Pitfalls in communication with Hispanic and African-American patients: do translators help or harm?

The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems.