SPEAKER_01 0:00

Hi, and welcome to Global Interpreting Services Podcast. I'm Don Flanagan, the CEO and President and a Nationally Certified Sign Language Interpreter. And today we're going to talk about medical interpreting with Dr. John Sweetek.

SPEAKER_00 0:13

Hey Don, thanks for having me. So I'm Dr. John Sweetek. I'm Board Certified in Family Medicine and Osteopathic Manipulative Medicine. We run a clinic here in Clinton Township, Michigan, and uh we've been using Global Interpretive Services for quite some time.

SPEAKER_01 0:30

So, how has using interpreters made a difference in your practice or in working with a patient?

SPEAKER_00 0:37

So everything is about communication medicine. We need to make sure our message is clear, we need to make sure the patient's message is clear, we need to make sure we know what their needs are, and we need them to know what we need them to do to have a successful relationship, to have good outcomes, things like that. We can be take care of the patient safely, optimize outcomes, things like that.

SPEAKER_01 1:11

A lot of doctors feel like if they use an interpreter, it's gonna increase the time of the appointment. Um, how do you feel? Does it increase your appointment time?

SPEAKER_00 1:19

That's a good question. I'd say on average it's about the same, which is pretty interesting. Um, I will say some of them will be faster because generally when when patients don't speak English, they would they want to keep it to the point, I'd say, and they do um they keep it brief and succinct, and those can actually be very quick. But also, this is a benefit. Sometimes these patients they're they're neglected in society, they don't have a way to express everything they need to express. So um when they come and they have a translator, they they they're able to uh unload the the burden they're carrying. Um, so we do have some that are a little bit longer. I don't think the translation itself makes it longer. There it's it's pretty efficient. I'd say on average it ends up being about the same, which is uh honest cancer there.

SPEAKER_01 2:12

Great. And so what you're saying is because they haven't been able to communicate effectively with either mental health professionals or other doctors, when they come to you and they use the service, they feel like they can tell you everything that's wrong and really good get good appropriate services.

SPEAKER_00 2:27

Absolutely.

SPEAKER_01 2:28

Are you at all concerned about patient privacy with using um an interpreter or a translator?

SPEAKER_00 2:34

Good question. So, absolutely, privacy is huge, especially in this day and age. Um, I trust you guys, and I haven't had any problems. Um, the the translators are professional, it seems like they're following codes and all their ethical obligations. Um you always worry about I wouldn't just get some random place, find something online, and do some random service. Who knows? Um, I know your team has the training and and the compliance stuff to make sure that stuff stays where it needs to be and kind of go from there.

SPEAKER_01 3:08

The benefit of using interpreters who are professional instead of a family member. So, how do you feel about them using a family member or a friend or child even to or a parent of a child to communicate? How does how do you feel about that personally?

SPEAKER_00 3:24

So that's a big one, and and it's one that we should definitely unpack. So we always, and I think by I think we're obligated, we always offer translator. It's it's up to the patient whether they want to use one or use their own family member. But what I've found is when you use a family member, sometimes I know the language to some extent. I've I've seen a few scenarios. Sometimes a family member will censor um things, um, personal say a certain message and they'll they'll change it a little bit, and it's hard for the patient to know if what's actually being translated, what's being truncated, what's being adjusted. Um, I see that also. Sometimes I see that when they have a family member come talking, they might um the family member might talk for them entirely, and I don't think that's right because I'm trying to tell a person, hey, you gotta do this, and they'll they'll say, Yeah, I don't know if they're actually gonna tell them and stuff like that. So that's a big challenge and a struggle. Um, you always worry if you you don't know what their relationship is. Um I've you wonder if if there's something going on that they're not telling you and they're just giving a different story. Uh fortunately, I think we get to the bottom of it, but when you have a professional translator that's trained, you can get around that stuff. You can make sure the message is clear and it's unfiltered, uncensored, things like that. Um, sometimes, too, I wonder about sensitive topics. Um say, for example, a patient has something to do with mental health they don't want to their family member to know about, they might leave that part out and they're struggling with it, they have no way to get treatment and uh management for that. Um, there's a lot of issues, sometimes sexual health, there's barriers there. It could be anything. There's culturally, you have to be sensitive, and we don't know what they are allowed to talk about, what they're not allowed to talk about. So those are the challenges, and that's all um mostly remedied with having a good translating service.

SPEAKER_01 5:31

Now I know that you are pretty fluent or feel fluent in a language. Has that do you feel okay providing services one-on-one, or have you ever come across a time where you are fluent in a language, you're conversing with the person, but you just don't feel it's working? Have you ever come across that and then used a translator to help?

SPEAKER_00 5:53

Yeah, I'm glad you asked that. And I actually do have a very good um uh example. So I'm fluent in many of the Balkan languages. Um, every once in a while I'll get someone there, there's different dialects where I just can't get the message across, or um it doesn't seem like it's it's clicking, and sometimes I I would still consider myself fluent, but sometimes they just go fast and like I'm like slow down, slow down, I need to process this. Or they assume since I am the level I'm at that I know every single word, and that's not always the case. So um it can be tricky. I know a decent amount of Spanish and stuff, and sometimes we're able to get by, but same thing, once the conversation gets going, they'll just go rapid fire, and I gotta slow it down. Those things are where um a translator helps. But I told you guys a story. So I had a Bulkan patient, and um he's a long-term patient. I think we give long-term care with him. Um, he he came to me on a number of times where um he won't he was requesting a handicap pass, and you need valid medical reasons, there's strict criteria. And I can speak with him pretty fluently. Um, so he was asking for a handicap pass, and I'm like, Well, what's it for? And he's like, for my wife. I'm like, your wife's not even a patient here, I can't give you a handicap pass for your wife. Um, and this guy was so distraught about this. Um, and he came two, three times. I I did always offer the translator, but he he declined it. And he'd say, I need a handicap pass for my wife. I'm like, I can't give you one for your wife. If she's a patient, she has um like the right criteria, we we could help with that, but I I can't just give you one. And I'm like, what about you? Do you have any issues? And the message just wasn't getting across. Finally, I'm like, you know what? You've been here three times, I'm just gonna let's let's get a translator on. And the story unfolded. So he was embarrassed because he has to take his wife to different doctors' appointments at these hospitals and they don't have good parking. And he does have some leg and back issues that weren't bothering him enough to seek direct medical care for, but they certainly were present and they were an issue. So he was embarrassed because he has to take her to these um doctor's visits all over the place, and he can't even get out of the car and walk more than 20 feet to help her out. Um so the fact that we got the translator all opened up the story. Also, we were able to help with those issues too a little bit because now we were aware of them. And um he certainly met multiple criteria, so that was an eye-opener for sure.

SPEAKER_01 8:33

That's wonderful. Using an interpreter when you don't feel like everything is getting across. I mean, even as a sign language interpreter, sometimes you know the message is a little skewed until you can kind of step back and and go forward again. And using an interpreter who's used to doing those kinds of things and getting clarification, that was definitely a win-win for everybody. If you have a patient and they don't understand how to use their medication or to do their physical therapy appropriately, or just follow directions on self-care at home, what do you feel the legal ramifications are if you don't explain that clearly to them and they don't do it properly?

SPEAKER_00 9:11

Um we do, I I believe, and and I think everyone more or less by law needs to have some translators on service or on um on ready on call in case um there is a patient that can't speak English fluently. Um there's penalties for not having that service. Um we do have a few deaf patients, and we've had to use um sign language as well. I I know there's protections for the hard of hearing deaf community, um, so you need that um on standby as well. So having good translators on service helps avoid those penalties um and complaints and things like that. Obviously, if you're not able to um communicate the risks and instructions to the patient and they have a poor outcome, there's there's potential for malpractice um issues. Um there's a lot of different layers to to the regulations that you could violate if you're not using a translator and making sure everyone's on the same page.

SPEAKER_01 10:18

So it's not just about communication and providing, you know, what the law says you have to for communication. There's um responsibility on the part of the doctor and the medical team that they have to ensure that someone has to the best of your ability and their ability, understand what they need to do to have a successful outcome. That's what I'm hearing. That it could be malpractice, it could be all kinds of different things if you don't take care of that. Do you feel that it's morally and ethically appropriate to provide an interpreter rather than um, you know, we we heard the instance about you, you know, trying to get that message across with that fluent language that you speak, but that it just wasn't getting there, and you you finally said, look, this isn't your choice, this is my choice. I want an interpreter so I can make sure it's happening. Um, do you feel that there's moral and ethical obligations about providing interpreting services? Let's say one of your staff members was fluent in Spanish, but you weren't positive that they were fluent in the medical lingo, right? You said that was your tricky part was medical lingo. Do you feel like there's ethical and moral obligations with that to provide a professional person instead of an office person, or are you just trying to work through it?

SPEAKER_00 11:35

Medical lingo is certainly, we can agree, different than everyday lingo. Um, I'd also say this too. We've mentioned cultures a little bit, but um cultures are different. The way people express things are different. Um I I'm trying to think of a good example, but um let's say I had uh a Spanish speaking patient. Um the way they describe their symptoms are, and this isn't across the board, but I've seen this a few times, it's more emotional symptoms and things like that for headache or belly pain. So it was helpful to have a translator to um be able to comprehend that and um make sense of navigate those cultural bumps.

SPEAKER_01 12:22

Yeah, yeah.

SPEAKER_00 12:23

Um, so that's an added added bonus. We were thinking just the language, but it definitely also cultural um differences as well. The ethics that I kind of look at and they taught us in school. Number one is autonomy. You gotta make sure that the patient has um say in their care and they're the ultimate uh decider of it. I tend to really push that one at our practice. I see some places that set that one aside, and the old medical model used to be a little bit more like you do this, but I try to make sure the patient is driving the ship. Um, if they want me to make the decision, I can make it for them, but I'm ultimately leaving it up to them. So, in order to properly give them autonomy in their situation, you need to thoroughly be able to communicate and explain things. Um, you wouldn't be able to say, hey, do you want to do this? Do you want to do this? Do you want to do this? Hey, I see this, these are the options. You can't you can't have that um privilege for the patient if you don't have good communication, in this case through a translator. Number two is do no harm. Um a lot of times, how are you gonna do no harm if you're not getting the full message and you're just throwing random stuff at a person? The next one is beneficence. I might be saying a little bit wrong. I think I got it, but um, it's been a second since we heard them talk about it. That's you gotta do what's best for the patient. Um, what's best for the patient is good communication and and um making sure they understand what's going on. And then justice. I don't know if this one um how this one ties with this one, but I think you could say justice, like some fairness, and then they should have the privilege and right to um to have accurate communication.

SPEAKER_01 14:14

So it's great to to use interpreting services or to have them on standby if you need them. Um you feel that it gives the person who speaks another language or who are deaf or hard of hearing autonomy in their care. So no one is driving the ship for them, they're driving the ship themselves, which is so important. And really what we as interpreters strive for is letting people have that autonomy, and that you want to make sure that they get good, accurate, appropriate care. And by doing all of the things that we talked about, getting effective communication, letting them steer the ship, um, making sure they understand what they need to do in their own care for a successful outcome is so important. So those are some great reasons to provide an interpreter, even if you feel like I don't know, the cost. I mean, was that a concern for you? I it's well, it's got to be a concern for everyone, but was the cost the first thing that struck you as I don't want to pay for it? And you can be honest with us here, that's okay.

SPEAKER_00 15:19

Let me expand on it. I think you guys have been fairly economical. It's um, I know that you might have different plans and stuff, but in our case it's by the minute, and the the cost is reasonable. Um I I don't think it's anything obscene or anything. It it seems like if you you put the little investment in, you'll have a good relationship with the patient. Um, they'll trust you, they'll come to you, you'll you'll end up getting more visits. And usually they have family members or friends that also don't speak English, and they'll bring you more patients, so they'll feel comfortable. So it's it's a good investment all around. Um, I think you guys have been good there and fair there. Um, so that's that's the big one there. I mean, I'll throw in one more um cool thing that I've noticed. I've been impressed with these guys because the speed of getting a translator on has been very fast, and they do have a lot of languages. A few times we had some how would you say remote languages that you don't even know um exist?

SPEAKER_01 16:22

Like the pair languages.

SPEAKER_00 16:23

Yeah, I can't think of any off the top of my head, but I'm like, oh man, I'm gonna be in trouble. Uh how are we gonna do this? And you you you listen to the options and they've been there, so and then I'm like, well, maybe they don't, it's gonna be a while, or they might not have someone on site. They've been very reliable there. I don't think we've ever had a uh instance where we didn't have a translator available. Also, too, um sometimes after hours, I I believe it's a 24-hour service. Um a few times after hours we've needed to make a phone call or something, and um we've been able to uh call a patient and get them on. I don't have too many of those, but I believe we've done that a few times in the past. And not just for the patient visit, um for when patients are being roomed or checkout, things like that. Um they've been helpful there, and it's been great for our patients. They they they love the trust, they've opened up to us, and we've we've improved many lives together, so that's a big one.

SPEAKER_01 17:20

Wonderful. Thank you. Ian, why don't you tell us a little bit about your practice?

SPEAKER_00 17:24

Once again, um I run Sweetek Medical Center. Um, we're a clinic in Clinton Township, Michigan. Um, we like to say we treat people here, not just diseases. We like to be part of people's story and and find out more than just their heart, more than just their knee. We like to treat the people, the patients as a whole person. Um, and that includes their respecting their them as uh as a soul. Um we like uh and I I say this but head to toe, we we all factor everything together. We'd like to be a little bit more forward-thinking. We're not tied to corporate hospitals and things like that, so we can we have a little bit more free reign. Um we'd like to be a little bit forward-thinking, and and my whole team here kind of follows that um that mentality. Um, and I think our patients do like the different flavor that we offer. Um if you ever need anything and you're in the area, we'd be happy to take you on, either you or a loved one or friend, coworker, whatever. Um, once again, that's Sweet Tech Medical Center, and we're in Clinton Township, Michigan.

SPEAKER_01 18:33

Well, thank you for joining me today and for answering those questions and helping to educate um the general public about interpreters and medical services. And thank you for watching. And please check out our social media Facebook, TikTok, Instagram, uh, LinkedIn. We'd love to have you join us. Um, so check out them, check out us, and I will see you soon.