We should act more like professionals and less like merchants.

Dear Colleagues:

Interpreters are constantly fighting to be recognized as a profession, to be respected by their clients, and to be treated and remunerated as providers of a specialized service that requires a strong academic background. Although most interpreters strive to be viewed as fellow professionals of physicians, engineers, attorneys and accountants, many colleagues, including freelance interpreters, behave more like a tradesperson than a professional.

Because of poor legislation, pervasive ignorance, and a myth that any bilingual can interpret, the idea that professional interpreting services can be provided by a commercial agency has been accepted, or at least tolerated, around the world. Professional services have been bought and sold like commodities by businesspeople foreign to interpreting, stingy government agencies, and unscrupulous interpreters willing to sell out their profession to make a quick buck.

A world where physicians provide their services through a commercial agency’s model is unimaginable. Attorneys’ Bars around the world would oppose, and destroy, any efforts to sell legal representation by agencies where a high school teenager, calling herself a project manager, were to assign lawyers to their clients on an availability basis, without considering quality or experience to decide on the attorney who gets the case. Interpreters see this happening every day and do nothing about it. Not even freelancers question this commercial model; they join these merchants and help to undermine their own profession.

I am not naïve. Multinational interpreting agencies are powerful, greedy organizations willing to fight for what they consider their “industry” to the end. They launch advertising campaigns, misinformation efforts to convince potential customers (they do not have clients) that hiring an interpreter is very difficult; that it can only be done through an agency. They spend time and money convincing freelance interpreters they are their allies; they procure them work, deal with the customer, and pay them a fare “rate” (they do not pay professional fees) after taking the portion of the paycheck they have morally earned. Interesting that agencies never disclose interpreters what they charge their customers, and force freelancers to remain silent when approached by one of the customers about their professional fees or availability.

We will not get rid of these agencies, but I know that interpreters will only be viewed as professionals when they act the part. I also know that some, few, are managed by good people.

There are many colleagues around the world who work as I do. We operate as a doctor’s office or a law office work. When contacted by a client about an assignment that will require the services of interpreters in five languages, I provide my client with the name and contact information of trusted colleagues with the experience and language combination needed for the assignment. If the potential project involves languages commonly used in my part of the world, or several interpreters in my own language combination, I even forward the inquiry to my trusted colleagues, my allies. My client takes it from there and individually negotiates the fee. I also suggest, and sometimes forward, the request to a trusted equipment/technical support provider. The client negotiates costs directly with them. It is like going to a building where many physicians have their offices, all independent, but all trusted colleagues; they suggest one of their colleagues depending on the field of specialization needed by the patient, but each doctor negotiates and sends a separate bill. These professional alliances, professional groups, are a network of professionals who know each other’s quality of work, ethical values, and language combinations. The client has to pay the professional interpreters individually, but he need not look for interpreters with the right experience, language pairs, or availability. That is all done by the interpreter who the client contacted first. That interpreter is the point of contact who suggests colleagues she will vouch for, and she is moved by no other interest but her client’s satisfaction. She will not subcontract the other interpreters, she will not charge them a commission or referral fee, she will only do what all physicians do when you go to their office and they suggest you see the dentist downstairs or the eye doctor next door.

There will be instances when you cannot help the client. There are languages you never work with. Sometimes doctors cannot recommend a colleague because they have no proctologist in the building. That does not mean that the professional network they offer to their patients has no value.

My good clients love this option. They understand it is difficult to get quality in all booths. They trust me and know that I would not jeopardize my reputation by referring them to a mediocre interpreter. They know I suggest nobody services because they are cheap. They also trust my judgement and experience a lot more than they trust a young monolingual person with no practical or theoretical knowledge of the profession, who calls himself “project manager” and has met none of the interpreters he will line up for a job. Clients know that project managers abide by company rules and guidelines which include: profit at all costs. They know their professional pool is limited because they can only provide interpreters willing to work with the agency in exchange for lower fees, inadequate working conditions, and disrespectful treatment.  This professional network model operates as a virtual office where my trusted colleagues are all over the world. It has no time or space limitations.

Interpreters who want to grow and expand to a larger scale should do it, but they should do it as law firms do. Incorporate as a professional corporation or a limited liability corporation, not a commercial enterprise like agencies do. These solutions will let you work as formal partners or shareholders and protect from liability without giving up your professional identity. We need not look or operate like an agency. They are not us.

They want to commoditize our profession and turn it into an industry. They are outsiders with a different set and scale of values. We are professionals. We should act as such. I know many of you are already doing what I described. I also know many colleagues will dismiss these ideas and even defend the agency commercial model. I am aware professional associations are guided by board members who own agencies, and as we have seen, even board members refuse to recuse themselves from voting in association matters when there is a conflict of interest between interpreters and agencies. Finally, I know some interpreters are not ready to freelance, they fear they cannot get clients outside the agency world, or they are content with little money. There, stay with the agencies, that is what you like and deserve.  I now invite you to share your thoughts on this critical issue for our recognition as professional service providers.

Professional values and interpreter identity affirmed at a dental office.

Dear Colleagues:

Those of you who are regular readers of this blog know that I spend most of the year traveling for work. To me, travel is a priceless tool that lets me peek through a window and see the world as it is, unfiltered and first-hand. It was something that happened during my last trip of 2015 that made me think about who I am as an interpreter, what I need professionally, and in my opinion what the true professional interpreter and translator need so we can be better at what we do for living.

Last week, while in Mexico City, I lost a tooth filling and I had to go to a local dental office to take care of it.  Fortunately there was no pain, but this is one of those things that you have to take care of right away, so I made an appointment the following morning to see a local dentist.  For those of you who have received all of your dental care in the United States this would be a true cultural experience.  The first thing that surprised me was that as soon as I was sitting in the waiting room the dentist who was going to take care of my tooth came out to let me know that it would not be long before they call me to see him.

Even more shockingly, there was absolutely no paperwork to fill out. Being used to answering endless questionnaires and signing tons of forms and releases in the United States before seeing anybody from the medical profession, I have to admit that I was surprised. Then, almost instantly, it sank in: This was a professional dental practice managed by professional dentists who thought and acted like members of the dental profession. They saw me as a person who needed a professional service: I was a patient. It never crossed their minds that I was a customer, they never saw their job as an industry. There was no need for endless paperwork for the assembly line because I was dealing with real professionals in a field where there is no room for commodities. There were no forms, releases, or “cover your butt” documents to read and sign because the dentists were calling the shots, not the insurance companies, not the pharmaceutical conglomerates, not the professional associations that are in bed with all of these other members of the cast who are in the dentists’ environment, but hold different and many times opposing interests and points of view to those of the professional delivering the service that I was there for.  The service was delivered professionally and promptly and I left the dental office happy and satisfied with the way they treated me and the services I received.

Dear friends and colleagues, I saw in action what many of us have tried to do throughout our careers, and at the same time, I saw the ugly face of that “reality”, foreign to our profession, that so many are trying to sell us as the true state of affairs and the future of the “industry”.   Thanks to a dental problem in a foreign country I got to see what our profession really looks when the decisions are made by interpreters and translators instead of multinational agencies, incompetent project managers, and corrupt entities who want us to believe that we belong at the industrial park with the car manufacturer and the sweat shop, when in reality we are part of the professional services provider world with the physician, the lawyer, and the dentist among others who are downtown and very far away from the language maquiladoras where some want us to live.

I was a direct client, in this case a direct patient, who entered a professional services relationship with the professional to deliver the dental care.  I paid a professional fee for the service rendered, and I was treated like a valuable individual. The fact that I met the dentist from the get go, made me feel comfortable and safe, even in a place as scary as a dental office with all of its sounds and smells. I had peace of mind throughout the entire episode because I always felt, and knew, that I was dealing with the person who knew what needed to be done: the professional dentist.

My friends and colleagues, this is exactly what we need to do every day. We have to deal with the client directly, we need to get them to experience the abysmal difference between on one hand dealing with a professional interpreter or translator who knows the field, can solve problems, and can deliver a world-class service at a well-deserved and earned world-class professional fee, and on the other hand having to deal with ignorant front desk individuals, monolingual agency owners, and unscrupulous multinational entities who many times charge as much as a real top-notch professional interpreter or translator and pocket most of it while paying the timid, scared or mediocre individual who translated the documents or interpreted the event a fee that even a beggar would consider an insult; and on top of all that, they see them as customers in a made-up industry, instead of clients getting a professional service.

A visit to a dentist in Mexico City motivated me to reaffirm my commitment to the profession, and inspired me to continue to practice a professional service without falling for those self-serving sophisms spreading the idea that we are not professionals but part of an “industry”.  At this time of the year when most people make New Year’s determinations, I ask you to join me on this commitment to defend the profession and our livelihood from these outside forces who want to vanish the idea that a professional works and acts like that dentist who I met in Mexico City last week.  I now invite you to share your comments on the issue of how you are educating your clients about the big differences and huge risks of hiring a “maquiladora interpreter or translator” from the “industry” instead of a professional.

Is it medical interpreter, or healthcare interpreter?

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.