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

To Our Interpreters: Gracias, Shukriyah, Todah, Danyavad, Merci, Danke


When working with an interpreter, remember that they’re a person, not a machine. Saying “thank you” makes them feel like a valued member of the healthcare team. 

“Thank you for using our services. This is-.” [Click.] 


“Thank you for using our services. This is interpreter number 64-.” [Click.] 


“Thank you for using our services. This is interpreter number 6400 signing off.” [Click] 


How long did it take you to read that last sentence? Less than ten seconds? Five? 


In a recent conversation with Cecilia Murach, a colleague from language services, and a group of residents and faculty, we came to the disappointing realization that, in the midst of our busy emergency department practice, we don’t always take those few additional seconds to hear our phone interpreters’ farewell greeting, choosing instead to terminate the conversation as though it were an automated transaction. Rarer still is the occasion when we refer to them by their names or utter simple phrases like “Thank you,” or, “How’s your day?”  


In constantly moving from one patient to the next, we often forget the humanity of the disembodied voice on the line-the voice that helped us tell a young man that he had cancer, the voice that guided a conversation on a family’s choice to cease resuscitation of a loved one, the voice that was right there with us when we told a woman she’d lost her child. We forget that that voice belongs to a person-one who’s sharing these devastating moments with us from afar. And while we may be able to exit that encounter and share a commiserating look or conversation with a colleague, the person on the other end of the line processes that vicarious trauma alone. 


Our interpreters are a crucial component of the healthcare team, doing the monumental work of bridging communication between patients and team members. With the disappearance of in-person interpreter services during the pandemic, we’ve grown increasingly reliant upon phones or iPads as mediators of conversations. These technologies, while facilitating and expediting critical communication, also risk depersonalizing not only the patient, but our teammates on the other end of the line.  


Here are Murach’s suggestions for how we can not only effectively navigate conversations mediated by interpreters, but also how we can ensure we treat interpreters like the valued team members they are: 


1. Address patients directly and use the first person when speaking via an interpreter.  


2. Don’t have side conversations with others in the room with you.

This is especially important if the interpreter is interpreting over the phone, as they won’t know if you’re addressing someone else, or the patient. Also, the extra noise is extremely distracting to the interpreter. Look at your patient and remain present while the interpreter is rendering your message. 


3. If the interpreter is assisting you over the phone, try to give the interpreter some idea of environmental cues.

For example, if there’s silence while you are taking notes, you could say, “Interpreter, I’m taking a few notes.” If the room is very noisy, you explain that there are a lot of professionals in the room to assist the patient. If the patient seems confused, disoriented, or if intoxicated, and you’re trying to ascertain their state of mind, let the interpreter know that you suspect something may not be quite right with the patient, or that they may not be making sense. In some cases, asking the interpreter, after leaving the room, if they noticed something was “off” with the patient, or if what they said made sense, might give you insight into the patient’s condition. 


4. Pause to allow the interpreter to interpret.

Keep in mind that while interpreters will interpret everything you say, they’re not machines-what you say must be remembered by the interpreter so they can render it in the patient’s language. Don’t say too much at once, and pause to allow the interpreter to interpret your message fully and completely. This is not only important for accuracy of interpretation, but also to make sure you and the patient remain engaged with one another during your conversation. This will also prevent overwhelming the patient with too much information at once. 


5. Take a few minutes before walking into the patient’s room to give the interpreter an idea of what the conversation will be about.

This will help your interpreter to be prepared with any technical words pertinent to the expected conversation, and anticipate any “hiccups” that might occur, especially if the discussion will be sensitive. 


6. Thank the interpreter. This makes a world of difference.  


Interpreters are vital to giving excellent care to all patients. Remember that interpreters also speak the same language we do, which is the language of a team united in the mission of giving excellent care to all patients.








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