Dear Medical Team,
Do you know who are you letting into your exam rooms? Sure, you check to make sure you have the right patient. But when an interpreter is present, do you also check to make sure you have the “right” interpreter?
I’m not referring to the interpreter who speaks the required language. (Although it is a good idea to make sure that you have an Urdu interpreter when needed and not a Kurdish interpreter). I’m also not referring to the interpreter who is assigned to the appointment. (Although it is a good idea to make sure of that, too, since Interpreter Services Departments invest quite a bit in planning the logistics for the daily demands.)
I am referring to making sure that the person you’ve identified as the interpreter is, in fact, the interpreter. Let me elaborate…
Just because the person accompanying the patient speaks two languages and assists with some communication needs doesn’t mean that that person is the interpreter. The person could be a family member, a co-worker, a faith community acquaintance, or any number of other people who might have a legitimate reason to accompany the patient to the medical facility. (Note: The fact that someone accompanies a person to a medical facility – the building – doesn’t automatically give that person the right to be part of the patient’s medical encounter. Think about it. If you bummed a ride from your neighbor, would you want them sitting in the exam room while you hash over your stuff with the doctor? I’m guessing not.) At any rate, it is literally not safe to assume that the bilingual person with the patient is the interpreter.
To show that this is not hypothetical hyperbole, I’ll illustrate with one true situation:
The patient registrar assumed that the bilingual person with the patient was the interpreter and so progressed with registering the patient for the clinic appointment. When the actual interpreter arrived a few minutes later, the registrar was confused since someone else was already there interpreting. After a little clarification, it was quickly discovered that the assumed interpreter was, in fact, a bilingual employee of the transportation company who was teaching the patient how to use their transportation services to independently get to and from medical appointments. The medical transportation employee spoke average Spanish – enough to establish rapport and give basic instructions related to transportation services. This person was definitely not the interpreter and didn’t claim to be either. The clinic staff member made an assumption that could have created a really sticky situation had it not been caught and corrected in time.
Just because a person identifies as the interpreter doesn’t mean that is the person you contracted for the assignment. There are instances when the interpreter contracted for the event cannot make it. Unfortunately, in some cases those interpreters take it upon themselves to recruit someone else to cover the assignment in their place. This “replacement recruit” might not even be an interpreter.
To show that this is not hypothetical hyperbole, I’ll illustrate with one true situation:
The staff questioned if the interpreter present was really an interpreter. Why was that? Because in a previous encounter, the person who showed up and identified as the interpreter said, “Sorry, I don’t have any documents for you to sign regarding the service I provided. My aunt was supposed to be here to interpret, but since she couldn’t make it, she called me last minute to come in her place.” To make matters worse, the staff also learned that the nephew had no training or qualifications to interpret and had no binding agreement to abide by HIPAA or any other professional or legal standards.
Just because a person presents documentation that appears legitimate, doesn’t mean it is. There are instances when people will present training course certificates, certification documents, and even ID badges that look impressive and even legitimate. Unfortunately, there are cases when these documents are falsifications. Sometimes it is an obviously altered document; other times it is nearly impossible to tell that it isn’t legitimate.
Instead of sharing a true situation, I’ll direct you to two sites, as examples, where you can see for yourself that misrepresentation of qualifications and credentials does happen:
https://cchicertification.org/sanctions/
https://www.atanet.org/about-us/code-of-ethics/sanctioned-members/
What can you do to make sure the person you are letting into the exam room is in fact the legitimate interpreter? Here are a few suggestions:
Work with reputable service providers with a proven track record of professional integrity. Legitimate and trustworthy business entities – no matter their size – will not engage in shady business practices.
Check the interpreter’s ID badge before proceeding with the encounter. The ID badge should have a photo of the person and other identifying features, including their name and organization they represent.
Verify the legitimacy of any documentation (i.e., certificate, attestation, ID badge, etc.) of qualifications or credentials with the organization that is listed on the document.
Bonus tip: pay attention to expiration dates for certification; interpreters need to meet renewal requirements, such as completing continuing education activities, to maintain their certification over the years.
The age-old adage of “trust but verify” is a fitting rule of thumb.
Final thought for this PSA: Don’t think that fraudulent activities are limited to interpreters who are present onsite; it can happen in telephonic and video modalities, too.