BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less satisfactory communication with physicians; few have studied how actual communication takes place through an interpreter in a clinical setting. OBJECTIVE: Record and analyze physician-interpreter-patient interactions. DESIGN: Primary care physicians with high-volume Hispanic practices were recruited for a communication study. Dyslipidemic Hispanic patients, either monolingual Spanish or bilingual Spanish-English, were recruited on the day of a normally scheduled appointment and, once consented, recorded without a researcher present in the room. Separate postvisit interviews were conducted with the patient and the physician. All interactions were fully transcribed and analyzed. PARTICIPANTS: Sixteen patients were recorded interacting with 9 physicians. Thirteen patients used an interpreter with 8 physicians, and 3 patients spoke Spanish with the 1 bilingual physician. APPROACH: Transcript analysis based on sociolinguistic and discourse analytic techniques, including but not limited to time speaking, analysis of questions asked and answered, and the loss of semantic information. RESULTS: Speech was significantly reduced and revised by the interpreter, resulting in an alteration of linguistic features such as content, meaning, reinforcement/validation, repetition, and affect. In addition, visits that included an interpreter had virtually no rapport-building "small talk," which typically enables the physician to gain comprehensive patient history, learn clinically relevant information, and increase emotional engagement in treatment. CONCLUSIONS: The presence of an interpreter increases the difficulty of achieving good physician-patient communication. Physicians and interpreters should be trained in the process of communication and interpretation, to minimize conversational loss and maximize the information and relational exchange with interpreted patients.
BACKGROUND: Numerous articles have detailed how the presence of an interpreter leads to less satisfactory communication with physicians; few have studied how actual communication takes place through an interpreter in a clinical setting. OBJECTIVE: Record and analyze physician-interpreter-patient interactions. DESIGN: Primary care physicians with high-volume Hispanic practices were recruited for a communication study. Dyslipidemic Hispanic patients, either monolingual Spanish or bilingual Spanish-English, were recruited on the day of a normally scheduled appointment and, once consented, recorded without a researcher present in the room. Separate postvisit interviews were conducted with the patient and the physician. All interactions were fully transcribed and analyzed. PARTICIPANTS: Sixteen patients were recorded interacting with 9 physicians. Thirteen patients used an interpreter with 8 physicians, and 3 patients spoke Spanish with the 1 bilingual physician. APPROACH: Transcript analysis based on sociolinguistic and discourse analytic techniques, including but not limited to time speaking, analysis of questions asked and answered, and the loss of semantic information. RESULTS: Speech was significantly reduced and revised by the interpreter, resulting in an alteration of linguistic features such as content, meaning, reinforcement/validation, repetition, and affect. In addition, visits that included an interpreter had virtually no rapport-building "small talk," which typically enables the physician to gain comprehensive patient history, learn clinically relevant information, and increase emotional engagement in treatment. CONCLUSIONS: The presence of an interpreter increases the difficulty of achieving good physician-patient communication. Physicians and interpreters should be trained in the process of communication and interpretation, to minimize conversational loss and maximize the information and relational exchange with interpreted patients.
Authors: Alicia Fernandez; Dean Schillinger; Kevin Grumbach; Anne Rosenthal; Anita L Stewart; Frances Wang; Eliseo J Pérez-Stable Journal: J Gen Intern Med Date: 2004-02 Impact factor: 5.128
Authors: Carol M Ashton; Paul Haidet; Debora A Paterniti; Tracie C Collins; Howard S Gordon; Kimberly O'Malley; Laura A Petersen; Barbara F Sharf; Maria E Suarez-Almazor; Nelda P Wray; Richard L Street Journal: J Gen Intern Med Date: 2003-02 Impact factor: 5.128
Authors: Anna M Nápoles; Jasmine Santoyo-Olsson; Leah S Karliner; Steven E Gregorich; Eliseo J Pérez-Stable Journal: Med Care Date: 2015-11 Impact factor: 2.983
Authors: Richard B Lipton; Steven R Hahn; Roger K Cady; Jan Lewis Brandes; Suzanne E Simons; Philip A Bain; Meaghan R Nelson Journal: J Gen Intern Med Date: 2008-05-06 Impact factor: 5.128