The medical Tower of Babel  

By Drs. Akhil Gangula & Amy Yu, Johns Hopkins Medicine

As Dr. Y and I entered the room, we saw Mr. J, a cheerful man in his seventies, lying in his hospital bed. He was a Spanish-speaking immigrant with a hearing impairment. While the doctor talked with him using a phone interpreter, I realized how his language and hearing challenges affected his access to healthcare. Despite immigrating to the U.S. over 20 years ago, Mr. J hadn’t seen a doctor until he was hospitalized for an infection. He didn’t have a primary care physician (PCP), a common challenge for immigrants. During his hospitalization, further workup and a screening colonoscopy revealed the presence of colon cancer. 

As an immigrant myself, his story struck a deep chord. Coming from India, a linguistically diverse nation where every state speaks a different language, we often relied on the availability of uncertified bilingual staff to serve as impromptu interpreters. This practice compromised patient safety due to the potential for miscommunication of critical medical information. Even though the U.S. has made significant progress in providing language access through certified interpreters, inconsistencies in the use of interpreter services and their availability remain. 

Narrowing the gap 

Overcoming language and cultural barriers is crucial for delivering exceptional patient care. In-person interpreting is more effective than phone interpreters as it allows for interpreting nonverbal cues. By utilizing certified medical interpreters, we can ensure that every patient receives the care they deserve. Finally, if a patient who is an immigrant needs a PCP, connect them with a social worker to help them establish care. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.