Is it medical interpreter, or healthcare interpreter?

June 26, 2014 § 4 Comments

Dear colleagues:

I have struggled with the issue of how to refer to a growing number of our colleagues whose work mainly takes place in hospitals, clinics, or medical and dental offices. Their primary function is to enable communication between a person who does not speak the language of the land and a healthcare provider: physician, dentist, nurse, psychologist, paramedic, and other support staff. As you all know, this area of interpretation has been around for some time, but it has just become formally regulated in the recent past. Because of globalization and its migration consequences, now many countries experience the need to have somebody to bridge the gap of communication that has developed between native speakers and immigrant communities. These developments have augmented the need for court interpreters, legal translators, school interpreters and many others; the healthcare field has not been an exception; in fact, this is the area where we can appreciate the most dramatic changes to the old “business as usual” format. Unlike other interpreting specialties, like conference, military and court interpreting, which have been around for a long time, these new service providers just organized a few years ago. Great efforts and devotion on the part of some individuals have produced important results like the creation of professional associations, the adoption of ethical and professional responsibility canons, and the development of certification programs and examinations. This is truly admirable.

There are two organizations in the United States that have emerged as standard-bearers of this profession: The International Medical Interpreters Association (IMIA) which endorses the National Board of Certification for Medical Interpreters exam, and the Certification Commission of Healthcare Interpreters (CCHI).

Keeping in mind the services provided by these professionals (based on the organizations’ websites, several hospitals’ information, and conversations with many of my esteemed colleagues) I reviewed all information I could find on the two certification exams that test English, professional conduct and ethics. To a lesser degree they test some medical-related vocabulary that a true bilingual individual should know, without any medical or pharmacological terminology studies, and they include very short paragraphs, or vignettes as one of the test refers to them, where patient and healthcare provider communicate regarding the symptoms that the non-native speaker is experiencing. The dialogue is an everyday conversation at a moderate to low register. Finally, I also noticed that the main part of the score overwhelmingly goes to the consecutive interpretation, leaving simultaneous and sight translation at about 10 to 15 percent each.

I am convinced that the work these colleagues do is essential to the healthcare industry and well-being of those individuals who otherwise would see their chances of receiving appropriate services diminished by reason of the language they speak. Nobody is disputing this. I also applaud the conditions under which they constantly work in hospitals, emergency rooms, and urgent care facilities where people perform under great stress. The writing of this post was simply motivated by my need to find a term I can feel comfortable with when referring to my colleagues, but before I am ready to form an opinion I should also consider what the rest of the world is doing and saying on this issue.

In Europe the services performed by our medical interpreters are part of what is known as public service interpreting or community interpreting in some countries. This public service interpreting also covers legal interpreting but not court interpreting as I will explain in a moment.

Public service interpreting refers to those services provided by an interpreter to help two individuals who speak different languages so they can communicate regarding everyday affairs, personal issues, including important topics, in cases when individuals who speak the same language would usually speak for themselves, but in this particular situation, because of the language difference, and cultural considerations, an interpreter is needed.

My dear friends and colleagues, conference interpreters provide their services to make it possible for individuals who do not speak the same language to communicate, by interpreting almost exclusively on the simultaneous mode, complex information at a high register. Their audience is usually formally educated. Court interpreters provide their services in cases when one or more individuals do not speak the language employed in court, to make it possible for officers of the court, litigants, jurors, and others, to communicate on the simultaneous, consecutive, whispered, and sight translation modes, everyday information, complex legal concepts and terminology, and expert witness testimony, at a variety of register levels.

Now I ask you to contrast these job descriptions with the job that public service interpreters such as school interpreters, welfare services interpreters, church interpreters, and community organization interpreters do. These professionals (and sometimes paraprofessionals that may include a family member) provide their services so that individuals who do not share the same language can communicate about important everyday matters such as parent-teacher conferences, services provided by religious organizations, and dealings with government agencies at the customer service window or over the phone. This work is almost exclusively performed on the consecutive mode, unlike court interpreting, and there are no formal rules to keep the interpreter from asking questions and give explanations to facilitate the communication. The main objective is to bridge the language gap without any consideration for rules of evidence or procedure. These interpreters can interrupt the parties and ask them to speak slower or in shorter sentences. While conference and court interpreters work with complicated and sometimes rarely used words as part of their everyday job, public service interpreters work with common vocabulary; not simple words, but words that anyone with a certain level of formal education, regardless of any interpreting training, should know.

This explains why we occasionally see conference interpreters in the courtroom and court interpreters in the booth. It also explains why conference interpreters, and not medical interpreters, interpret medical and pharmaceutical conferences; and why court interpreters, not medical interpreters, interpret the expert testimony of a pathologist or other medical professional during a trial.

I mentioned earlier that there was a difference between court and legal interpreters in many countries, and why the latter are considered public sector interpreters: A court interpreter provides her services in a formal court setting and during out of court events that are related to a current or future court or legal proceeding. A legal interpreter assists an individual who needs help with his dealings with the authority, such as getting a driver’s license, applying for government benefits, or requesting government documents. These interpreters are clearly outside the scope of the very strict canons of ethics and professional responsibility that govern the activity of court interpreters. Just as we may encounter a conference interpreter in court or a court interpreter in the booth, we may find a school interpreter or a medical interpreter in a government agency assisting a foreign language speaker with some excruciating government administrative process. I hope the example clarifies the issue, but I also ask you to look at this very carefully, because there are some who would like to assimilate the services provided by a court interpreter outside a courtroom to those of a public service or community interpreter; they would argue that these services are “legal” and not court services. They are wrong.

They are wrong because the terminology of legal versus court interpreter that was valid in the past does not apply to our globalized world. When most countries had a written legal system there was very little work for a court interpreter. In those days legal translators did most of the court work because everything was done in writing. Legal interpreters were then relegated to in-office interviews and customer service windows. If you consider that migration was less popular than it is now, then you would have a very low demand for court or even legal interpreters. Lack of migration did not impact legal translators who had to translate official documents, contracts, deeds, and many other written statements that originated within the other country. At the time the legal interpreter was really a community or public service interpreter. That reality is so different from ours. Presently, an interpreter who works before an administrative law judge, such as an immigration court, workers’ compensation court, or social security court, is subject to the same ethical and professional rules as the court interpreter who appears before a traditional court. The fact that some jurisdictions allow for non-certified or licensed interpreters to provide their services in administrative law courts does not mean that community interpreters should do the job. These courts still abide by rules of evidence and procedure, the interpreter has to act as if working before the traditional judiciary, the job must be done at a higher register, with specialized complex legal terminology, and on a simultaneous interpreting mode that does not allow to stop the procedure so the interpreter can request the litigants to slow down, or a consecutive rendition where the interpreter cannot ask the parties to speak in shorter sentences. The same can be said for civil depositions, jailhouse visits, and the transcription of wiretaps. On the other hand, those individuals who are appearing before the motor vehicle office are better off employing the services of a community interpreter because this professional knows more about handling situations where the interpreter has the freedom to step outside the box to achieve communication between the parties.

After considering all of these concepts and possible scenarios, and after reviewing the materials I have mentioned before, I understand that there are arguments to be made for the term medical interpreter, but I just do not believe that in my book that would be accurate. I think that the appropriate and accurate way to describe this very important segment of our profession is the one adopted by the Certification Commission of Healthcare Interpreters (CCHI). For this reason, I believe that we should call our colleagues Healthcare Interpreters instead of Medical Interpreters. Please let us all know your comments on this issue that to some may seem irrelevant, but is actually very important.

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§ 4 Responses to Is it medical interpreter, or healthcare interpreter?

  • tezajovy says:

    Tony

    You make excellent arguements. We have had the same discussion in Chile, in the newly emerging field of work in the hospital setting. What we did was draw from the terminology used for work with our indigenous peoples-who for some time now have been entitled to “intercultural facilitators” — to create the role of “language facilitators.” As the profession grows, as regulations and standards of performance and educational opportunities expand, I would imagine we would move toward calling them “healthcare interpreters” (interpretes en el area de la salud), but for the time being, the “facilitador linguistico” seems to cover the role and avoid confusion. Your thoughts on this are warmly welcome!

  • Jeff Alfonso says:

    If I understand this correctly, Certification Commission of Healthcare Interpreters (CCHI) and (IMIA) are non profit organizations that are not affiliated with any companies. It seems to me that the term “Health Care interpreter” represents the entire scope of the service better. I believe that the CCHI test includes simultaneous interpretation and CMI doesn’t. For me, Certified Health Care interpreters have established all around skill because of the simultaneous segment.

  • marzolian says:

    Tony, if there was just one certification, I would agree with you, “healthcare” is probably a better choice. There is a major difference between interpreting for a doctor and patient, and interpreting a conversation between two doctors, or a presentation about a medical procedure.

    For related reasons, I believe the term “licensed” would, in some cases, be a better term than “certified” for some types of interpreters.

    However, as a practical matter, it doesn’t really matter; people will get used to it. Every language and every culture, is full of terms that are being used in ways that are not precisely correct. The United States “Defense” department also conducts offensive operations; some companies claim that their employees are “associates”. In Texas, the state Railroad Commission has nothing to do with railroads, it only regulates the oil and gas industry. People usually don’t get fired, they are “outsourced” or “terminated”.

    We’ll live.

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