This week AM analysts have been monitoring reporting on the challenges faced by Spanish speakers who have been hospitalized during the COVID-19 pandemic. On occasions, complications and misunderstandings have resulted due to language barriers existing between patients and medical staff and highlighted the need for more doctors and medical staff who speak Spanish. Despite the fact that Spanish is the second most spoken language in the United States, with 13% of the population speaking it at home, only 5.8% of doctors identify themselves as Hispanic and can speak the language at a native level.
ProPublica reported at the beginning of the pandemic how health providers in New York City struggled to provide proper treatment to patients who did not speak English. It was reported that one doctor had to rely on Google Translate to assess a patient and there was an instance in which a woman who spoke Spanish died from COVID after it was thought that she spoke Hungarian. A medical resident at the hospital affirmed that she would have received better treatment had she been able to speak English.
Even though the Civil Rights Act of 1964 and the Affordable Care Act require hospitals that receive federal funding to provide interpretation services for patients, this requirement is regularly violated. Often the services of an interpreter are replaced by unqualified bilingual speakers such as family members who may not be able to communicate essential medical information to doctors and hospital staff. Some hospitals have continued to provide interpretation services through phone calls and video conferencing, but many interpreters are still working in person when medical facilities don’t have the technological capabilities to offer the service remotely. However, even when interpreters are available, the process can be time consuming and may pose yet another challenge for patients who need immediate treatment.
Problems can also result when physicians who are not fluent in Spanish misinterpret what the patients are saying to them. For example, it was reported that an emergency room resident in Brooklyn who could communicate in Spanish and did not use an interpreter, admitted a patient into the hospital after he misunderstood the severity of her medical history. Unfortunately, this doesn’t seem to be an isolated case. In 2019, a survey of fifty clinicians who took a test measuring their proficiency in medical Spanish showed that 44% of the 32 clinicians who failed the test reported that they enlisted professional Spanish interpreters “some of the time,” “rarely,” or “never.”
Some solutions have been offered to solve these issues. To satisfy the demand for doctors who can speak the language, Dr. Carolina Abuelo, primary care physician at Massachusetts General Hospital’s Charlestown HealthCare Center and a public voices fellow with The OpEd Project, suggests that Spanish-speaking physicians should be provided with emergency credentials. Furthermore, she recommends that incentives should be given to increase the number of Spanish speakers who apply to medical schools. “The same reason COVID-19 is disproportionately impacting Black and brown communities is the same reason medical professionals are predominantly white: social and economic inequality. Kids without access to decent primary and secondary school education do not even go on to college, much less aspire to medical school,” she affirms. For 2020-2021, there were only 3,331 applicants of Hispanic or Spanish origin to U.S. medical schools, out of a total of 52,963. Conclusively, to help increase this number would help to eliminate the language barriers that currently exist in hospitals and ensure that patients receive the medical treatment they require during the pandemic.
AM recognizes the challenges of providing access to native language speakers. In our work across the country, where we operate in many communities experiencing health and social inequities, whether it is on the streets or in the schools, we prioritize the recruiting and training of multilingual personnel so that we can make sure we communicate effectively – which goes a long way to building trust and reducing misunderstandings.