The Minnesota Department of Health gives these recommendations for working with a healthcare interpreter.

As professional interpreters, we often introduce ourselves telling the provider… “and please speak directly to each other. I am simply here to be your voice in the other person’s language, saying exactly what you say.”

Often, doctors inadvertently lapse into this type of conversation…

Dr: Please tell the patient to sit down.

Interpreter: The doctor just asked you to sit down.

[Patient sits down.]

Doctor: Please ask the patient why she came.

Interpreter: The doctor would like to know why you are here.

Patient: Interpreter, what do you think I should tell the doctor? I don’t really know how to explain this…


Now, picture this conversation:

Doctor: Mary, good afternoon.

Interpreter: Good afternoon, Mary.

Mary: Good afternoon, Doctor.

Interpreter: Good afternoon, Doctor.

Doctor: Please sit down, Mary.

Interpreter: Please sit down, Mary.

[Mary sits down.]

Doctor: What brings you here today, Mary?

Interpreter: What brings you here today, Mary?

Mary: Well, Doctor, I was walking down the street, and there was a patch of mud. I slipped, and I think I might have broken something. It hurts a lot. I have had a lot of trouble walking…

Interpreter: Well, Doctor, I was walking down the street, and there was a patch of mud. I slipped, and I think I might have broken something. It hurts a lot. I have had a lot of trouble walking…

What differences do we see in these conversations?

  1. The interpreter is much more unobtrusive in the second one. The interpreter can stay out of side conversations effortlessly.
  2. The message conversion is much simpler, and therefore much more accurate!
  3. The patient is much more respected. The patient is treated just the same way as any other English-speaking patient. This helps the patient participate in his/her own decisions and avoid leaning on the interpreter for decision-making and security.

To encourage this direct communication, interpreters may use a variety of strategies:

  • Gestures, to remind the parties to communicate directly with each other
  • Visually positioning themselves so they are in the line of sight to encourage direct communication between the parties: people address the person they are looking at, so interpreters position themselves in a way to avoid neck strain on the part of the speakers.
  • Maintaining the register and the tone of voice, so the conversation is a true conversation
  • Interrupting the conversation as little as possible: using note-taking to allow the parties to express as complete of a thought as possible before interrupting the flow of their thinking.
  • Wearing clothing that does not attract attention to the interpreter.
  • Stepping out of the room every time the provider steps out of the room: when there is nobody who does not speak a language the patient does not understand, the interpreter is not needed. These may be good moments for the interpreter to clarify issues with the provider, if needed.

As interpreters, our goal is, as the Oregon Court Interpreters say, “to put the non-English speaker on the same footing as an English speaker”.

According to CLAS Standard 5, one of the purposes of language assistance is

  • To help individuals understand their care and service options and participate in decisions regarding their health and health care

The Oregon Law states that interpreters must follow the Standards of Practice of the National Council for Health Care Interpreters. On page 13, Standard of Practice #12 states:

The Interpreter promotes direct communication among all parties in the encounter.

For example, an interpreter may tell the patient and provider to address each other, rather than the interpreter.

Related ethical principle: Interpreters treat all parties with respect.