Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How do you build trust with a patient when talking through an interpreter?


Read a few thoughtful tips from four physicians.

Connecting with Patients | June 8, 2018 | <1 min read


Michael Crocetti, MD, Johns Hopkins Community Physicians

When talking through interpreter it’s most important to make the patient feel like you’re directly speaking with them even though you can’t speak their language.


This means that I sit at the level of the patient and I speak to them just as I would any other patient with direct eye contact. If you’re using an in-person interpreter or a video interpreter make sure the person or the monitor is behind you but facing the patient as well. If using a phone make sure the speaker is in a good position to both hear you and the patient.


I also speak clearly and I allow for frequent pauses so that the interpreter can speak to the patient in a way that they best understand. Pauses also allow for me to survey the patient’s face and body language to see if they are understanding the content.  

Mike Fingerhood, MD, Johns Hopkins University School of Medicine

I try to use non-verbal communication, eye contact, head nod, and body language, as much as possible.


I always ask the interpreter to double-check an answer, especially when a patient speaks for two minutes and then the interpreter speaks for 20 seconds. I then ask, “What else was said?”, if the patient’s answer seemed longer.

What do you think?

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Panagis Galiatsatos, MD, Johns Hopkins University School of Medicine

Right away, I ask the patient to teach me a few phrases in their language, always including, “thank you.” Then I use those phrase as many times as appropriate.

Roy Ziegelstein, MD, Johns Hopkins University School of Medicine

I go through the same process I do with any other patients, however I start by acknowledging the obvious. I begin by apologizing for having to rely on an interpreter and noting that I wish that I could speak their language. I tell the patient that I recognize that this makes the interaction different than it would be if we were speaking by ourselves. However, I note that to the extent possible, I will try to forget that there is an interpreter present, and would ask that they do the same.


I would also note that frequently when there is a need for an interpreter there are also differences related to culture and customs—and expectations related to the patient-physician relationship—that need to be taken into consideration and that, in fact, often pose greater challenges to developing trust than differences in native language.