A despicable practice in healthcare interpreting.

Dear Colleagues:

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.

Something is going on in social media that may be detrimental to the profession.

Dear Colleagues:

Interpreters benefit from the use of the internet in many ways.  We can study, do research, market our services, and communicate with each other anywhere in the world by using our telephone.  Technology helps us to stay competitive in difficult markets and saves us time. Gone are the days when we had to go to a library to research a topic. We can now access the best libraries worldwide from the booth where we are working.

Social media also gave us the very popular and numerous forums, list serves, and chat rooms that all of us visit regularly.  I must confess that, even though I am very active in many social media outlets, I visit very few interpreter forums, and none of the list serves.  For me, the main reason to visit these forums is to keep up with the most recent news that impact the profession, so I can widen my knowledge and understanding of everything that is happening out there .  For the same reason, I am sometimes turned off by some of our colleagues who visit these virtual sites.  I have nothing against learning more about our language combinations, but sometimes it gets to me to see how some interpreters post basic vocabulary questions to the forum members without even bothering to do some research on their own first. I know this is popular with many, and we have discussed it in the past, so I will not dwell on this issue. Like I said, it turns me off, but it does not disgust me.

On the other hand, there is a relatively new trend going around several of the forums that I visit. A practice that has the potential to harm the profession, and end the career of those who participate or advocate this practice.

I am talking about those colleagues who post confidential, and sometimes what can be considered privileged information in the case of court interpreters. I am also referring to those who ridicule and make fun of their own clients.

Interpreting is a profession, and as such, it is governed by a series of legal, moral and ethical principles expected from all those who practice as professionals anywhere in the world. Legal, moral, and ethical rules and principles such as diligence, honesty, and confidentiality are an essential part of an interpreter’s job description. We cannot go around divulging the knowledge acquired in confidence. We are a fiduciary profession. It is not ethical for an interpreter to reveal secrete or confidential information. It is not ethical to share the client’s personal information and private life in public either.

These duties of privacy and confidentiality are even stricter in the case of a court interpreter. Let’s take the case of the United States where court interpreters are legally and ethically bound to keep their mouth shot by Articles 5 and 6 of the Federal Court Interpreter Code of Ethics:

“5: Confidentiality.  Interpreters shall protect the confidentiality of all privileged and other confidential information.”   

“6: Restriction of Public Comment.  Interpreters shall not publicly discuss, report, or offer an opinion concerning a matter in which they are or have been engaged, even when that information is not privileged or required by law to be confidential.”

Moreover, when working as agents of an attorney, interpreters are also covered and bound by the stricter client-attorney privilege; a privilege held by the attorney’s client that gives him the right to refuse to disclose, and to prevent any other person from disclosing confidential communications between the client and the attorney (Black’s Law Dictionary).

Rule 1.6 of the American Bar Association (ABA) Model Rules of Professional Conduct, reads:

“Rule 1.6 Confidentiality of Information. (a) A lawyer shall not reveal information relating to the representation of a client unless the client gives informed consent…”

These communications cannot be shared with the public, even with a court order, unless the client waives the privilege (there are some exceptions to the rule that do not apply to our subject matter) and the privilege extends to the attorney’s agents who are considered as action as an “extension” of the lawyer. These agents include legal secretaries, paralegals, investigators, and interpreters, among others (“United States v. Kovel,” 296 F.2d 918, 921 2^nd. Cir. 1961)

In the past weeks I have read posts and comments in at least two different forums by individuals who present themselves as court interpreters  (I do not know them by name or in person) revealing information and details of private conversations between an attorney and his client. Moreover, several people have opined about the issues presented by this individual, without the slightest concern about a conduct that is definitely violating all codes of ethics, and may be illegal. I should mention that a few colleagues warned this person and asked this individual not to do this anymore, but for the most part, the person who was doing the posting, and those commenting on the post, continued their debate like noting had happened. I was so bothered by this use of the forum that I left and never went back, so I do not know how long this debate lasted; and even though I do not know the person who posted this, apparently privileged, information, I got the impression that the privileged information was not posted with the intention to breach a legal duty, but out of ignorance and a lack of desire to learn. I should mention that this person did not give names and other details that could easily identify the holder of the privilege, but there was enough privileged information for anyone interested on learning more about the case to find out who were the parties involved.

The second post that I saw was less likely to pierce the client-attorney privilege, but in my opinion it violated the rules of ethics and professional conduct in a truly disgusting way. This was a post by another person who called himself a court interpreter, and went on to argue that his “job as a court interpreter” was not boring because he saw different and new situations every day. Nothing wrong to this point, but next, he gave some examples of the “variety” of cases he is routinely exposed to, by sharing details of some of these cases, and giving his opinion about the parties involved, in a very offensive and demeaning way. These are some of this individual’s comments: “…The… family was lying through their teeth, but… (the) officials were gullible enough to grant them asylum…” and how about this one: “…hours of telephonic interpreting for illegal immigrants… (I) had to hear and interpret a lot of BS…” or this more troubling one: “…defendant asked why he doesn’t qualify for (a legal benefit) the answer was… he had to rat about the people who paid… for his defense…”  Unlike the first case I mentioned above, this individual received many warnings and criticisms for doing what he did, and I believe that for this reason, within a week, this person went back to the same forum and now alleged that the cases were real, but that he had “…added imaginary twists, actions or actors…” that although most (not all) of the cases were not real, “…for the purpose of initiating an intelligent debate, (he) presented them as actual, real cases…” and claimed to be a victim of attacks by those who did not want any “personal opinions”.  Finally, to make things even worse, this person defended his posts by indicating that he was justified to do so, because they had been posted in a closed forum… on the internet!

I did not write this blog to attack anybody or to end the career of any colleagues or alleged colleagues. That is why I did not revealed any names of individuals or forums, and I tried to show just enough of the published posts to convey the idea of what is troubling me. I wrote this piece because I see what is going on in these social media outlets and it concerns me. I believe that the rules of ethics and professional conduct must be observed because we are professionals, and more importantly, because they affect others who confided on us as providers of this fiduciary service. It is not the same to betray your clients’ confidence and air private matters the way these people did, or to present the facts of a case to your colleagues in a professional forum, observing all professional and ethical rules, in order to get an opinion or to dissipate a doubt. This is done by all professionals: physicians, attorneys. accountants, and interpreters on a daily basis.

I think that the majority of those who have violated these rules did not know what they were doing, and I believe that social media forums, when used appropriately, are a valuable tool.  Perhaps we need to educate those who do not know the rules, and maybe we need to assess the moderators and the guidelines of some of these forums.  What we cannot allow is a situation that will leave us all in a bad place as a profession, and in an ugly position as individual practitioners; and I am not even mentioning the tremendous liability that those who violate these canons (and in some cases the law) are exposing themselves to. I ask you to share your comments on this topic, and to do so without any personal attacks.