Most pediatricians use untrained interpreters to
communicate with families who are not proficient in
English, according to the results of a nationwide survey of
doctors led by researchers at Johns Hopkins.
Nearly two-thirds of the pediatricians surveyed said
they relied on the patient's bilingual family member to
relay health information. Pediatricians in rural areas or
in states with higher proportions of non-English-proficient
populations were the least likely to use professional
translation services. The study is published in the April
issue of Pediatrics.
"Our results show that language services for patients
with limited English proficiency are clearly inadequate,
especially in smaller rural communities," said lead author
Dennis Z. Kuo, a general pediatrics fellow at the School of
Medicine. "This is really an overlooked problem, given all
that we know about the adverse health outcomes that can
arise from miscommunication between physicians and their
The study was based on the results of a survey of
1,829 physicians from the American Academy of Pediatrics.
Of the physicians surveyed, 70 percent reported using the
patient's bilingual family member to relay health
information, and 58 percent reported using bilingual staff
for assistance. Only 40 percent reported using professional
interpreters, and 35 percent offered translated written
materials in the office. In this study, limited English
proficiency was defined as those for whom English was not
the primary language and who spoke English less than "very
Pediatricians in states with large numbers of
Spanish-speaking patients were less likely to use
professional interpreters. Instead, they reported greater
reliance on bilingual staff members to relay information.
In addition, doctors in states where translation services
were covered by public health insurance were more likely to
use professional interpreters.
Cynthia S. Minkovitz, senior author of the study and
associate professor in the
Department of Population, Family and Reproductive
Health at the Bloomberg School of Public Health, said,
"There is an urgent need to promote appropriate language
services through the use of interpreters, translated
written materials, provider training and third-party
Failure to address these issues, the authors note,
will contribute to worse health status, compromised patient
safety, decreased patient satisfaction and increased costs
of health care services.
The study, written by Kuo, Karen G. O'Conner, Glenn
Flores and Minkovitz, was supported by the American Academy
of Pediatrics and a grant from the Maternal and Child
Health Bureau, Health Resources and Services
Administration. It was a collaborative effort of The Johns
Hopkins University, the American Academy of Pediatrics and
the Medical College of Wisconsin.