academy of Pediatrics and a grant from the Maternal and Child Health Bureau, Health Resources and Services Administration. The study was a collaborative effort of Johns Hopkins University, the American Academy of Pediatrics, and the Medical College of Wisconsin.

“Pediatricians’ Use of Language Services for Families With Limited English Proficiency” was written by Dennis Z. Kuo, Karen G. O’Conner, Glenn Flores and Cynthia Minkovitz.