Tackling Language Barriers in Healthcare

Authored By: Grace Liu Art By: Laura Lee

Language is the basis for connection, communication, and engagement. In healthcare settings, effective communication between medical providers and patients is critical for improved health outcomes. However, language barriers pose a significant and growing problem in the U.S., where immigrant populations—many of whom speak a native language other than English—continue to rise. Ineffective communication makes it challenging for physicians to understand patient concerns and prevents patients from fully understanding diagnoses, treatment plans, and preventive care. Misinterpretations during treatment compromise patient safety and reduce the quality of healthcare services, which disproportionately affects non-English speaking populations and will exacerbate disparities over time.

The consequences of language barriers in healthcare are far-reaching. Ineffective communication due to language barriers can lead to longer emergency department visits, increased hospital admissions, more workups, and ultimately, greater medical charges [1]. These inefficiencies ultimately strain healthcare resources and create frustration for both patients and providers, causing decreased patient compliance and a lack of satisfaction with treatment. Moreover, critical information like hospital discharge instructions is often printed in English, leading to misunderstandings even after the appointment has concluded [2].

Approximately 8% of the U.S. population above the age of five has limited English proficiency and requires or desires language assistance services. While many of these patients rely on interpretation done by family members and other untrained personnel, research has found that translation conducted by non-trained professionals is inaccurate nearly one-quarter of the time. This is especially alarming because minor translation errors can create severe consequences in patient care. Trained medical interpreters are significantly more skilled in catching these nuances and ensuring accurate communication, emphasizing a need for professional language services in healthcare settings [1].

There are many ways to provide interpretation services during appointments. The most traditional method utilizes live, in-person trained medical interpreters.. However, this option is labor-intensive and constrained by a limited pool of interpreters for certain languages. Another option is utilizing trained hospital personnel, like nurses and other employees, who have been trained to be medical interpreters in a language they are fluent in. While this approach is more cost-effective, many bilingual hospital employees are still not fully trained in communicating patient needs. Other remote interpretation services through phone or video can also provide a variety of languages [1].

Federal laws in the U.S., like Title VI of the Civil Rights Act and the Affordable Care Act, work to prevent discrimination in healthcare programs by requiring healthcare providers to have language interpretation services available [3]. While these services would be effective in theory, they pose critical challenges for access and financial burden. Past studies have found that many healthcare institutions still have limited access to interpreter services or none at all. Despite legal requirements, over ⅓ of hospitals fail to offer language interpretation services [4]. Even when translation methods are offered, their use often indirectly raises treatment costs and the duration of visits.

Utilizing other translation tools like Google Translate or MediBabble has emerged as a promising solution to overcome these challenges [2]. However, the effectiveness and accuracy of these platforms still need to be tested further. A 2021 study found that the effectiveness of using Google Translate for discharge instructions was highly variable among different languages and should not be relied on for patient instructions. For instance, they found much higher inaccuracy rates and potential rates of harm to patients among Chinese translations compared to Spanish ones [5]. While these tools show immense promise, they cannot be considered a substitute for professional medical interpreters in their current state.

It is time to take concrete steps to eliminate language barriers in healthcare through increased funding, improved translation tools, and more inclusive medical practices. Investing further in research and translation services will lessen language barriers in the medical field and lead to improved health outcomes. This will likely require increased funding and policy support due to the high costs. Furthermore, translation software should be further developed and tested to improve its accuracy and reliability in medical contexts. Finally, physicians should foster an environment that welcomes people of all languages and cultures. Patients should be sent home with medical discharge information accurately translated into their native languages, and physicians should consider relying more on images and diagrams to explain the situation clearly. There are several ways to improve health communication, but we need to put in more effort to make them happen.

References

[1] Slade S, Sergent SR. Language Barrier. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507819/

[2] Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of Language Barriers for Healthcare: A Systematic Review. Oman medical journal, 35(2), e122. https://doi.org/10.5001/omj.2020.40

[3] Müller, F., Ngo, J., Arnetz, J. E., & Holman, H. T. (2024). Development and validation of the provider assessed quality of consultations with language interpretation scale (PQC-LI). BMC research notes, 17(1), 15. https://doi.org/10.1186/s13104-023-06675-7

[4] Cohen, R. (2016). Required Translators Missing from Many U.S. Hospitals. Reuters. www.reuters.com/article/business/healthcare-pharmaceuticals/required-translators-missing-from-many-us-hospitals-idUSKCN10M29L/.

[5] Taira, B. R., Kreger, V., Orue, A., & Diamond, L. C. (2021). A Pragmatic Assessment of Google Translate for Emergency Department Instructions. Journal of general internal medicine, 36(11), 3361–3365. https://doi.org/10.1007/s11606-021-06666-z