Blame the beurocrats running your hospital. The systems were in place, just have been absolutely gutted.
Blame the beurocrats running your hospital. The systems were in place, just have been absolutely gutted.
I think it'd probably be nice if there was an english fluent person on staff at the emerg but I think it's unreasonable to expect local clinics to have support for translating especially when English is a rather unlikely language to be spoken in that area - having someone German and Italian literate would be nice and having someone Spanish literate (and, ideally, Basque literate) would be much more important.
If you're running a hospital in Vancouver you better have a French[1], Punjabi and Mandarin translator on staff - outside of those I think it's reasonable to rely on tools like Google Translate, it sucks but full language coverage isn't reasonable.
1. I think a French translator might be legally required due to the bilingual nature of Canada but it's honestly much less common on the west coast compared to Punjabi and Mandarin.
I think I could have been successful if I knew some French, but alas, I opted for Spanish in high school. At the time it seemed Bulgarians over a certain age had French for their second (or third) language, and the younger folks had English.
Yes this happens in Spain too. People over 50 or 55 or so were taught French at school but younger people were taught English.
However don’t expect most of them to speak much of it.
This isn't too far off how prescriptions work in many places in europe, east or west. If you're lucky, they'll hand-write instructions on the box (that are incomprehensible to me).
For added confusion, the chemists don't count pills/break packages. So if your order is for 7 doses, but they come in boxes of 5, you'll get 10 doses.
Or even a longer-term immigrant who never quite learned much medical vocabulary.
Far better than what was possible before, when as a tourist you maybe had a phrasebook or something similar.
This is part of the risk of travel into an area where you don't know the language.
Also if you are going to permanently move to such a place, it's incumbent on you to become functionally fluent in the local language. Nobody there owes you a special accomodation.
Functional fluency doesn't really cover hospital interactions though, right? I can live for decades in Paris without knowing what the word for chest pains or sprained ankle are.
I could certainly say “chest pain” though.
Of course nobody owes anybody anything. I do think that in countries with nationalized health care, at the very least having a call center to help out with language difficulties around this feels like almost a no brainer though.
There are doctors with specialized dictionaries and the like as well, of course.
And... yeah honestly, Google Translate (or my favorite solution of "go to wikipedia page and find the linked article in local language") can help a lot.
The only real benefit I found to in person is that it's a bit more personal feeling and you don't have as many issues with the patient not hearing what they said on the tablet and vice-versa.
I found the language barriers are not a huge deal with options like this. I've also worked for a 911 call center taking ambulance calls and it's much harder to manage language barriers there as it can be hard to tell someone who speaks none of your language that you're getting a translation service on the line.
One Guatemalan defendant who natively spoke a Mayan language had to go through a chain of three court-appointed interpreters: one from his language to a different, more widely-spoken Mayan language, one to go from that to Spanish, and one from Spanish to English. He told my friend (his lawyer) something like: “this is amazing; in Guatemala they’d have just told me ‘sorry, the national language is Spanish’ and I’ve had been out of luck!”
I don’t believe it would be legally possible in the US to convict a monolingual Khmer speaker of a crime without providing an interpreter, in Miami or anywhere else.
It is a balance of features vs price. Right now, we need to do absolutely everything we can to keep the price of medical care as low as possible.
In the US it might make sense for most hospitals to have people on staff for Spanish. I don't think we as a country can afford 270 other languages of full time staff. We should use tech in any way possible to cut this cost.
Thanks, monopolies.
AFAICT, over the past 150+ years, a qualitative argument like this is made every time a skilled job can be replaced by automation, but the automation wins anyway. The automation quality ends up improving to the point where the economics are inescapable.
When it comes to comparisons with other countries, much of the dialogue in the US is centered on insurance coverage. That said, I'm curious if other countries have found better solutions to similarly fundamental issues, such as doctors working long hours, doctors being forced to maximize the number of patients, continued medical education, and patient education about the doctor-patient relationship.
From what I remember: Insurance is one reason, Hospitals not engaging in collective bargaining (e.g. vs. NHS in England which makes decisions about what to spend money on and makes companies bid on contracts for the whole country), wasteful premium care that adds little to patient outcomes (e.g. vs Singapore which has a privatised tiered healthcare system but heavily regulates healthcare so this doesn't happen), and simply paying Doctors far more money.
Biggest problem (w.r.t. provider overwork and availability) is regulatory capture by AMA and hospital groups. The AMA has for decades induced an artificial shortage of MDs by limiting the number of available residency slots. In particular, there's an acute shortage of slots for primary care providers (gen practice, family med, internal medicine, OBGYN) - which combined with financial incentive, leads to an oversupply of specialists.
AMA is also very assertive about keeping alternative providers (e.g. nurse practitioners) from having the rights to perform certain procedures - again as a form of financial protectionism. I'm picking the worst possible example, because it goes wrong all the time, but in many LatAm countries for example, routine x-rays and ultrasounds are often read by technologists rather than radiologists. Broadly speaking, there's a chilling effect of provider liability, in that your PCP may not be a dermatologist, so instead of doing a mole screen themselves during your annual office visit, they send you for a specialist visit instead of doing it in house (to avoid the unlikely chance they miss something subtle the derm might've caught) - costing more money, fueling the oversupply of specialty care, and letting the "general" skills of GPs atrophy even further.
TLDR: The American Medical Association kills people.
P.S. I found this tidbit on tobacco particularly troublesome [2].
[1] - https://en.wikipedia.org/wiki/American_Medical_Association#C...
[2] - https://www.sourcewatch.org/index.php/American_Medical_Assoc...
What would be your middle-ground proposition for the large swath of doctor cabinets and hospitals who won't win/can't afford enough of the on-staff interpreters lottery and still get patients that need support in different languages ?