By Rebecca Salowe
Scheie Vision Summer 2017
It may seem unusual for four different languages to be spoken during a single patient appointment. However, this was the situation that Dr. Jane Portnoy, an Associate Professor of Ophthalmology, found herself in a few months ago. The patient and her father-in-law, both from the Republic of Guinea, spoke two different dialects of Fulani, while Dr. Portnoy spoke French (which both patients could understand) and English (which an interpreter could translate). For Dr. Portnoy, this appointment represented a typical day at Mercy Fitzgerald Hospital, one of Scheie Eye Institute’s satellite locations.
“Philadelphia is a melting pot and it is especially represented at Mercy Fitzgerald,” she said. “There’s a huge West African community as well as patients from South America, Mexico, India, Pakistan, Afghanistan, Cambodia, Vietnam, and more. The languages are so diverse, so we often encounter communication issues.”
Interpretation services for the growing number of non-English speaking patients are crucial. Patients with limited English have historically experienced greater health disparities, including poorer quality of care, longer hospital stays, and greater risk of infection or hospital readmission. The Agency for Healthcare Research and Quality estimates that nearly 9% of the US population is at risk for an adverse event because of language barriers.
Free medical interpretation services at Penn help to bridge this language divide and provide high-quality care to all patients. Non-English speaking patients can request an interpreter when making an appointment, with over 140 choices of languages. Penn Language Link, an organization of medical, nursing, and pre-health students that provide volunteer interpretation services, is another viable option for patients. The interpreter attends the patient’s appointment and translates the physician’s words.
“We speak directly to the patient as if there is no one else in the room,” Dr. Portnoy said. “As I am speaking, the interpreter will say exactly what I say. I want to establish a doctor-patient relationship.”
“I see generations of families come in and need interpreters,” added Carly Breen, a Clinical Research Coordinator who often recruits at Mercy Fitzgerald. “The physicians then get to know the whole family. It really creates a sense of community and a friendly atmosphere.”
While interpreter services used to be optional, with many non-English speaking patients opting for bilingual family members to translate, hospitals now require the use of an official interpreter service. Studies found that reliance on family members to translate often had unintended negative consequences. In fact, the use of a trained interpreter versus a family member was associated with fewer medical errors and greater patient satisfaction. “Sometimes the family members take on an ‘editor’ role,” explained Dr. Portnoy. “I go through a five minute explanation and then they say five words to the patient. I’m like, wait a minute – I just spoke for five minutes!”
The University of Pennsylvania also recently became a paying client of the Canopy App, which contains a library of translated medical phrases. The user can scroll through this library to find the appropriate medical phrase, which is then read out loud by a digitally recorded voice. The app also connects to an on-call interpretation service.
At this point in its development, Canopy is mainly appropriate for quick, rudimentary conversations where the physician speaks a second language, but may need to look up the equivalent of a specific medical term.
Dr. Portnoy loves to see the patients’ reactions when she starts speaking French or the interpreter begins translating. “They just light up,” she said. “The whole doctor-patient relationship improves.”