Will greed win over quality medical interpreting in the middle of a pandemic?

September 9, 2021 § 4 Comments

Dear colleagues:

On May 15, 2021 the Certification Commission for Healthcare Interpreters (CCHI) released a study suggesting that an English-to-English exam might solve the shortage of healthcare interpreters in what they call “languages of lesser diffusion,” meaning languages other than Spanish, Arabic or Mandarin. The reason for this “sui-generis” affirmation is very simple: developing actual interpretation exams to test candidates on simultaneous and consecutive interpreting, and sight translation in both: source and target languages would be too expensive and therefore not profitable. Interesting solution: examine candidates’ English language skills (reading comprehension, medical concepts, fill-in the blanks, and what they consider can show the candidate’s “potential correlation with overall interpreting ability”: “listening comprehension.”) An English only exam will catapult an individual into an E.R. to perform as an interpreter without ever testing on interpretation!

What about native English speakers, who in the study scored an average of 87.9% compared to non-native speakers, who scored an average of 76.6%? No problem, says CCHI; passing score is 60% and Spanish language interpreters will continue to take the interpretation exam already in existence. I suppose the expectation might be that people who speak other “languages of lesser diffusion” in the United States have a higher academic background and their English proficiency is higher. Another point that makes this “solution” attractive is that most interpreter encounters in hospitals, offices and emergency rooms involve Spanish speakers, which brings the possibility of lawsuits for interpreter malpractice to a low, manageable incidence. I would add that many people needing interpreting services will not even consider a lawsuit because of ignorance, fear or immigration status. The good news: CCHI concluded that although this English-to-English exam option “is a promising measure…(it)…requires additional revision and piloting prior to use for high-stakes testing.” (https://slator.com/can-a-monolingual-oral-exam-level-the-playing-field-for-certifying-us-interpreters/)

Reading of this report and the article on Slator got me thinking about the current status of healthcare interpreting in the Covid-19 pandemic. How long will the American healthcare system ignore that the country is everyday more diverse and in need of professional, well-prepared healthcare interpreters in all languages? The answer is difficult and easy at the same time.

A difficult answer.

It is difficult because we live in a reality where every day, American patients face a system with very few capable healthcare interpreters, most in a handful of language combinations, and practically all of them in large and middle-sized cities. The two healthcare certification programs have poor exams. One of them does not even test simultaneous interpreting, and the other tests a candidates’ simultaneous skills with two 2-minute-long vignettes (one in English and the other in the second language). Consecutive skills are also tested at a very basic level with four vignettes of twenty-four 35 or fewer-words “utterances” each. It is impossible to assess somebody interpreting skills with such an exam after just 40 hours of interpreter training. (https://cchicertification.org/uploads/CHI_Exam_Structure-Interface-2020.pdf).

Except for those interpreters with an academic background or prepared on their own because they care about the service they provide, the current system provides a warm body, or a face on a screen, not a healthcare interpreter. Because the motivation is a robust profit, it is conceived and designed to protect the interests of insurance companies, hospital shareholders, and language services agencies. It has been structured to project the false impression these entities are complying with the spirit of the law; It is not designed to protect the physician or the patient.  

In 1974 the United States Supreme Court ruled that failing to provide language support for someone with limited English proficiency is a form of discrimination on the basis of national origin (https://www.federalregister.gov/documents/2000/08/30/00-22140/title-vi-of-the-civil-rights-act-of-1964-policy-guidance-on-the-prohibition-against-national-origin).  The ruling was later broadened and implemented by the Americans with Disabilities Act (ADA) (https://www.ada.gov/effective-comm.htm) and the Affordable Care Act (ACA) commonly known as “Obamacare.” (https://www.hhs.gov/sites/default/files/1557-fs-lep-508.pdf) This legislation specify that healthcare organizations must offer qualified medical interpreters for patients of limited English proficiency and those who are deaf or hard of hearing.

An easy answer.

Despite the reality we face, the answer to the question above is easily attainable because the healthcare industry has immense financial resources and a system that lets them capture money at a scale no other industry can.

The healthcare sector deals with the lives and quality of living of all individuals present in the United States. Their reason to exist is to save lives, not to produce ever-growing dividends to its shareholders every year. This is an industry that spends unimaginable amounts of money in medical equipment, state-of-the-art technology, physicians, surgeons, nurses, therapists, researchers, attorneys, and managerial staff salaries. New expensive hospitals, medical office buildings, clinics, laboratories, and rehab centers are built all the time. This industry can spend top money in those sectors because it is good for business. It is an investment that produces a profit. I am not even scratching the surface of these expenses, but even if we ignore the money spent in food, gear, vehicles (land and air), utilities, clerical staff, janitorial staff, and medical aide positions, we can safely conclude this is an industry that knows how to spend money when an expense is viewed as an investment that will produce a financial benefit.

Designing good medical interpreter exams in many languages is expensive, paying professional-level fees to healthcare interpreters will cost money, managing a continuing education program will not be cheap, but the healthcare sector cannot cry poverty. They have the funds to do it. It is incomprehensible how a business that bankrupts its patients after one surgery or a chronic disease can argue with a straight face, they can only pay 30 to 50 dollars an hour to a medical interpreter. This is an industry that charges you fifty dollars for a plastic pitcher of water or twenty dollars for a box of tissue they replace every day.

Quality interpreting, and living up to the spirit of the law, cannot happen when an organization spends money to look for shortcuts such as testing English-to-English in an interpreting program. Only the promise of a professional income will attract the best minds to healthcare interpreting. Current conditions, including low pay, an agency-run system, and searching for shortcuts to go around the law will never produce quality interpreters.

If those deciding understand good professional healthcare interpreters are an investment as valuable as good physicians, surgeons and nurses, the solution can begin immediately. Designing and administering a quality interpretation exam will take time, getting colleges and universities to start interpreting programs that include medical interpreting will not be easy, but there are steps that can improve the level of interpreting services right away.   

A higher pay, comparable to that of conference interpreters will immediately attract top interpreters in all languages, at least temporarily or part-time to the field. Many top interpreters see the need for quality services during the pandemic, and they feel a need to help, but they have to make a living and healthcare interpreter fees do not meet the mark.

Instead of thinking of English-to-English exams to create an illusion they are forming interpreters, stakeholders should recruit native speakers of languages where interpreters are hard to find, but they must stop looking for “ad-hoc” interpreters in restaurant kitchens and hotel cleaning crews, and start talking to college students and professors, to scientists and physicians from those countries who now practice in the United States. With current technology, hospitals should look for their interpreters among the interpreter community in the country where a language is spoken and retain their services to interpret remotely, instead of opening massive call centers in developing countries, using the technology to generate a higher profit instead of better quality.  

Hospital Boards must find the money and allocate it to interpreting services. In these cases, such as Medicaid and others, the cost of interpreter services should be considered an operating expense. Insurers do not reimburse for nursing and ancillary staff. Hospitals and practices pay their salaries.

Payers may also benefit by covering interpreter services. Although data are limited according to the Journal of the American Medical Association Forum, studies suggest that when physicians struggle to communicate with patients, they are more likely to order unnecessary tests and treatments. This not only puts patients at increased risk, but also directly increases payer spending. Limited English proficiency patients may need care more frequently or seek treatment in more expensive settings, such as the emergency room, when they cannot communicate with primary care providers. Similar to insurers in fee-for-service arrangements, risk-bearing provider groups in alternative payment models face a similar incentive to curtail unnecessary or wasteful utilization. Poor interpreting services will also result in malpractice lawsuits against hospitals, language service providers, insurance companies and medical staff. In the long run, by far, this makes investing in quality interpreter services and interpreting education/certification programs a smaller expense. “Paying for interpreter services, from cost-based reimbursement, to their inclusion in prospective payment models, to insurer-led contracting of remote interpreters, would not only address the disparities exposed by the pandemic, but also help support practices facing financial peril due to the pandemic.” (https://jamanetwork.com/journals/jama-health-forum/fullarticle/2771859) It is time to grow up and stand up to the stakeholders in the healthcare sector; it is time to unmask the real intentions of language service providers who take advantage of often-poorly prepared interpreters to get a profit. It is time to have a serious healthcare interpreter certification exam that really tests the candidate’s interpreting skills. We need university and college programs, and a different recruitment system led by hospitals and insurance companies not multinational interpreting agencies, or ill-prepared small local players. Interpreters cannot be made in 40 hours and we can’t have newly trained interpreters learning at the cost of real patients’ safety. The pandemic showed us the importance of healthcare interpreting, let’s seize the opportunity to professionalize it.

We should act more like professionals and less like merchants.

April 29, 2019 § 6 Comments

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.

Interpreters: Your clients, and your clients’ clients.

June 4, 2018 § 8 Comments

Dear colleagues:

I get goosebumps every time I hear freelance interpreters talk about their “boss”. I am constantly surprised at the huge number of independent contractor colleagues who refer to the authorities at the agencies, hospitals and courthouses they provide interpreter services for as their bosses.

This is an abomination when used to describe the other party to a professional services contractual relationship, now exacerbated by the very dangerous ruling by the United States National Labor Relations Board (NLRB) in SOSi where it ordered this interpreting agency to reclassify its interpreters working as independent contractors as employees. SOSi is appealing the decision, and we will discuss it in depth on a future post.

Our concern today is the conscious or subconscious lack of understanding of the professional services relationship derived from a contract where an independent interpreter is the service provider.

Freelance interpreters are independent professionals who provide their services for a fee. The terms of such services and fees are agreed upon by the interpreter providing the service and the individual or corporation recipient of the interpreting services in a contract. The parties to this contract are: The professional (who provides the interpretation, in other words, the interpreter) and the recipient of the professional service, called the client.

Yes, dear friends and colleagues, as freelance professional interpreters we provide our services to a counterpart called the client. Our main contractual duty is to render the interpreting services as agreed with the client, and the client’s main obligation is to pay the agreed fee in exchange for those services. The contract is called: Professional services contract.

Freelance interpreters are independent professionals free to choose the clients they want, under the terms they see fit, and for the service they picked. There is no authority figure over the freelance interpreter. All duties, responsibilities and obligations are contained in a voluntary contract (oral or written), a professional code of ethics, and the legislation governing the profession in a particular jurisdiction.  Client and interpreter are equals. There is no boss.

Bosses exist in labor relations where a part: the employee, is in a subordinate position to the other: the employer or boss, who gives directions, orders, and instructions to the subordinate who must comply with these commands during working hours, in exchange for a fixed wage. Employer and employee are not equals in this relationship. An employee cannot choose what she does. If she does not comply she will be sanctioned and even fired.

Webster states that: a client is “… a person who engages the professional advice or services of another…” Oxford tells us that a client is “…a person or organization using the services of a lawyer or other professional person or company…”

Interpreting is a profession. Interpreters perform a professional service. Interpreters, like all professional service providers, have clients.

Here we see then that we must not call a client a boss because it is inaccurate, and it immediately puts the interpreter at a disadvantage. Calling your client “boss” creates a subservient relationship in your mind that will quickly translate into an attitude and lifestyle. It paralyzes the interpreter as she or he will no longer feel capable or worthy of arguing work conditions, professional fees, or assignments.

For those of you who see judges, doctors, court and hospital administrators, and language service agencies: Eliminate that thought. It is wrong. They are your clients, and you can negotiate and refuse assignments when you consider it appropriate.  Your duties and responsibilities to do a professional top-notch job come from the contract, the legislation, and from your professionalism. You do a good job because you are a professional who wants to provide a good service because you want to keep the client, or you just want to do the right thing. You don’t do it because you have somebody breathing on your neck looking over your shoulder micromanaging everything you do. You do not need someone telling you how to dress for an assignment, or reminding you to get there on time. However, as long as you see the client as your boss, they will act as your employer.

Professional interpreters have clients and charge professional fees. They do not charge rates. A commercial product vendor or a non-professional service supplier do not have clients. They have customers. A customer buys goods or non-professional services from a business. Webster defines them as: “…one that purchases a commodity or service…” Oxford gives more details when it tells us that a customer is “…a person who buys goods or services from a shop or business…” Unlike professionals, these merchants get a rate or a price in exchange for the goods or non-professional services purchased.

Physicians and dentists are professional service providers, so they technically have clients, but for historical reasons, and due to the nature of their services, these service recipients are called patients. According to the American Medical Association’s Code of Ethics (AMA), physicians must be “…dedicated to providing competent medical care, with compassion and respect for human dignity and right.” It also considers that people with an illness must wait to see a doctor or to be treated, and that requires patience. Webster indicates that a patient is “…an individual awaiting or under medical care and treatment…”  To Oxford it is “…a person receiving or registered to receive medical treatment…”

I have observed how many freelance interpreters have a hard time separating their client from others who may participate in the process like vendors and providers. The convention center or hotel events center are not the interpreter clients, they are vendors who provided the facility so there can be a conference. Unless the interpreter hired them directly, they have no contractual relation with the interpreter. They are the interpreters’ clients’ problem. The same can be said for the technical support: booths, interpreting equipment, sound system, etc. Unless they were hired directly by the interpreters, these are also suppliers who have a contract with the interpreters’ client, not with the interpreters. They are not your problem either.

Another common mistake is to confuse the direct beneficiary of the interpretation with the interpreter’s client. Usually, they are not your client. The five hundred people in the auditorium listening to your rendition are the direct beneficiaries of your professional rendition. Without you they could not attend the event; however, they are not your clients. They are your client’s clients. As professionals we must accommodate all reasonable requests by the audience and the speakers, but they are not the ones paying your fee. They are paying your client because they are your client’s clients. For this reason if a person in the auditorium asks you to speak louder, you may consider the request, and even honor it when reasonable; but if somebody attending the conference asks you to take a recorder to the booth and record the rendition for him, you will decline, and direct him to your client (please read my blog post on what to do in this situation).

Dear friends and colleagues, as professional interpreters who provide our services as freelancers we have many clients we choose. We decide who we want as our client, and who we do not. We have the last word on whether we do an assignment, and when a professional relationship with a client must end. We set and negotiate the terms of our work, our pay, and out booth mates.  Employees do not get to do this because they have a boss: the employer. We do not. We practice in a world where we are equals with our counterparts in a professional contractual relationship. We do a magnificent job, we accommodate all reasonable requests of our clients’ clients, and we cooperate and support other providers and suppliers such as facility workers and technical support staff, but we do it because we are professionals and we have made a business decision to keep the client we want to keep, not because we are told to do so. Please stop referring to your client as your “boss”, and the next time a project manager tells you what to wear to an assignment, to be on time; or the next time a hotel waiter tells you not to have a cup of coffee, please stand up for your dignity and that of the profession. I now invite you to share your thoughts on this issue.

U.S. Immigration Court interpreters’ other enemy.

October 18, 2016 § 4 Comments

Dear Colleagues:

About two months ago the California immigration court interpreters started a movement to force the hand of SOSi and the EOIR with the goal of achieving better work conditions, a professional pay for the services rendered, and to keep the authorities from hiring new interpreters and interpretation students for a lower fee.  This entry will not deal with the merits or the outcome of such movement. We will talk about the elephant in the room: the big obstacle to the professionalization of the interpreting services in American immigration courts that can be changed by the interpreters themselves.

I know that this blog entry will make some uncomfortable, and I do not like to do that. Unfortunately, my life-long effort to fight for the professionalization of interpreting does not allow me to keep silent. To me, that would be equivalent to betraying my own professional standards. I write this piece with respect and with no desire to offend, knowing that by the time some of you finish reading this article, you will feel offended. I only ask you to reflect on what bothered you, and honestly acknowledge, at least to yourself, that you are not really up to save the profession (as a true profession, not as a laborer’s occupation) in the immigration court arena.

For several years now, there has been a tendency to credentialize interpreters who provide services to the public, who perform a fiduciary function.  Because of the wide variety of languages regularly spoken in the United States, and due to the millions of people who do not speak English at all, or at least good enough to go through a legal or medical process, most efforts have been applied to the certification of Spanish interpreters, by far the most popular foreign language nationwide, and finding other solutions for the other languages.

Court interpreters had an early start and developed the federal Spanish court interpreter certification exam. Many States followed and the States’ Consortium for State Court Interpreter Certification was born, later taking us to the current Language Access Advisory Committee (LAAC) and Council of Language Access Coordinators (CLAC).

Healthcare interpreters followed suit and developed two different interpreter certification programs (the Certification Commission for Healthcare Interpreters: CCHI, and the National Board of Certification for Medical Interpreters’ CMI program) both of them widely spread and recognized throughout the United States. Granted, the term “medical interpreter” to describe the functions of these professionals is less accurate that “healthcare interpreter”, and compared to the court interpreter certification federal and state-level exams, both healthcare certifications are way behind in content and degree of difficulty; but unlike court interpreter certification programs, healthcare interpreters have achieved something extremely valuable that court interpreters can only dream of: an examination administered by an independent entity, just like lawyers and physicians, instead of the uncomfortable government-run court interpreter programs that always raise the issue of the real conflict of interests when the entity certifying interpreters is the same one who hires them.

At any rate, healthcare interpreters in the United States now have a way to prove that they are minimally qualified to do their job, that they adhere to a code of ethics, and that they comply with continuing education requirements that will keep them current in language, interpreting, terminology, and medical issues. In other words, healthcare interpreters sitting at the table with court interpreters can now bring up their credential and feel at the same professional level than their legal colleagues, instead of having to give a speech about how certifications do not mean a thing, that it is working in the trenches that makes you a good interpreter, and that your field is so unique that no existing certification exam could test what is needed to work in that field.

Well, dear friends and colleagues, this takes me straight to a very real, and somewhat uncomfortable problem, faced everyday by immigration court interpreters in the United Stets: They have no certification program requirement to work in court, and for that reason, there is no way to prove a certain minimum level, thus allowing bad interpreters to work in the immigration court system for years.

Court interpreting is a highly skilled occupation that requires of a professional provider. By its nature, it is also a fiduciary function where a judge, attorneys, respondents and witnesses must trust the knowledge and skill of the interpreter who will speak throughout the proceedings while at least half of those present will not understand a word of what was said. It is an awesome responsibility that cannot be left to the paraprofessional or the untested.

Presently, all Article Three courts in the United States, at all levels (federal and state) have a Spanish language court interpreter certification program that includes minimum requirements to take the exam, passing a comprehensive and difficult test (at least at the federal level), observing a code of ethics, and (with the exception of the federal program) complying with continuing education in the legal, interpreting, and language fields to be able to keep the certification. These courts are part of the Judiciary Branch of government.

Immigration Courts are not a part of the Judiciary. They are in the Executive Branch of government and are referred to as Article One courts because of their legal basis in the U.S. Constitution. The thing is, my colleagues, these courts deal with societal, family, and personal values and interests as important as those heard by Article Three judges. They are courts of law that abide by a set of substantive and adjective laws.  For practical reasons, they operate just like any judicial court: there is a judge, there are parties (one of them will be the government just like in criminal law), there are witnesses, and there are attorneys.  Although the controversies are different, immigration proceedings also include a first appearance, motions hearings, a court trial, and a verdict. There is a burden of proof, rules of evidence and procedure, and the possibility of an appeal to a higher court (Board of Immigration Appeals). The fact that the terminology calls these hearings “master calendar”, “bond redetermination”, “credible fear”, or “individual hearing” does not make much difference.   The cases are as different from those interpreted in an Article Three courtroom, as a criminal case differs from a civil or a family law proceeding.

The skills required to interpret are the same as in any other type of court proceeding: There is a need for simultaneous and consecutive interpreting, as well as sight translation. Interpreters use equipment just the same (in fact, in many cases even the same brand), and the expected ethical and professional conduct of the interpreter is the same.

It is a fact that immigration court interpreters are disrespected by their client: the EOIR on a daily basis. There is no denial that they make little money, work long hours, and they do it solo, regardless of the complexity or duration of a hearing. It is also well-known that they are treated in humiliating fashion by being forced to jump through many administrative hoops that no other court interpreter will ever face, in part because they are subcontracted by a multinational agency that tries to keep control over the interpreters without physically being at the courthouse, but also in part because interpreters are not considered professionals, they are not acknowledged as officers of the court.

I firmly believe that the only way to earn the credibility they need so much, Spanish language (for now, and ideally all widely used language combinations later) immigration court interpreters in the United States must demand a court interpreter certification requirement to be able to work.  They need it for their credibility among their peers and with the public opinion.  Once they have a credential, together with a code of ethics and continuing education requirements, they will be in a much better position to negotiate with anybody.

Because immigration court is a federal matter, and the services provided by the interpreter are the same as the ones in all federal courts, I think that the certification they need to have is the already existing FCICE. It would be very simple, all they need to do is convince the EOIR of this need. The exam already exists, all these interpreters would need to do is register and take the test. Then, if both, EOIR and the immigration interpreter community think it is appropriate, there could be a short immigration terminology exam (although I don’t think it necessary just like current certified court interpreters do not need to test every time they interpret a different kind of hearing. Part of an interpreter’s duty is to get ready for an assignment and that professional obligation should be enough).  This would be the best way to demonstrate that their simultaneous, consecutive, and sight skills are at a minimum level to deserve that trust we discussed above. In fact, by getting EOIR to agree, immigration interpreters would have until the Summer of 2018 to take and pass the written portion of the federal exam, and then until the Summer of 2019 to take and pass the oral test. In the meantime, it could be agreed that those currently working would continue to do so until the Summer of 2018.

This solution would immediate put immigration court interpreters at the same negotiating level as their Article Three federal counterparts; In fact, it would benefit everyone: Currently federally certified Spanish court interpreters would consider working in immigration court as the pay would be the same (or almost), and newly federally certified immigration court interpreters would have the opportunity to broaden their professional horizons and work in federal courts.

Of course, this means that two things must happen: First, the certification exam cannot be a “Mickey Mouse test” like the ones offered to immigration court interpreters by multinational agency contractors; they have no scientific value and a very poor reputation. And second, immigration court interpreters need to understand that those who do not pass the exam must go, regardless of the time they have been a fixture at the immigration courthouse. Any other “solution” would defeat the purpose and discredit the credential. This, my friends, is the “other” enemy of the U.S. immigration interpreter: the bad interpreter who has never been able to pass a court certification exam, knows that they never will, and spend all their time and energy trying to convince others that certifications are worthless, exams are rigged, and that the only way to learn the profession in in the courtroom.  These people have to go away. They are like a cancer that is slowing down the progress of the rest of their colleagues.

To argue “unity” to protect and keep these individuals is misleading. Professional unity can only happen among professionals, and the individuals I just described above may be paraprofessionals but they are definitely not professional material. Imagine for one moment going to the hospital for emergency surgery and being told that the person who will operate on you has never taken or passed the Board, but has a lot of experience. Would you let this non-doctor cut you open?

I understand it is very hard to set aside our emotions and empathy for these individuals, but it is time to think of yourselves, your families and your peers. Unless you want to continue to struggle as an immigration court interpreter, you have to get certified. A decision to dodge the certification issue, or to settle for a lower standard of certification, because someone who cannot pass the test convinced you to support other options, will be a vote for the status quo, sacrificing the good ones to protect those who do not deserve to be there.

Many medical interpreters are missing out on a prestigious and profitable field.

March 16, 2014 § 21 Comments

Dear colleagues:

Last year I interpreted for several medical and pharmaceutical conferences.  Some were presentations of scientific papers before an audience of  peers, others were geared to non-physicians who work in the pharmaceutical field.  All of them were interesting and they all paid well.  They also had something else in common:  There were absolutely no medical interpreters or former medical interpreters in any of the booths.  As I sat in the Spanish booth during a conference on the 98th floor of the Hancock Building in Chicago, I examined all the booths for the other languages and realized that there were excellent, very dedicated professional conference interpreters everywhere.  I knew the interpretation was going to be top-notch, but I couldn’t help but notice that there were no medical doctors, registered nurses, or medical interpreters anywhere.

My friends, conference interpreters are second to none as far as quality and professionalism; they prepare for every assignment and show up to work equipped with the experience, knowledge, and skill needed to take care of just about any possible situation that may arise during the assignment.  A conference where real conference interpreters are hired to work could not be in better hands.  However, even though the same can be said of any other subject matter, in the United States, and other countries, you can find former attorneys and court interpreters in many events that deal with legal and business issues.  Medical interpreting attracts hundreds of interpreters in the United States alone.  Every day these professionals work in hospitals, clinics, emergency rooms, and medical offices, so the logical question is: Why this does not happen in the medical conferences?

I do not have a general answer, but based on my observations and years in the profession I can bring up the following factors:

There are several very capable medical interpreters who regularly work as conference interpreters.  I know this because some of them are my friends and I have shared the booth with many.  The problem is that there are not enough of them.  Please understand that here I am referring to what is generally recognized as conference interpreting, and purposely excluding community interpreting even though some colleagues, in my opinion erroneously, on occasion refer to this boothless informal interpretation as conference.

Compared to legal interpreters, medical interpreters have a tougher time “breaking away” from medical interpreting because there is a widely shared concept that medical interpreters are not good or professional.  This is a belief that many agencies, and even other interpreters, share.

Now, we have to recognize that this characterization of the medical interpreter profession has some truth to it.  At least in the United States until fairly recently there was no regulation or minimal standards in medical interpreting.  Many bilinguals who failed the court interpreter certification went to the medical field because there were no rules and often no quality control.  Because the conditions were so poor in this unchartered territory, many language agencies filled the void by taking over most of the things needed to provide a medical interpreting service.  They were setting policy and criteria as far as who could work, how they could work, and more importantly, how much these interpreters would be paid.  For years I heard this all over the United States: “Medical interpreting? No way! It pays nothing.”  Unfortunately my friends and colleagues, that was (and regrettably still is) the case.

So there you have it.  Most interpreters who had invested time and money studying and getting themselves ready to practice their profession did not want to work for very little pay.  This scared many good people away from the field.

There is much to be done at this time. Too many doctors and hospital administrators to educate, too many bad agencies to expel from the field, and too many mediocre interpreters to push to the side so there is room for those, new and experienced professionals, willing to play ball under the new rules of certification, ethics and uniformity.

It is certain that the profession will continue to grow and will eventually catch up with older interpreting fields such as conference, diplomatic, court, and military interpreting.  As this happens, medical interpreting will attract more capable professionals, competition will be brutal like in all profitable professional environments, and interpreting fees will dramatically increase.  In the meantime during the process, and in my opinion, to enhance our professional versatility and skills, good medical interpreters who want to elevate their profession, better themselves, and receive a fair decent compensation for their service will have to look at expanding their practice.  To achieve this goal you basically have two options:  The less complicated possibility of doing medical-related work that up until now, with some exceptions, has been handled by court interpreters:  interpreting for independent medical examinations and evaluations specifically done for litigation purposes in the area of worker’s compensation and civil law.  Medical interpreters should be able to learn and provide these services by taking advantage of their medical knowledge.  The sad part is that this field, like most of the medical interpretation field, is controlled by agencies that pay very little. In fact, they are many times the same agencies that hire interpreters for medical work.

The second option, and my motivation for writing this piece, is conference interpreting.  Undoubtedly a more difficult goal.  Medical conferences require of knowledge in the medical, biological, and pharmacological sciences.  Good medical interpreters should already have it, especially if they have a medical or nursing background.  It also requires familiarity with the “medical culture.”  Medical interpreters come in contact with it on a daily basis.

Conference interpreter also requires that the professional providing these services be able to do it simultaneously. It demands agility of mind and speedy thinking while handling very complex concepts and precise terminology.  It requires of booth etiquette and assignment preparation, and it must be performed as a team.  Most if not all of these characteristics are not part of an everyday medical interpreter repertoire.  It sounds hard and complicated because it is very difficult and extremely sophisticated work.

However, my dear friends and colleagues, the rewards are enormous: you get to develop as an interpreter by acquiring the master key that opens the door to all interpreting work: simultaneous rendition. Working as the interpreter for a medical conference you will earn amounts never seen in the medical interpreting field, and you will learn about the science and policy that is applied to hospitals, medical practitioners, and insurance companies every day.  As conference interpreters you will experience the satisfaction of doing a job that is understood by all those who are listening as part of your sophisticated audience.  Now, you may say that conference interpreting will not give you the satisfaction of helping to save a life, of being a part of preventing a disease; that you decided to become a medical interpreter for this reason.  That is not true. As a medical conference interpreter you will be right in the middle of saving lives as the interpreter who reveals a medical breakthrough for the first time in your language pair; you will be the voice of physicians who will ask questions about a new drug or procedure; and of course, keep in mind that you will not stop medical interpreting. You will diversify your practice and widen your clientele.  I look forward to the time when I regularly get to share the booth of a medical conference with a professional and highly capable interpreter with a medical interpreting background.   I invite you to share your thoughts and opinions about this very important professional aspect of our profession.

Remote conference interpreting: The interpreter’s new best friend?

April 23, 2013 § 18 Comments

Dear colleagues:

I constantly read about all the changes that modernity is bringing to our profession. I read of the new technological developments and I hear the voices of anger and fear from many in our profession. I must tell you that I fully accept and embrace these changes because they make our work easier and better: Who wants to go back to the days before computers and on-line resources when we had to drag along a library to the job? Is there an individual who longs for the days of endless consecutive interpretation before simultaneous interpretation equipment was introduced and developed for the Nuremberg Trials and the United Nations?  We need to keep in mind that as interpreters we work with languages, and as all linguists know, a language doesn’t stand still. Language constantly evolves; it reflects our ever-changing human society. It is not like we didn’t know that languages change when we first decided to enter this career.  I think that those who complain that there is too much new technology in the world of interpretation, and the interpreters who get angry when a new scientific term is created or the legal terminology of a country changes, should pause and think that it is not only their professional world that is being altered; they should think of all the engineers who gladly embrace new technology for our collective benefit, all the physicians who hurry to learn about the new discoveries published on the most recent science publication, all the attorneys who hit the books to learn the newly enacted legal reforms.  I am glad that medical doctors don’t get mad when a new vaccine is announced. I am thankful that they embrace change and learn for the benefit of society.  Dear colleagues, our profession is no different, we should face technological changes with the same attitude all other professionals do.  And by the way, it is also the right business decision as modernization will not stop, it will not slow down, but it will surely leave us behind if we don’t adjust and embrace it.

Just like many of you, I have been doing more remote interpreting than ever before.  At the beginning of my career I had my share of telephonic interpretation for the big agencies as many others did. After I developed my own clientele and as I became better-known I didn’t do much of this work for many years. There were a few exceptions and now and then I did the occasional business negotiation with a foreign counterpart that was done over a speaker phone, the court arraignments by video that some State Courts in the U.S. have been doing for about a decade, and the depositions by video with an attorney asking questions from a different location.  Then we get the economic crisis and the need to rethink procedures to save money during difficult times. This is when a few years ago the immigration courts began to hold master hearings by video from the detention centers, and the federal court system decided to implement the Telephone Interpreting Program (TIP) now widely used to cover most of the outline areas of the United States.

Of course, I have done all of the above assignments and I am familiar with the technology employed, but we were still talking about events where the job was to interpret for one person, usually for a short period of time, generally in regard to a single topic well-known by the interpreter, and with the parties sitting down around a speaker phone or in front of a PC-type video camera.  It was when I started to get requests to do conference interpreting from a facility different from the site of the event that I understood that the trend was irreversible. If I wanted to stay relevant I had to adapt.

I went down career memory lane to my previous assignments and selected those elements that I had learned doing all the jobs mentioned above.  As I was doing it, I began to remember other experiences that would be helpful:  Broadcast interpretation of live TV events that I did in the past such as award ceremonies, presidential debates, and political conventions came to mind. These were assignments that I had worked aided by a TV monitor and oftentimes from a different studio and even a different location after all.

Remote conference interpreting has been around for some time and it continues to grow. I have been able to solve some of my concerns as I have worked more of these assignments. It is obvious that a good sound system and a great technician are key to a successful remote interpretation. I have also learned that the broadcast quality is as important as the sound equipment. Sometimes the equipment is fine, but if the broadcast is poor you will suffer in the booth (or studio) and sometimes it is up to the events going on in the Solar System. Once I had a hard time on an assignment in the United States where the presenter was appearing by video from Scotland. Due to some solar flares affecting earth the transatlantic broadcast was choppy and the image and sound were very poor.

It is important to mention that remote conference interpreting is very appealing for our clients because it will always be more cost-effective than flying a bunch of interpreters to an event, paying for their hotel, ground transportation, meals, and travel time. It also benefits the interpreter as it allows us to do more work without so many travel days, and it puts us on a global market since the interpreter’s physical location will matter less. You can go from one job to another and still sleep at home. You can even do two half-day events on the same day.

At the beginning one of my biggest reservations about remote conference interpreting was that I would not be able to see the speaker or the power point on the screen whenever I wanted, or even worse, that I would never see those asking questions from the audience.  Like many interpreters, sometimes I relay on facial expressions to determine meaning and to understand difficult accents.  I have learned that the solution to all of these concerns can be found on the camera director. This is the person who sits in the video truck or the video room and switches from one camera to another.  A good conversation with the director and his camera operators on the day before the conference starts can be extremely helpful. I have explained to them the importance of seeing the power point on the screen when the speaker changes slides, the advantage of seeing the speaker as he addresses the audience, and the absolute need of having on screen the person asking a question while he is speaking.  This has made my life so much easier!

Of course, not all directors are the same, some are better than others (as I recently learned during an event on the west coast when the director did not work one weekday and the interpreters noticed it immediately, even before we were told that we had a different director for one day) and there are certain things that we miss with remote interpreting (like a world-class chefs’ cooking event I did last year where there were constant references to the smell of food that we could not experience from a different location) but I am confident that as technology advances, we as interpreters prepare better for this new challenges, and the market leaves us no other work alternative, the wrinkles will be ironed and we will be praising remote conference interpreting just as we now do with simultaneous over consecutive. I would love to read your opinions and experiences regarding this very important professional issue.

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