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Did You Know? Working with Translators in Various Time Zones

Did you know that we have translators in so many times zones that we have to factor in this small, but very important, detail when we set up delivery deadlines with our clients? That's right! We find the very best translators and editors to work on our clients' translation projects. At Accessible Translation Solutions (ATS) we work directly with professionals all over the world, from Hong Kong to Kefar-Sava, Israel, from Montevideo to Kampot, Cambodia. Of course, we have many U.S.-based translators and editors, so we deal with at least four of the six U.S. time zones as well.

How does this affect our clients' delivery deadlines? Well, first we have to make sure we can take on a project from a client in the amount of time they specify. This includes the time it takes for us to manage the project from start to finish, allowing our translators and editors ample time to work on the job and giving ourselves enough time to perform the quality assurance step that takes place before we send the final deliverables to our clients. Time zones factor into this scenario because if a translator is in one time zone and the editor is in another, which is often the case, we have to ensure that the files are passed from the translation step to the editing step seamlessly and without delay. In our line of work, time is always of the essence. We know our clients need to receive their translation projects back in a timely manner, so we do everything we can to make sure our processes and timelines run smoothly.

If our translators or editors have specific questions about a text they are working on, we need to make sure that they receive the best information, straight from the client. This is why we make a point of discussing specific aspects of our clients' projects with them in as much detail as possible, and we relay that information as quickly as possible during our translators' and editors' working hours in their respective time zones. This may mean we are working with our Hebrew translators in Israel on Sundays instead of Fridays, as their weekends are observed as Friday and Saturday. All of these little details must be considered in order for us to ensure that we always meet our clients' deadlines!

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Medical Translation and Interpreting: Saving Money, Saving Lives

Some professions can be very competitive and those who don't perform the same type of job duties may not understand why. Sometimes I think, "Why are these people being so competitive and cut-throat with their colleagues? It's not like they're saving lives!" However, in the field of medical translation and interpreting, we can say that yes, linguists often might be saving lives. Here are two examples of how medical translators and interpreters can save clients money while their work can save lives: The first example is found in an article posted in January 2009 in American Medical News from the American Medical Association. This case involved a New Jersey rheumatologist who refused to provide a sign language interpreter for a patient being treated for lupus. This patient consistently requested an interpreter, but claims that her requests were always denied. The physician's argument was that Medicare did not reimburse the entire cost of an interpreter for each visit. Instead, he passed written notes back and forth to the patient and her family.

Apparently, this was not enough for the patient to feel as though she understood what was happening at the medical visits and she transferred to another doctor. The patient sued the original physician, claiming violation of the federal Americans with Disabilities Act and the Rehabilitation Act, along with New Jersey's anti-discrimination law. The jury found the rheumatologist had indeed discriminated against the patient when failing to provide a sign language interpreter.

If a medical interpreter had been present at the child's visits with the rheumatologist, she might have felt differently about the care she received and would not have sued the physician, which will likely cost him more than an interpreter would have.

Then there is the story of Lia Lee, a child raised in California of Hmong refugees and the focus of Anne Fadiman's book, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. Lia was misdiagnosed twice as having had pneumonia, when in reality, she was epileptic from the time she was an infant. Lia's parents did not speak English well enough to communicate with the doctors who treated her, and they often misunderstood how to care for her at home. They did not know how to describe the child's seizures effectively to her physicians, as in their own culture, these episodes seemed to convey that her body was being overtaken by a spirit.

Misunderstandings continued between Lia's parents and her physicians, as both sides were unable to communicate effectively and understand each other's cultures. A New York Times article reported, "The seizures worsened; by the time Lia was 4 ½, she had made more than 100 outpatient visits to medical facilities and been admitted to the hospital 17 times. When she was not quite 3, in frustration at what he viewed as her parents’ refusal to administer her medication, Dr. Ernst (Lia's physician) had Lia legally removed from the family home." Lia was sent to live in foster care for one year, yet another blow to her parents. Her health worsened and the relationships between her parents and her physicians were strained, as neither side seemed to adequately comprehend the culture and language of the other. Lia died on August 31, 2012.

A medical interpreter at Lia's visits and proper translation of her prescriptions and care instructions could have allowed Lia to receive consistent and proper care for her condition, likely avoiding her placement in foster care. Needless to say, such services would have greatly improved her quality of life.

These are only two of the stories about how medical translation and interpretation can save lives and reduce costs by avoiding unnecessary tests, misdiagnoses, treatment errors and miscommunication. To ensure compliance with federal regulations as a health care provider, be sure to request professional interpreting and translation for patients and their families. It truly can save you money and continue to save lives.

“Obamacare” and LEPs: How does the law upheld by the Supreme Court affect the translation/interpretation industry?

What a week it’s been in politics! Now that the Health Care Law has finally gone before the Supreme Court, which upheld it on a 5 to 4 vote, those of us who work in medical translation and interpretation on a daily basis want to know: What does this mean for us?! For most Americans, the Health Care Law has been confusing from the start. However, imagine how confusing it could be for those millions of Americans who have limited English proficiency (LEP). This can be even more confusing for them. What are their rights? First, we have to look at what the rights have been so far for these individuals when it comes to language access in health care.

Title VI of the 1964 Civil Rights Act

Executive Order 13166, Title VI of the Civil Rights Act of 1964 states, “No person in the United States shall, on the ground of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” (42 U.S.C. Section 2000d). In short, any organization, whether a clinic, hospital or other health care facility that receives federal funding must comply with this executive order by providing language access (free of charge) to LEP individuals. This is also true in areas of law and other fields, but for the sake of this post, we’ll stick to the health care issue at hand.

Unfortunately, many health care facilities will try to get around this law by asking patients to bring a friend or family member who is bilingual, or many times, they’ll have someone on staff come in to “interpret” for LEP patients. For those who work as interpreters and language agency owners or project managers, we know that this is a bigger problem, as those individuals are usually not trained in the medical terminology needed to carry out the appointment, nor are they trained in the fine skill of interpretation. Much of these attempts to weasel one’s way out of providing professional, quality service stems from the fact that these facilities have to foot the bill.

Don’t get us wrong. Many, many hospitals and doctors offices DO comply with Title VI;, however, many, many more do not. According to the National Center on Immigration Policy, LEP individuals accounted for 25.2 million (9%) of the population in 2010, although large concentrations of these demographics were attributed to states like California, Texas, New York, Florida, Hawaii, New Mexico and Massachusetts, among others. More and more states are seeing a rising number in minority populations whose first language is not English. In fact, although the Latino population has had steady growth in the past ten years, just recently, Asian Americans became the fastest-growing minority in the U.S.

So, what does all this have to do with language access in the health care debate?

One of the biggest issues in the political discussion on health care has been cutting costs and allowing all to receive health care and be insured. Although we may not see health care insurance covering the cost of language access for LEP patients anytime soon, we should see money saved by both insurance companies and health care facilities that provide professional language services to patients, as many more individuals will be able to go to the doctor and receive the care they need. Those who do not provide these services, but rather, rely on untrained individuals or (even more sadly) no one at all, will see their costs go up and possibly skyrocket, because miscommunications often lead to more doctor’s visits and adverse events that could have otherwise been avoided by providing proper language access to their LEP patients.

One section of the law discusses the implementation of effective approaches and specifically identifies “the ongoing, accurate, and timely collection and evaluation of data on health care disparities on the basis of race, ethnicity, sex, primary language, and disability status.” This data will be invaluable to many of us and it will be interesting to see if the information on patients’ primary languages affects the way that health care providers are reimbursed for offering professional language access services to patients.

Although up until now health care providers have not reimbursed by Medicare and Medicaid, we may see this change as a result of the passing of the Health Care Law. Provenzano argues, “Ultimately, one of the best arguments for Medicare reimbursement for language services is that the services themselves represent the linguistic equivalent of preventive care. By spending modestly up front to communicate effectively with LEP patients, Medicare—as well as Medicaid and private insurers—can save significantly through the prevention of costly errors.”

For those of us in the interpretation and translation industry, we will see a larger need from our clients who require on-site and telephonic oral interpretation, as well as the translation of vaccination records, consent forms, insurance policies, prescriptions, medical charts, etc. We’ll be on the edge of our seats to see what the next several years hold in store for all of us as Americans, especially LEP patients and we who provide professional language access to them every day.

For more information on LEP rights, please visit http://www.lep.gov/