Diamond, L. et al (2009) Getting By: Underuse of Interpreters by Resident Physicians. In Journal of General Internal Medicine, 24(2): 256-262.
Language barriers complicate physician– patient communication and adversely affect healthcare
quality. Research suggests that physicians underuse interpreters despite evidence of benefits and even when services are readily available. The reasons underlying the underuse of interpreters are poorly understood.
20 internal medicine resident physicians from two urban teaching hospitals with excellent
interpreter services participated in the research.
Four recurrent themes emerged:
1) Resident physicians recognized that they underused professional interpreters, and described this phenomenon as “getting by;”
2) Resident physicians made decisions about interpreter use by weighing the perceived value of communication in clinical decision making against their own time constraints;
3) The decision to call an interpreter could be preempted by the convenience of using family members or the resident physician’s use of his/her own second language skills;
4) Resident physicians normalized the underuse of professional interpreters, despite recognition that patients with LEP are not receiving equal care.
Although previous research has identifiedtime constraints and lack of availability of interpreters as reasons for their underuse, our data suggest that the reasons are far more complex. Residents at thestudy institutions with interpreters readily availablefound it easier to “get by” without an interpreter, despite misgivings about negative implications for quality of care. Findings suggest that increasing interpreter usewill require interventions targeted at both individual physicians and the practice environment.