A despicable practice in healthcare interpreting.
March 8, 2017 § 3 Comments
For several months I have received phone calls and emails from some of our healthcare interpreter colleagues in the United States complaining about the same situation: Unscrupulous interpreting agencies asking them to work for laughable fees. I know this is not breaking news to you; we all run from time to time into these glorious representatives of the “industry”. What makes this situation different, and motivated me to write this post, are the shameless tactics used by these agencies’ recruiters. They have decided that giving the interpreter a guilt trip will soften us up enough to work for a miserable fee that will not even pay for gas and parking, or for the babysitter.
Oftentimes when interpreters provide their fee schedule for healthcare interpreting services, these programmers, recruiters, project managers, or whatever may be their official title in that particular agency, throw the ball right back in the interpreter’s court, not to negotiate a professional fee that is fair considering the complexity of the service requested, but for the interpreter to feel awful about turning down an assignment. The argument goes like this: “…but the patient does not speak English and he is really sick… we cannot afford the fee you requested; his condition will get worse unless you help him… the patient really needs you…” Another version they use brings up the issue of all patients’ right to an interpreter derived from Title VI of the Civil Rights Act. In that case, the agency representative would add something like: “…but you know these people must have an interpreter if they don’t speak English, and you are the only one in town. We all need to comply with the law. It is your duty as a healthcare interpreter. You cannot use the fee as an excuse…” To make a long story short, these agencies are passing the ball to the interpreter through guilt trips and fear.
The good thing, dear colleagues, is that interpreters are not obligated to provide professional services under Title VI of the Civil Rights Act. The fact that there may not be an interpreter to assist the patient may be something awful, but it is not your problem. Let me explain:
Title VI of the Civil Rights Act of 1964, 42 USC Section 200d et seq. prohibits discrimination on the basis of race, color, or national origin (including language, according to President Clinton’s Executive Order No. 13166, Aug. 11, 2000, 65 F.R. 50121) in any program or activity that receives federal funds or other form of federal financial assistance. The term “program or activity” and the term “program” mean all of the operations of a department, agency, special purpose district, or other instrumentality of a State or of a local government; or the entity of such State or local government that distributes such assistance and each such department or agency (and each other State or local government entity) to which the assistance is extended, in the case of assistance to a State or local government. It also includes colleges, universities, or a public system of higher education; and a corporation, partnership, or other private organization, or an entire sole proprietorship if assistance is extended to such corporation, partnership, private organization, or sole proprietorship as a whole, or if it is principally engaged in the business of providing health care, or social services.
Therefore, it is the hospital who has the obligation to provide the interpreter. Not you. In fact it is not the interpreting agency’s legal obligation either. Federal funds and other types of assistance are very important to hospitals and universities for research and other purposes. It is extremely unlikely that one of these institutions would risk losing those resources just because they are unwilling to pay the healthcare interpreter’s professional fee.
If the interpreter is contacted by an agency, it means that said company has a contractual relationship with the hospital or medical institution to provide interpreters in order to comply with the mandate of Title VI. The agency is getting paid by the hospital, but they now want to profit a little more at the expense of the interpreter. When an agency has this plan of action to be more profitable, they direct their agents to generate the highest profit possible. This is when they resort to despicable practices like the ones described above.
It is important that we as interpreters understand the law, and recognize these horrible practices. It is also essential that we take action in two different ways: (1) Always turn down these agencies, and (2) Let the hospital know that their contractor agency is jeopardizing the hospital’s Title VI compliance by scaring away the professional interpreters because of low interpreting fees and disgusting practices such as these guilt trips. I am sure that hospital administrators will put an end to this “activities” very quickly.
I now invite you to share with the rest of us any experiences like the ones above that you, or another colleague had with an agency, and what action you took to stop this from happening again.
These agencies have learned their skills (and the fees they charge) from the UK. The previous Justice (ha,ha!) Minister, Chris Grayling, handed over all interpreting services to an agency for a flat fee. The agency in question was run by a monolingual charlatan who learned his trade by working for a very big agency and proceeded to steal its clients. This move by the government was supposed to save the taxpayer £12 million a year in interpreting costs. In fact it COST the taxpayer far more than this in lost court time, etc. and the interpreters are and were incompetent. The government defended the contract against all attacks (well, it would, since it created the contract, it was acting as judge and jury) but when the three-year period ended, the contract was re-awarded, this time to the very agency from whom the original contract-owner stole the client list! This agency is just as greedy and the results will be just as dire, and other countries, such as the USA, are “getting in on the act” and emulating the UK in paying the sort of money to skilled interpreters that works out at well below the legal minimum wage.
Ask the agency to waive their 100+% mark up fee for your services.
As a freelancer, one is not obligated to carry out an assignment without an (agreed) fee whether in U.S or elsewhere. No more than the subject agency to cover medical costs of the LES patient.
First, why do we continue calling these companies “agencies”? They are not agents in the true sense of the word — they do not represent language professionals.
Another tactic I often hear about is lying about how other colleagues are accepting the lower fees. On the other hand, if it’s not a lie and language professionals (who may not see themselves as such) are indeed accepting impossibly-low fees, then who’s fault is it that the market keeps heading downward?