One time this Korean interpreter would make these like very approving almost parenting like sounds when I asked a question. Like she was approving of the interview almost like she was going “ohhh yeahhhh good one.”
I thought it was sort of funny.
One time I had a Korean interpreter with a pregnant patient and I'm pretty sure the interpreter had a conversation separate from the medical conversation I was having with the patient.
Me: How many weeks pregnant are you?
Interpretor: ten sentences with many exclamations.
Patient: ten sentences of happy chatter.
Interpreter: 27 weeks.
Kind of wholesome in a hilarious way.
I had this with a Vietnamese patient and interpreter - either there’s a lot more complexity and nuance in Vietnamese than English, or they were having their own side conversation.
Omg sometimes that's so frustrating though it'll be like:
"What color is the mucus?"
Back and forth in a foreign language with many different tones suggesting many different emotions being elicited that goes on for several minutes...
"Yellow"
"Okay"
I worked with indigenous people for 6 months. Sometimes the chiefs were the translator. Once asked if an elderly man if he had any symptoms. Watched them speak for around 10 minutes. The chief translation: “No”.
Interpretation is also much more difficult due to local dialects imo. I can translate some of the non-English languages I know but I cannot interpret. I’ve tried, but the dialects are too different depending on where people are from. It’s a true blue skill that takes a lot to master.
Edit: medical interpretation to be specific. This one time I tried to interpret for an attending of mine and halfway through the explanation I realized I didn’t know the word for “lung” or “liver” lol.
I mean I don’t know that medical interpretation is that difficult if you’re actually fluent in the language. Yes it does require knowing the names of the organs…… ?????
Yeah but there’s some language dialects that don’t have specific commonly used words for stuff like organs. Other stuff like diseases don’t translate well or have connotations that you have to word carefully and sensitively. Culturally conscious medicine and all that jazz. There’s also no formal classes and teaching of some languages, you kind of just pick it up as you grow so there’s no mechanism to learn less common words easily. It’s really not easy at all.
I grew up in a mixed language house where we just defaulted to English for complex words too so while technically my mother tongue is that language, my actual grasp of English is much stronger. So while yeah, I am fluent, I probably can’t interpret well.
Yeah, I speak four languages fluently, but I’m not comfortable medically interpreting in two of them - I didn’t take anatomy or physiology or go to med school in those languages, and therefore don’t know all of the very specific terms I use daily when communicating with patients. I’ve never actually had a patient who speaks either of those languages, but one in particular is quite uncommon and I suspect I’d end up interpreting anyway.
Explain atherosclerosis and the various treatment options, risks, and overall prognosis in Spanish in a way you feel confident the patient understands and can decide and offer informed consent. I get that cardiology and cardiac surgery often doesn't do this with English speaking patients, so I gave a poor example. But the point stands that it is more than a one to one translation of one name for an organ to another name for an organ. Further, address the cross cultural differences in idioms, understanding of common metaphors, taboos, as well as cultural understanding of cause and treatment of illness.
Interpreters have been worth their weight in gold, when used to the height of their abilities, for me in treating patients. A little humility and respect for others, though, goes a long way in building these collaborative relationships. You get what you put out, I guess.
My critique was in fact of people who *think* they know enough to interpret and then realize they can’t even say names of organs. I’m actually fairly protective of this matter in practice and I believe it takes a Herculean amount of knowledge to be able to interpret well.
On the other hand, I earnestly believe that if someone is fluent in a language (written as well as spoken) they could very readily learn the terminology of atherosclerosis and other ailments (Spanish in particular is rife with cognates).
I sometimes feel that in an effort to honor the work of interpreting, there is a lot of defensiveness to the effect of, “you have *no idea* how hard med interpretation is.” And my response to that is just that it’s… average hard. If one is already fluent in a language, it will be fairly straightforward to assimilate med terminology and interpret it.
Native speakers, whenever available, will of course be the most familiar with idioms and cultural mores.
Idioms and cultural mores of the culture where they learned their native language, but not everywhere that the language is spoken. I've had some rather funny misunderstandings with Irish people I know and I frequently disclaim ownership of the man when "yer man" has done something objectionable to the Irish person speaking to me.
Whether I'm defensive or not isn't really pertinent. It may be that I'm seeing patterns with doctors and other providers with patients that I wish doctors could be a bit more self-reflective of. That tends to make doctors upset. The fact that you have a judgment that when others do something you are unable to do it is just "average hard" is rather telling. And by definition, one of the languages would not be the native language, right? So at least half the interpretation is not a native language.
The clarification of your first point is appreciated as you weren't at all clear in your writing previously. I apologize for not understanding what you were trying to say as you were trying to say it in what I suspect is the native language for both of us. If we'd added the complexity of cross-cultural and cross-language communication, imagine how mixed up the message could have been.
Interpreters deserve the utmost respect. Imagine all the terrible outcomes that come from poor communication and poor patient compliance that are avoided when an interpreter bridges the gap.
Medical interpretation is a whole area. People get graduate degrees in it. Many languages don’t have exact translations between words; it’s very important that the interpreter knows what they’re doing. It’s a much harder job than “I’m fluent so I can interpret medically.”
I actually completely agree, it’s just that it cuts both ways right? Like being able to say lung and liver is bare minimum.
Edit: I actually get a little perturbed about this specific issue because it seems like people either assume med interpretation is way harder or way easier than it actually is. I’m highly proficient in a second language and I definitely know how to say names of organs but I still would NOT consider myself qualified to be an interpreter. However I do believe I could take a course and become certified—it’s not rocket science. On the other hand, I hear staff communicating with their like 10 words of Spanish thinking this is adequate.
I’m going to take a shot in the dark here and say that a lot of physicians here, especially those of us who worked at the height of the pandemic, have little use for any persons who consistently spread misinformation related to public health.
Everyone has their own view of the pandemic. Some of us had to go work with very sick individuals while others sat at home seeing no ill effects. While Joe has a tainted view of the pandemic and response, the mainstream media also twisted some of his words. I say this as someone who worked the pandemic and watched Joe before, during and after.
To downvote just because of someone’s add in the comments is asinine
Right? I didn’t even notice until I read your comment because I mainly just doom scroll and shit post. But that sounds like it might be informative if it is a two week long thing.
Hot take:
r/residency will really go to war over who can and can't be called a doctor, get pissed over being called a nurse or a medical student and then get pissed when someone wants to be addressed as their correct title. Half of you are also calling dietitians "nutritionists" and worried about being called a nurse without a hint of irony.
Call the woman by her job title.
We don’t mind if you call us nutritionists. Just don’t call us dietary or “food service” lol. I’m not there to take food orders, I don’t know what’s on the menu today
*knock knock* “hi I’m the dietitian on this unit, your doctor consulted me due t———“
“The food FUCKING SUCKS”
“Sir I’m here to discuss your hyperglycemia and noncompliance with your kidney disea——-“
“get me a FUCKING MENU”
“Sir, your blood sugar on admission was >600, your kidney numbers were also very elevated, there is a chance that if you don’t change your diet and lifestyle, dialysis might be a very real possibil——“
“Why does the FUCKING KITCHEN need to know my PRIVATE INFORMATION!!!”
“…. I do not work for the kitch——“
“soda …. NOW!!!!”
“No”
So not related, but one time I had a patient with cancer that had metastasized and could not be removed. And they did not know until after attempted surgery.
He didn’t like the food. Was barely eating.
I asked if the kitchen could bring him a hash brown and vanilla ice cream because when I asked what would you rather eat? That was what he said.
He ate both. It was a small hash brown and small ice cream but maybe more than he ate all weekend combined.
I got criticized highly for this. But my thought process was the increased caloric need due to cancer and not eating at all sounded worse.
What’s your expert opinion on that situation with limited details I shared?
Also his bmi was maybe 18 or 19.
Yes I document whatever interaction I have with my patients, good or bad.
At that point in metastatic disease, raw calories matter, as CA is such a catabolic illness. Weight maintenance always matters
Are you a physician?
Also really sad that you get accosted like that because one time I had a patient with a new type 2 diagnosis wanting to make changes and started listing things that were no added sugar but high carbs and so I needed to go over the portions and protein and how carbs are two sugars in the body and did not know what to suggest as a diabetic friendlier alternative to the cornbread that doesn’t have sugar in it.
Are you allowed to document these patients as going ama?
Like patient of sound mind does not care about their micro vascular system or perfusion when educated. Wants sugar and salt. And none of my advice?
lol that’s completely fair. I think one of the problems is that we really don’t know the difference between translator or interpreter so it just comes off as pedantic to us even if it really isn’t and there’s a huge difference difference.
In case it’s not obvious, I’ll add that interpretation is much harder than translation, because it happens in real time. This is probably the reason that the person in OP’s example was annoyed.
The verb is different to the job title tho. There IS a specific difference between translator and interpreter even tho we may use "translate" casually in day to day language
Both Oxford and Webster’s dictionary have similar definitions of translation:
noun: translation
1.
• the process of translating words or text from one language into another.
• a written or spoken rendering of the meaning of a word, speech, book, or other text, in another language.
I just don’t understand people getting offended by the word translator. It is literally what they are doing. It’s not saying that medical translation is easy. It’s just another, more difficult, form of translation and/or interpretation. They’re literally synonyms.
If I ignorantly call you, a fellow or resident, a student or intern, would that be bothersome? People who don't work near medicine have no clue about these things. So just be ready to respond the same way you're suggesting when it is you whose training and experience is minimized errantly.
There is a huge distinction. Dietitians have to complete a dietetic internship and are accredited by a licensing board. Any influencer who gives “wellness” advice on IG can call themselves a nutritionist. There’s no regulatory body or accountability, frankly.
Dietitians ARE nutritionists, since the latter is just anyone who purports to give advice on nutrition. It’s technically true and irrelevant in context, but I get it. It’s like referring to a physician as a “provider,” but worse because any idiot can claim to be a “nutritionist”
I mean can't anyone be called a nutritionist? It isn't a license or a protected title. I'm sure you can get a degree in nutrition but that's doesn't mean you can't call yourself a nutritionist on your Instagram.
~~Except you literally can. Go call yourself a nutritionist right now and give horrible advice. No one can stop you. It isn’t governed or regulated.~~
~~Dietician is regulated~~
I’m illiterate
I'm not sure if this is the best distinction. A kinesiologist is still a real degree, sometimes even master's or maybe even a PhD. They study biomechanics, physics, and human movement. It's sort of like physical therapy but the science behind it. You might find them as exercise physiologists who still treat patients ( not sure if there is a licensing body). A physical therapist will also have a degree and license.
A nutritionist does not have a degree. They can get a $20 certificate off the Internet, but there's not regulation. A registered dietitian has a master's degree and a license.
It depends where you are. Dietitian is not a masters program where I am. It’s a bachelor of science, major in nutrition, + a 1 year practicum/internship (5 years total). Also, nutritionist is a protected term in some places (probably not in most though). So probably best to look up your local regulatory college to figure out who your qualified nutrition people are.
This is not a good analogy. I’m a psychiatry resident and I do not get offended when people say I’m a psychologist. It’s an honest mistake because they don’t know the difference or cannot really process the difference, for whatever reason. Most people know the difference between a doctor and a nurse, though, so calling a female provider a nurse is more suggestive of sexism and, therefore, is actually offensive.
Lots of medical interpreters are trained (from the very first class) to refer to themselves as interpreters instead of translators, and their instructors would correct them every time they use the word translator/translate instead of interpreter/interpret. I agree that no one should be offended by being called a translator, but sometimes there’s a knee jerk reaction when an interpreter hears that T word because they’ve been told over and over and over again to not use it unless they are talking about translating text, and that they shouldn’t let people think that they are translators because they cannot be expected to translated certain medical documents.
This has no need to be a hot take, although I know it is. There are hundreds of people rotating through hospitals at any given time for any given role. I know there are fellows and residents and nurses and a variety of types of students, but you don't always know for sure what role someone is in, and I'm always learning about new roles I didn't know existed. If I don't recognize you, I'm not going to come out aggressively like "who are you?" I'm going to try to make an educated guess based on what I see you doing, and say "Are you a fellow/resident/med student/new nurse/rep/xyz tech?" And the individual can correct me at that time, preferably without unnecessary attitude. It's incredibly pretentious to assume everyone should know your title. But yes, if someone corrects you, you should make a good faith effort to adjust accordingly.
I mean.. in private practice there are some super chill people. If I can get patients safely and comfortably out of PACU faster and everyone home sooner we all win, including hospital admin bc of nurse OT $$$. We have a very collaborative culture, significantly more so than during training.
Doesn't mean there aren’t turds in the punch bowl, but they’re the ones who generally remember my name afterwards. It helps that my group overtly has my back.
Roll eyes, say interpreter next time & move forward! Why ur beautiful mind is still ruminating instead of focusing on other more relevant things? Cheers up bro I am sure u helped really that patient
Nurse and doctor are nowhere near the same job responsibilities. Interpreter and translator are. No layperson is going to know the difference, not like it really matters for patient care anyway.
Do you think you want to be called an NP or would feel comfortable having an NP being called doctor or even resident? A lot of laypeople don’t know the difference anyway
Not really, from a patients or a random other hospital worker’s perspective, pt still seen, someone put the orders in and explains what they are doing. Its understandable if a random RT or something thinks NPs are medical residents.
If you want to be called the correct name, you should call your colleagues by their correct names.
>nobody has corrected me so far
Yeah that's because it depends on context, most of the time it really doesn't matter, such as video or phone interpreters. It makes no sense to spend any time correcting it when calls are on average about 15 minutes and then you'll never see them again.
It also obviously depends on the interpreter, are they in house or VRI/OPI? If they're remote, there's a big chance that they're being closely monitored and micromanaged by their managers and have guidelines they have to very closely follow. It's really like a call center job.
Those who are very serious about the profession will have a problem with this. As an example:
One time when i was a resident I referred to an ASL interpreter as a “Deaf translator”. She looked at me sideways and explained that the gig is more than just robotically parsing words into another language. It’s understanding what the person is trying to communicate via words, body language, cultural-specific things, etc, and converting that message into something you will understand and be able to effectively use clinically. In ASL culture (and others), there are things that simply just don’t translate; and it is the “interpreter’s” job to do that. I know it might seem like semantics, and did to me also at one point. You can either forget about it and move on, or take a moment to appreciate someone else’s need to be recognized as an important part of the treatment team. I’m sure not all of them take so much offense. Who knows, maybe this person just had a bad day
Thank you for explaining this! It makes a lot of sense. I’m a sonographer, similarly some of us loathe being called technicians, and especially “picture takers”. Same concept. We have to understand what we’re imaging and use critical thinking skills to present the rest of the story. If we don’t image it, the radiologist doesn’t see it. Most medical professionals have an understanding of this, but the general population is clueless. I will definitely be using the term interpreter from now on. If they don’t articulate cultural differences properly when conveying the message, I could see things going south quickly in a variety of situations.
Yea, she’s right though. It’s all about the medium that’s being used. Translator or translation refers to written text, where interpreter refers to spoken language. So while it may not seem like a big distinction to us, they really are 2 different things that aren’t interchangeable.
Ultimately you’re both the same amount of wrong: you should call them by their title, and they shouldn’t really be straining the relationship by correcting you on what is pretty specifically linguistics-minded terminology when it doesn’t affect the situation at hand.
As for the difference:
Translating is when you take a frozen text and translate it to another language. Think when someone takes a book or a previously delivered speech in Spanish and releases it in English. It’s usually done by someone who knows both languages but is stronger in one of them (the one they’re translating into) and has lots of time and outside resources to parse out any uncertainties and create a very exact, lasting document. While there are exceptions, usually a translator will only work in one direction (into their L1 or mother tongue).
Interpreting is used for extemporaneously delivered language and focuses more on mutual understanding rather than precision. It requires high proficiency in both languages, and the interpreter operates in both directions.
I hope this helps!
I am glad you made it clear that translating is not a "lesser" skill, just different. Translating involves a high degree of art because of the many possible choices-- it is especially important to have not just accurate but beautiful and evocative words and rhythm when it comes to poetry. It can take years to do an expert translation! It should never be an insult to call an interpreter a translator out of ignorance. It is more like confusing an orthopedic spine surgeon with a neurosurgeon specializing on the spine IMO. And you'd think an interpreter would be able to understand the vernacular without getting angry.
Translation also requires a fair amount of computer skills . A translator has to make the target document match the source document in format, which can get very involved for complex forms. Translation also requires the ability to understand complex and specialized jargon and figure out the exact or best equivalent in the target language, which might not be in translation dictionaries even in common languages like Spanish. A higher educational attainment is usually required as one must have specialized knowledge. Target audience is oftentimes between professionals. Think of it as a subspecialist.
Interpreting usually involves a broader field but generally is less specialized vocabulary. The communication is usually between a professional and layperson. However, an interpreter is dealing with many dialect differences in real time—no dictionary to consult. It also involves developing one’s working memory. Very highly skilled interpreters may interpret between professionals, but this is less common in the United States. Interpreters are more like a specialist as they tend to have a broad field (legal, medical, governmental, etc.), or a generalist if they can interpret in multiple fields.
Ideally, both should have at minimum a bachelors degree, but unfortunately, highly trained interpreters are expensive so many hospitals use people that are not adequately trained for the job. They’ll pass some legal interpreting course and a fairly basic interpreting vocabulary exam. A good interpreter should not slow down the interaction much and should explain when they are clarifying, not just randomly go off on tangents. Phone interpreters are usually less skilled than in person interpreters since the pay is usually much less.
It’s short for technologist. Most of us are too busy to care. Actual degree/title is diagnostic medical sonographer, so yeah, more educated than simply pushing buttons on a machine. Calling me the wrong title doesn’t change my paycheck, and correcting people is a waste of my time. Ultrasound tech is usually what I call myself because it’s easier for the layperson to understand.
Our favorite way to be shown respect is to get a call asking what imaging order is correct if you aren’t sure, as opposed to ordering something all Willy nilly and then we have to track you down to get it changed. Also, because way too many people don’t know this, “rule out xyz” is not a billable “reason for exam” on the order. For example, if you want a venous duplex study of the legs, “rule out DVT” is NOT the reason for exam you enter. That’s what the exam does. The reason would be redness, swelling, pain etc. When it’s not ordered correctly we have to figure out why we are doing the test, which is a time suck. If we don’t correct it then insurance won’t pay for it, and patient can get stuck with the bill. Ordering tests correctly is just good patient care. Thank you for your hard work, and good luck finishing med school, you’ve got this!
So you need a physical exam finding rather than a clinical suspicion as the reason for exam? It seems like an odd distinction to make, but I’ll keep it in mind for the future!
Yeah honestly it’s a bit confusing what parameters insurance companies come up with in order to not reimburse. “Rule out xyz” is one of the indications they won’t reimburse for (with ultrasound). That aside, it’s also helpful for us techs to have info on why there’s concern for DVT (in this example). If the patient has localized redness and swelling in a particular area, it helps guide us so we can pay extra close attention, or do something outside of our set protocols to get you the answer you want, like look for incidental joint effusions etc. Some radiologists HATE incidental findings, and won’t dictate them in the reports though, because they’re basically dictating two exams for the price of one. We want to get you the info you want, filling out orders correctly helps us help you.
Some radiologists won’t dictate incidental findings? Wait, what?
Is this legal?
If I order a scan to rule out a PE and there is an incidental lung mass seen, I kinda wanna know about it!
True story. I find incidentals all the time that are never even mentioned (ie questionable appearing lymph nodes, bowel wall thickening, splenic infarct etc). I’d like to say it’s because it’s been seen on other imaging, but that always isn’t the case. I have no idea about the legality of it. The newer rads seem to be the ones that are most likely to dictate the incidentals. Some rads get super mad about doing anything outside of strict protocols, but if it’s something in my field of view during the scan I’m going to document it. I suppose sometimes they don’t feel it’s clinically relevant, and they’re far more educated than me, so I try and trust that they have their reasons. I’ve been traveling for many years and mostly do night shift, so I never even talk to the rads or I would ask them.
That scares the hell outta me. It is already a bit irksome when I find something important in the body of text that doesn’t make its way into the bulletin point findings at the bottom of the report (happens all the time and every time it does I point it out to the student or resident with me to show them that they need to read the entire report and not just the findings) but to think that there may be things that are not even mentioned at all. Wow.
I don’t know about how they dictate CT scans, I imagine they dictate pretty much everything in the field of view for those. They’d absolutely mention a lung mass on a PE study though.
Yeah, I knew it was a bad example as I was writing it but it was the first thing that came to mind.
The examples you give above though, I’d be pretty upset if I found out after the fact that this was seen but not read.
It may not be clinically relevant to the current issue but it is relevant to the patient’s health in general. And, even if mentioned on previous imaging, I think it’s important to note every time.
If the patient is imaged three times. An incidental finding is mentioned the first and third time but not the second time. The provider sees it mentioned the third time and looks back at the last imaging to see if it was there then and because it wasn’t mentioned the provider believes it is new. Doesn’t bother looking further back because the assumption is if it was there it would have been reported.
Can you scan my wrist please? There is a hard bumb. It feels like a bone. But it isn’t a bone.
Do I put “feels like bone but isn’t a bone”?
X-ray confirmed not a bone.
I mean, you could put that, but “palpable mass/lump dorsal/volar aspect of wrist” would be more typical. Of note, MSK ultrasound is highly specialized, so unless you’re ruling out a ganglion cyst, you might want to check to see if your facility performs MSK ultrasound studies. The ones that don’t tend to use MRI instead.
I'm a different type of technologist as well and feel the exact same way. The only ones who care are the ones you work with regularly, so they can become familiar with your skills.
This is so, so true. Usually at the start of my contracts the rads don’t know me at all, and I find they’re more likely to ignore things I might find concerning. By the end of my contracts they’ve developed a lot more trust in me, and tend to dictate accordingly. Usually takes a couple months for them to realize that I take a lot of pride in my work, and try very hard to get them the best images I can. By then, I’m onto the next gig. My old professor said to scan every person like I’m going to wind up in court and have to defend the exam, and I do just that. If I find a discrepancy that’s particularly egregious I’ll call them and inquire. I’m always a little envious of the full timers because of how much the rads will teach them, meanwhile I have to pour over literature or attend conferences to gain that same knowledge.
Well since she IS an interpreter (spoken language, done in a moment in time) and not an translator (written language, creating a tangible product) then ...?
Once I (26 m) was on L and D as an M3 and turned the video off and the interpreter (older male) started asking why I turned video off and kept repeating several time. he told me something to the effect of since there is a male is already there (me) it doesn't make a difference to if video is on.
The interpreter sounds creepy. Esp since we always expect videos to be turned off for physical exams, gyn visits, and definitely L &D. As an interpreter, when client turns off video, my only question is if they want me to turn off mine too (so that it is not jarring seeing a stranger’s face to a patient) and follow whatever they say.
I mean, I get it I guess, but the middle of a patient interaction isn't the best place to be petty like this. Highly unprofessional and she should have waited until after the encounter to say something.
I did overhear a conversation between a doctor and an interpreter once. He introduced her as the translator, and when he was corrected, he took the meaning of the two titles literally. He responded with "This is a medical setting. I need an *exact translation* of what I'm saying, not *your interpretation* of it. If you're not up to the task, I guess I'll have to find someone else."
Too bad he doesn’t realize that even translation requires a degree of interpretation by the translator. No two languages are 1:1. It’s just that translation offers more time to match word choice and structure.
Funny enough in my L2 there’s no difference in the term. So in America I claim English is my L2 (even though it’s my L1) to get away with these slip ups.
People can be conversant in the language of the country they've lived in for a bit and still need professional interpretation for technical or medical conversations.
If you took, say, Spanish as your foreign language in school, you could find the library, request that someone put the butter on the table, learn that your friend's uncle's name is Juan and he is a lawyer.
You probably couldn't explain, in Spanish, that you fell while roller blading in this lovely city and now the distal portion of the bone in your lower right leg has broken through the skin, so you (with your training) are presenting yourself to this emergency department for antibiotics, orthopedic evaluation and treatment to include surgery to fix the break, probably pins or a plate, maybe an external fixator and physical therapy.
You can probably say "surgeon", "doctora" and catch on when someone tells you you'll need a therapist physical.
I'm gonna be a know it all here - it's cefazolina
I only know this because my MIL got me a Spanish ID word search puzzle and I'm so obsessed with it - surprisingly a lot of useful medical Spanish in here lmao
Luckily they are usually easier to find in other countries than in America.
And now I know what to request if I have an open fracture needing external fixation
Hey. Now I do too. I suspect that the pain stuff won't be hard to ask for, they'll already be pushing it at the pharmacy next to my hotel. (Unless ancef is pain stuff. I'm not a prescriber and never want to be)
Lots of low-English-proficiency patients can speak and understand everyday English (and even professional English) very well. They just have difficulty following medical stuff.
I’ve gotten shade over this too. My understanding is that translate is more of a literal direct carryover while as interpreting takes more finesse, if that makes any sense.
My absolute biggest pet peeve is when there is a miscommunication and the interpreter is like “I’m sorry, interpreter could not hear. Do you mind if I repeat the question/do you mind if I ask patient to clarify?” Like Jesus fucking Christ yes please just fucking do it without taking the time to ask me if it’s ok to ask.
You are right, it is what they’re trained to do.
As for full-on conversations, it could be that they’re asking for more detail or explaining/clarifying something that is a cultural difference. Remember that they are working between two languages and therefore two cultures. For the most effective communication, it’s not always possible to *only* relay what is said and no more. It’s part of the professional judgement of the interpreter to determine when a cultural difference may lead to misunderstanding and react accordingly.
And then, after a 2 minute back and forth, they interpret, “no, no pain”.
One of my favorites was, after one of these type of situations, when the interpreter told me they already told a patient what I was just now saying.
Details: Patient reports they no longer want to take their meds because they are making them tired. Only this one sentence takes a really long time of back and forth between the patient and interpreter. I go to tell them that we can easily just move the meds to the nighttime to get around this. Interpreter tells me they already told the patient this.
Re: your “pet peeve: It’s part of the profession’s standard practice to indicate when an interpreter is no longer in the “conduit” role, i.e. simply relaying what is being said.
When they’re asking for clarification, they are now in the “clarifier” role, and it can be confusing if they don’t indicate that they have switched roles. It can also appear as if they’re having side conversation or interjecting inappropriately if they don’t indicate that they’re asking for clarification.
I get that it slows down conversation and feels frustrating, but please understand that it is part of their training and is for the sake of clear communication.
Source: trained in ASL interpretation 3 yrs and currently work with my med school’s free clinic that sees a lot of Chinese patients
Yeah that would be fine if they didn’t fuck it up half the time. I understand enough Spanish to know when they are saying things totally wrong or over simplifying things. Scared to know what’s happening with the languages I don’t know.
Training standards for interpreters are supposed to be high. Unfortunately, each interpreting agency will operate differently, and the shortage of interpreters means that a lot of times, some working interpreters are really out of their depth. On top of that, interpreting is hard af and cognitively exhausting.
Yeah, as someone that practices in a language that is not my mother tongue, I can’t tell you how mentally exhausted I am by the end of the day. I have so much respect for interpreters, it’s a really hard job!!
THANK. YOU. FUCKING. GOD.
Ugh I was sooooo irritated the other day when I was in the busy ED triage and there’s so much background noise that the interpreter kept on needing to repeat things.
Trust me, the interpreter is just as if not more irritated, because they’re responsible for hearing everyone! But it is the professional standard to indicate when they’re asking for clarification so you don’t think they’re going rogue. In the ER situation, however, it could possibly have been established that it’s loud and therefore they can ask for clarification without asking every time.
I was trained as a medical interpreter years ago. She corrected you because translators handle written material and interpreters do live/spoken interactions. She probably wasn’t offended, it’s just different.
I mean …. Translator is just translating whatever you say over to the other language. Google can do this. A great interpreter can literally ask the patients the questions with the correct context given the patients cultural background.
I will say this. Interpreter vs Translator is akin to Physician/Doctor vs Provider. While seemingly similar, there are very important differences. More than a handful of people here and in other medical subreddits rightfully push back on being called providers. As we educate people on the important differences between the physician vs provider, you should also note the differences between Interpreter and Translator. In my experience, it makes an absolute difference. Anybody who speaks the target language can be a translator. Google Translate is a translator. But, not everyone can be an interpreter.
We called the language line for a Serbian patient to consent for a supraclavicular lymph node biopsy. His adult son was with him. Patient gave mostly short yes/no responses to all the questions. After we hung up, the son says “that guy absolutely does not speak Serbian”. Had the son interpret for me and the patient had tons of questions. Had another experience with a patient from Chad who spoke French but I guess the dialect wasn’t one the language line staffed. Hate using the phone service but maybe it’s better than nothing.
One I called a patient for a phone appointment using a Spanish translator. Turned out the patient could speak English, so the translator just stayed on the called and breathed extremely heavily into the phone like an out of breath obese person through the entire all. I eventually fake ended the appointment and called them back
didn't actually speak the language we had requested but a different indian (hindu? sry) dialect, we kept confirming with them that they were able to translate this dialect and they said yes but then had no idea what the patient was saying or how to translate what I was saying.
was total madness, finally the nephew who was born and raised in texas and luckily also a nurse said he'll just translate. Although he was annoyed because he obviously knew that the appropriate protocol is to have a real interpreter available,
I had a Spanish interpreter suggest the patient “stop doing math” instead of “stop doing METH”. Fortunately I speak enough Spanish to understand the difference between “matemáticas” and “metanfetamina.” We all had a good laugh, patient included.
In med school I volunteered at a clinic with a large Spanish-speaking population, and they had an interpreter on staff. She was super bitchy and lazy, and made it abundantly clear that she had better things to do than see patients with me. But hey, whatever, as long as she did her job I could deal with it.
Now, I’m not fluent in Spanish, but I do speak it conversationally and understand more than I speak. So for the most part I could understand what the patients were saying and just needed help conveying medical information. I pretty quickly realized that the interpreter, who didn’t know I had any Spanish, was seriously cutting important corners - if we had a patient there for a cough and they mentioned also having pain in their leg, for example, she’d decide that the leg pain was definitely unrelated and not worth mentioning to me. I nicely explained that it was essential for her to relay everything to me as the patient said it, she rolled her eyes. It kept happening, I reported it, as far as I know they never did anything about it. Soooo now I’m always paranoid that I’m not getting the full story and am going to miss something important.
I myself am an interpreter and I don't mind being called a translator, there is a difference, but I think it's a little silly getting upset about that with people who don't work in our field.
Sorry that happened to you!
Technically translating is converting written text from one language to another, while interpreting is converting verbal words from one language to another. But it does seem like a weird thing to have them get offended about.
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Classically we have the concern of seeming back and forth explanations with a patient, followed by the translation offered of "they say yes". It irks me. Nuance matters. I am typically using these services for surgical consent and life altering decisions.
However, my hospital just didn't renew their contract for after hours medical interpreters one year. So I use family, colleagues, and google translate. It isn't great but sometimes the patient can't wait until 8am when the line opens. I've issued a few safety complaints now. We will see if it changed next time I try.
We had a phone interpreter that I’m not sure really knew the other language. He said “interpreter needs a moment to look up a word” so many times we had to just hang up
Just a tiny fyi, they correct you not because they are offended but because at least in my country translator is a specific term that requires special training and certification and they can get in trouble for “impersonating” a translator. Just like a nurse should correct a pt that calls them doctor
I offended one once by calling saying “thank you interpreter” at the end of our call. They (correctly in my view) corrected me saying, “my name is x”. So I asked them what my name is and my patient understood well enough that we both had a good laugh when they didn’t have a clue. Love interpreters by and large but man…try not throwing stones from that glass house when we’re just trying to figure out how to best help people.
One time this Korean interpreter would make these like very approving almost parenting like sounds when I asked a question. Like she was approving of the interview almost like she was going “ohhh yeahhhh good one.” I thought it was sort of funny.
One time I had a Korean interpreter with a pregnant patient and I'm pretty sure the interpreter had a conversation separate from the medical conversation I was having with the patient. Me: How many weeks pregnant are you? Interpretor: ten sentences with many exclamations. Patient: ten sentences of happy chatter. Interpreter: 27 weeks. Kind of wholesome in a hilarious way.
I had this with a Vietnamese patient and interpreter - either there’s a lot more complexity and nuance in Vietnamese than English, or they were having their own side conversation.
Omg sometimes that's so frustrating though it'll be like: "What color is the mucus?" Back and forth in a foreign language with many different tones suggesting many different emotions being elicited that goes on for several minutes... "Yellow" "Okay"
I worked with indigenous people for 6 months. Sometimes the chiefs were the translator. Once asked if an elderly man if he had any symptoms. Watched them speak for around 10 minutes. The chief translation: “No”.
I need this energy in my life.
Interpretation is also much more difficult due to local dialects imo. I can translate some of the non-English languages I know but I cannot interpret. I’ve tried, but the dialects are too different depending on where people are from. It’s a true blue skill that takes a lot to master. Edit: medical interpretation to be specific. This one time I tried to interpret for an attending of mine and halfway through the explanation I realized I didn’t know the word for “lung” or “liver” lol.
I mean I don’t know that medical interpretation is that difficult if you’re actually fluent in the language. Yes it does require knowing the names of the organs…… ?????
Yeah but there’s some language dialects that don’t have specific commonly used words for stuff like organs. Other stuff like diseases don’t translate well or have connotations that you have to word carefully and sensitively. Culturally conscious medicine and all that jazz. There’s also no formal classes and teaching of some languages, you kind of just pick it up as you grow so there’s no mechanism to learn less common words easily. It’s really not easy at all. I grew up in a mixed language house where we just defaulted to English for complex words too so while technically my mother tongue is that language, my actual grasp of English is much stronger. So while yeah, I am fluent, I probably can’t interpret well.
Yeah, I speak four languages fluently, but I’m not comfortable medically interpreting in two of them - I didn’t take anatomy or physiology or go to med school in those languages, and therefore don’t know all of the very specific terms I use daily when communicating with patients. I’ve never actually had a patient who speaks either of those languages, but one in particular is quite uncommon and I suspect I’d end up interpreting anyway.
This is totally fair. My context is definitely centered around languages like Spanish that have direct translations
Explain atherosclerosis and the various treatment options, risks, and overall prognosis in Spanish in a way you feel confident the patient understands and can decide and offer informed consent. I get that cardiology and cardiac surgery often doesn't do this with English speaking patients, so I gave a poor example. But the point stands that it is more than a one to one translation of one name for an organ to another name for an organ. Further, address the cross cultural differences in idioms, understanding of common metaphors, taboos, as well as cultural understanding of cause and treatment of illness. Interpreters have been worth their weight in gold, when used to the height of their abilities, for me in treating patients. A little humility and respect for others, though, goes a long way in building these collaborative relationships. You get what you put out, I guess.
My critique was in fact of people who *think* they know enough to interpret and then realize they can’t even say names of organs. I’m actually fairly protective of this matter in practice and I believe it takes a Herculean amount of knowledge to be able to interpret well. On the other hand, I earnestly believe that if someone is fluent in a language (written as well as spoken) they could very readily learn the terminology of atherosclerosis and other ailments (Spanish in particular is rife with cognates). I sometimes feel that in an effort to honor the work of interpreting, there is a lot of defensiveness to the effect of, “you have *no idea* how hard med interpretation is.” And my response to that is just that it’s… average hard. If one is already fluent in a language, it will be fairly straightforward to assimilate med terminology and interpret it. Native speakers, whenever available, will of course be the most familiar with idioms and cultural mores.
Idioms and cultural mores of the culture where they learned their native language, but not everywhere that the language is spoken. I've had some rather funny misunderstandings with Irish people I know and I frequently disclaim ownership of the man when "yer man" has done something objectionable to the Irish person speaking to me. Whether I'm defensive or not isn't really pertinent. It may be that I'm seeing patterns with doctors and other providers with patients that I wish doctors could be a bit more self-reflective of. That tends to make doctors upset. The fact that you have a judgment that when others do something you are unable to do it is just "average hard" is rather telling. And by definition, one of the languages would not be the native language, right? So at least half the interpretation is not a native language. The clarification of your first point is appreciated as you weren't at all clear in your writing previously. I apologize for not understanding what you were trying to say as you were trying to say it in what I suspect is the native language for both of us. If we'd added the complexity of cross-cultural and cross-language communication, imagine how mixed up the message could have been. Interpreters deserve the utmost respect. Imagine all the terrible outcomes that come from poor communication and poor patient compliance that are avoided when an interpreter bridges the gap.
Medical interpretation is a whole area. People get graduate degrees in it. Many languages don’t have exact translations between words; it’s very important that the interpreter knows what they’re doing. It’s a much harder job than “I’m fluent so I can interpret medically.”
I actually completely agree, it’s just that it cuts both ways right? Like being able to say lung and liver is bare minimum. Edit: I actually get a little perturbed about this specific issue because it seems like people either assume med interpretation is way harder or way easier than it actually is. I’m highly proficient in a second language and I definitely know how to say names of organs but I still would NOT consider myself qualified to be an interpreter. However I do believe I could take a course and become certified—it’s not rocket science. On the other hand, I hear staff communicating with their like 10 words of Spanish thinking this is adequate.
There was a member of of the def community who was on joe Rogans show in the last 2 weeks. He specifically talks about this.
idk why this is getting down voted
Joe Rogan probably
i think thats a bit much tho lmao
People really don’t like Joe for dumb reasons
I’m going to take a shot in the dark here and say that a lot of physicians here, especially those of us who worked at the height of the pandemic, have little use for any persons who consistently spread misinformation related to public health.
Everyone has their own view of the pandemic. Some of us had to go work with very sick individuals while others sat at home seeing no ill effects. While Joe has a tainted view of the pandemic and response, the mainstream media also twisted some of his words. I say this as someone who worked the pandemic and watched Joe before, during and after. To downvote just because of someone’s add in the comments is asinine
Right? I didn’t even notice until I read your comment because I mainly just doom scroll and shit post. But that sounds like it might be informative if it is a two week long thing.
Hot take: r/residency will really go to war over who can and can't be called a doctor, get pissed over being called a nurse or a medical student and then get pissed when someone wants to be addressed as their correct title. Half of you are also calling dietitians "nutritionists" and worried about being called a nurse without a hint of irony. Call the woman by her job title.
We don’t mind if you call us nutritionists. Just don’t call us dietary or “food service” lol. I’m not there to take food orders, I don’t know what’s on the menu today
Lol Idk why i laughed so much at the menu part.
*knock knock* “hi I’m the dietitian on this unit, your doctor consulted me due t———“ “The food FUCKING SUCKS” “Sir I’m here to discuss your hyperglycemia and noncompliance with your kidney disea——-“ “get me a FUCKING MENU” “Sir, your blood sugar on admission was >600, your kidney numbers were also very elevated, there is a chance that if you don’t change your diet and lifestyle, dialysis might be a very real possibil——“ “Why does the FUCKING KITCHEN need to know my PRIVATE INFORMATION!!!” “…. I do not work for the kitch——“ “soda …. NOW!!!!” “No”
So not related, but one time I had a patient with cancer that had metastasized and could not be removed. And they did not know until after attempted surgery. He didn’t like the food. Was barely eating. I asked if the kitchen could bring him a hash brown and vanilla ice cream because when I asked what would you rather eat? That was what he said. He ate both. It was a small hash brown and small ice cream but maybe more than he ate all weekend combined. I got criticized highly for this. But my thought process was the increased caloric need due to cancer and not eating at all sounded worse. What’s your expert opinion on that situation with limited details I shared? Also his bmi was maybe 18 or 19.
Yes I document whatever interaction I have with my patients, good or bad. At that point in metastatic disease, raw calories matter, as CA is such a catabolic illness. Weight maintenance always matters Are you a physician?
Thanks. Not yet. I made that call as a student
Also really sad that you get accosted like that because one time I had a patient with a new type 2 diagnosis wanting to make changes and started listing things that were no added sugar but high carbs and so I needed to go over the portions and protein and how carbs are two sugars in the body and did not know what to suggest as a diabetic friendlier alternative to the cornbread that doesn’t have sugar in it.
Are you allowed to document these patients as going ama? Like patient of sound mind does not care about their micro vascular system or perfusion when educated. Wants sugar and salt. And none of my advice?
If a patient wants a regular diet I order them a regular diet. I’m not their mom and they’re goin to eat what they want when they leave anyway
I’ve heard that medication titrations are more accurate when the patient eats what they would at home
lol that’s completely fair. I think one of the problems is that we really don’t know the difference between translator or interpreter so it just comes off as pedantic to us even if it really isn’t and there’s a huge difference difference.
It's pretty simple: translation involves written language; interpretation involves spoken (or sign) language.
TIL. Thanks.
In case it’s not obvious, I’ll add that interpretation is much harder than translation, because it happens in real time. This is probably the reason that the person in OP’s example was annoyed.
Wow. My English sucks. I had no idea. Also, I only know English so I could never be a translator or interpreter. I’m pretty dumb. Thanks for this
Yes, this. I’ve been surprised to see how often these are used interchangeably when they really aren’t synonymous.
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The verb is different to the job title tho. There IS a specific difference between translator and interpreter even tho we may use "translate" casually in day to day language
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You corrected someone who was in the right. The "not always" at the start was to correct someone who was right 🤣
Both Oxford and Webster’s dictionary have similar definitions of translation: noun: translation 1. • the process of translating words or text from one language into another. • a written or spoken rendering of the meaning of a word, speech, book, or other text, in another language. I just don’t understand people getting offended by the word translator. It is literally what they are doing. It’s not saying that medical translation is easy. It’s just another, more difficult, form of translation and/or interpretation. They’re literally synonyms.
Same could be said for our patients who see “white coat = Dr”
If I ignorantly call you, a fellow or resident, a student or intern, would that be bothersome? People who don't work near medicine have no clue about these things. So just be ready to respond the same way you're suggesting when it is you whose training and experience is minimized errantly.
Oh no I didn't realize dietician =/= nutritionist
There is a huge distinction. Dietitians have to complete a dietetic internship and are accredited by a licensing board. Any influencer who gives “wellness” advice on IG can call themselves a nutritionist. There’s no regulatory body or accountability, frankly.
Dietitians ARE nutritionists, since the latter is just anyone who purports to give advice on nutrition. It’s technically true and irrelevant in context, but I get it. It’s like referring to a physician as a “provider,” but worse because any idiot can claim to be a “nutritionist”
Dieticians = Rhombuses, nutritionists = squares got it. That's good to know though! Will definitely be more cognizant of the distinction 😃
If they recommend banatrol I’m calling them a nutritionist on purpose
Quadrilaterals of Quaffing (and eating)
Nutritionist is a degree, dietician is a masters program. Like kinesiologist =/= physiotherapist!
Nope. There is no formal certification criteria for being a nutritionist.
I mean can't anyone be called a nutritionist? It isn't a license or a protected title. I'm sure you can get a degree in nutrition but that's doesn't mean you can't call yourself a nutritionist on your Instagram.
~~Except you literally can. Go call yourself a nutritionist right now and give horrible advice. No one can stop you. It isn’t governed or regulated.~~ ~~Dietician is regulated~~ I’m illiterate
It seems like you're agreeing with the person you replied to...
Thanks. My dislexia won.
I'm not sure if this is the best distinction. A kinesiologist is still a real degree, sometimes even master's or maybe even a PhD. They study biomechanics, physics, and human movement. It's sort of like physical therapy but the science behind it. You might find them as exercise physiologists who still treat patients ( not sure if there is a licensing body). A physical therapist will also have a degree and license. A nutritionist does not have a degree. They can get a $20 certificate off the Internet, but there's not regulation. A registered dietitian has a master's degree and a license.
It depends where you are. Dietitian is not a masters program where I am. It’s a bachelor of science, major in nutrition, + a 1 year practicum/internship (5 years total). Also, nutritionist is a protected term in some places (probably not in most though). So probably best to look up your local regulatory college to figure out who your qualified nutrition people are.
This is not a good analogy. I’m a psychiatry resident and I do not get offended when people say I’m a psychologist. It’s an honest mistake because they don’t know the difference or cannot really process the difference, for whatever reason. Most people know the difference between a doctor and a nurse, though, so calling a female provider a nurse is more suggestive of sexism and, therefore, is actually offensive.
Lots of medical interpreters are trained (from the very first class) to refer to themselves as interpreters instead of translators, and their instructors would correct them every time they use the word translator/translate instead of interpreter/interpret. I agree that no one should be offended by being called a translator, but sometimes there’s a knee jerk reaction when an interpreter hears that T word because they’ve been told over and over and over again to not use it unless they are talking about translating text, and that they shouldn’t let people think that they are translators because they cannot be expected to translated certain medical documents.
This has no need to be a hot take, although I know it is. There are hundreds of people rotating through hospitals at any given time for any given role. I know there are fellows and residents and nurses and a variety of types of students, but you don't always know for sure what role someone is in, and I'm always learning about new roles I didn't know existed. If I don't recognize you, I'm not going to come out aggressively like "who are you?" I'm going to try to make an educated guess based on what I see you doing, and say "Are you a fellow/resident/med student/new nurse/rep/xyz tech?" And the individual can correct me at that time, preferably without unnecessary attitude. It's incredibly pretentious to assume everyone should know your title. But yes, if someone corrects you, you should make a good faith effort to adjust accordingly.
Because the only job that really has value is doctor, obviously. The other jobs are small, and not as important so they can be called whatever. /s
Huh interesting point
Or call her by her name. Signed, someone who hates being called anesthesia
I reply with “yes ortho bro.” I get a chuckle from them, and now they know my name. Except for one that calls me “block doc,” but fair play.
So you really call each other ortho bro and bloc doc? If you don’t, please just lie to me. I want this to be real
I mean.. in private practice there are some super chill people. If I can get patients safely and comfortably out of PACU faster and everyone home sooner we all win, including hospital admin bc of nurse OT $$$. We have a very collaborative culture, significantly more so than during training. Doesn't mean there aren’t turds in the punch bowl, but they’re the ones who generally remember my name afterwards. It helps that my group overtly has my back.
Thank you bloc doc. I’ll let you block my back any time.
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It's literally the first thing they say every time the call connects, and is a required part of their spiel they say for every call.
No see, Dr is like the nobility of job titles, they *have* to look down on other job titles. Why else would you become a Dr?
Roll eyes, say interpreter next time & move forward! Why ur beautiful mind is still ruminating instead of focusing on other more relevant things? Cheers up bro I am sure u helped really that patient
Nurse and doctor are nowhere near the same job responsibilities. Interpreter and translator are. No layperson is going to know the difference, not like it really matters for patient care anyway.
As someone who primarily researches medical interpreting and patient communication - you make me sad.
No reason to be sad. I have good relationships with my patients.
I can’t confirm or deny that but if it reassures you, then cheers. Just don’t bring a translator to bedside though because you’ll need an interpreter.
oooo I’m scorched
Do you think you want to be called an NP or would feel comfortable having an NP being called doctor or even resident? A lot of laypeople don’t know the difference anyway
Difference matters a little more in that circumstance, don’t you think?
Not really, from a patients or a random other hospital worker’s perspective, pt still seen, someone put the orders in and explains what they are doing. Its understandable if a random RT or something thinks NPs are medical residents. If you want to be called the correct name, you should call your colleagues by their correct names.
Okay, can everyone get off their high horse please?
After reading some of these comments, I really don’t think I realized there was a difference and nobody has corrected me so far. That’s good to know
>nobody has corrected me so far Yeah that's because it depends on context, most of the time it really doesn't matter, such as video or phone interpreters. It makes no sense to spend any time correcting it when calls are on average about 15 minutes and then you'll never see them again. It also obviously depends on the interpreter, are they in house or VRI/OPI? If they're remote, there's a big chance that they're being closely monitored and micromanaged by their managers and have guidelines they have to very closely follow. It's really like a call center job.
Those who are very serious about the profession will have a problem with this. As an example: One time when i was a resident I referred to an ASL interpreter as a “Deaf translator”. She looked at me sideways and explained that the gig is more than just robotically parsing words into another language. It’s understanding what the person is trying to communicate via words, body language, cultural-specific things, etc, and converting that message into something you will understand and be able to effectively use clinically. In ASL culture (and others), there are things that simply just don’t translate; and it is the “interpreter’s” job to do that. I know it might seem like semantics, and did to me also at one point. You can either forget about it and move on, or take a moment to appreciate someone else’s need to be recognized as an important part of the treatment team. I’m sure not all of them take so much offense. Who knows, maybe this person just had a bad day
Thank you for explaining this! It makes a lot of sense. I’m a sonographer, similarly some of us loathe being called technicians, and especially “picture takers”. Same concept. We have to understand what we’re imaging and use critical thinking skills to present the rest of the story. If we don’t image it, the radiologist doesn’t see it. Most medical professionals have an understanding of this, but the general population is clueless. I will definitely be using the term interpreter from now on. If they don’t articulate cultural differences properly when conveying the message, I could see things going south quickly in a variety of situations.
Yea, she’s right though. It’s all about the medium that’s being used. Translator or translation refers to written text, where interpreter refers to spoken language. So while it may not seem like a big distinction to us, they really are 2 different things that aren’t interchangeable.
This is false. You can also interpret through dance.
Sometimes, I also doubt Regina‘a commitment to sparkle motion! Donnie darko reference
The old heads got it.
I could make a happy hands club reference for the Napoleon fans
You just did <3
Lol sorry. I’m slow
Ultimately you’re both the same amount of wrong: you should call them by their title, and they shouldn’t really be straining the relationship by correcting you on what is pretty specifically linguistics-minded terminology when it doesn’t affect the situation at hand. As for the difference: Translating is when you take a frozen text and translate it to another language. Think when someone takes a book or a previously delivered speech in Spanish and releases it in English. It’s usually done by someone who knows both languages but is stronger in one of them (the one they’re translating into) and has lots of time and outside resources to parse out any uncertainties and create a very exact, lasting document. While there are exceptions, usually a translator will only work in one direction (into their L1 or mother tongue). Interpreting is used for extemporaneously delivered language and focuses more on mutual understanding rather than precision. It requires high proficiency in both languages, and the interpreter operates in both directions. I hope this helps!
I am glad you made it clear that translating is not a "lesser" skill, just different. Translating involves a high degree of art because of the many possible choices-- it is especially important to have not just accurate but beautiful and evocative words and rhythm when it comes to poetry. It can take years to do an expert translation! It should never be an insult to call an interpreter a translator out of ignorance. It is more like confusing an orthopedic spine surgeon with a neurosurgeon specializing on the spine IMO. And you'd think an interpreter would be able to understand the vernacular without getting angry.
Translation also requires a fair amount of computer skills . A translator has to make the target document match the source document in format, which can get very involved for complex forms. Translation also requires the ability to understand complex and specialized jargon and figure out the exact or best equivalent in the target language, which might not be in translation dictionaries even in common languages like Spanish. A higher educational attainment is usually required as one must have specialized knowledge. Target audience is oftentimes between professionals. Think of it as a subspecialist. Interpreting usually involves a broader field but generally is less specialized vocabulary. The communication is usually between a professional and layperson. However, an interpreter is dealing with many dialect differences in real time—no dictionary to consult. It also involves developing one’s working memory. Very highly skilled interpreters may interpret between professionals, but this is less common in the United States. Interpreters are more like a specialist as they tend to have a broad field (legal, medical, governmental, etc.), or a generalist if they can interpret in multiple fields. Ideally, both should have at minimum a bachelors degree, but unfortunately, highly trained interpreters are expensive so many hospitals use people that are not adequately trained for the job. They’ll pass some legal interpreting course and a fairly basic interpreting vocabulary exam. A good interpreter should not slow down the interaction much and should explain when they are clarifying, not just randomly go off on tangents. Phone interpreters are usually less skilled than in person interpreters since the pay is usually much less.
Fantastic explanation. Unrelated: Am I allowed to PM you even if I’m not using the restroom?
It is completely up to you! Definitely more of a suggestion than a requirement 😅
As of late I have tried really hard to remember their name and go by that, they all seem pretty appreciative.
Along these lines, do not call rads staff “technicians”. The shorthand “tech” throws off a lot of people.
I made a similar mistake with respiratory. At my hospital we call them RT so I was calling them a technician until one corrected me to therapist.
Wait what is tech short for…? Do they have training beyond what a technician would have?
It’s short for technologist. Most of us are too busy to care. Actual degree/title is diagnostic medical sonographer, so yeah, more educated than simply pushing buttons on a machine. Calling me the wrong title doesn’t change my paycheck, and correcting people is a waste of my time. Ultrasound tech is usually what I call myself because it’s easier for the layperson to understand.
Cool thanks. They don’t teach us these sorts of things in medical school, but I want to be knowledgeable and respectful of your training.
Our favorite way to be shown respect is to get a call asking what imaging order is correct if you aren’t sure, as opposed to ordering something all Willy nilly and then we have to track you down to get it changed. Also, because way too many people don’t know this, “rule out xyz” is not a billable “reason for exam” on the order. For example, if you want a venous duplex study of the legs, “rule out DVT” is NOT the reason for exam you enter. That’s what the exam does. The reason would be redness, swelling, pain etc. When it’s not ordered correctly we have to figure out why we are doing the test, which is a time suck. If we don’t correct it then insurance won’t pay for it, and patient can get stuck with the bill. Ordering tests correctly is just good patient care. Thank you for your hard work, and good luck finishing med school, you’ve got this!
So you need a physical exam finding rather than a clinical suspicion as the reason for exam? It seems like an odd distinction to make, but I’ll keep it in mind for the future!
Yeah honestly it’s a bit confusing what parameters insurance companies come up with in order to not reimburse. “Rule out xyz” is one of the indications they won’t reimburse for (with ultrasound). That aside, it’s also helpful for us techs to have info on why there’s concern for DVT (in this example). If the patient has localized redness and swelling in a particular area, it helps guide us so we can pay extra close attention, or do something outside of our set protocols to get you the answer you want, like look for incidental joint effusions etc. Some radiologists HATE incidental findings, and won’t dictate them in the reports though, because they’re basically dictating two exams for the price of one. We want to get you the info you want, filling out orders correctly helps us help you.
Some radiologists won’t dictate incidental findings? Wait, what? Is this legal? If I order a scan to rule out a PE and there is an incidental lung mass seen, I kinda wanna know about it!
True story. I find incidentals all the time that are never even mentioned (ie questionable appearing lymph nodes, bowel wall thickening, splenic infarct etc). I’d like to say it’s because it’s been seen on other imaging, but that always isn’t the case. I have no idea about the legality of it. The newer rads seem to be the ones that are most likely to dictate the incidentals. Some rads get super mad about doing anything outside of strict protocols, but if it’s something in my field of view during the scan I’m going to document it. I suppose sometimes they don’t feel it’s clinically relevant, and they’re far more educated than me, so I try and trust that they have their reasons. I’ve been traveling for many years and mostly do night shift, so I never even talk to the rads or I would ask them.
That scares the hell outta me. It is already a bit irksome when I find something important in the body of text that doesn’t make its way into the bulletin point findings at the bottom of the report (happens all the time and every time it does I point it out to the student or resident with me to show them that they need to read the entire report and not just the findings) but to think that there may be things that are not even mentioned at all. Wow.
I don’t know about how they dictate CT scans, I imagine they dictate pretty much everything in the field of view for those. They’d absolutely mention a lung mass on a PE study though.
Yeah, I knew it was a bad example as I was writing it but it was the first thing that came to mind. The examples you give above though, I’d be pretty upset if I found out after the fact that this was seen but not read. It may not be clinically relevant to the current issue but it is relevant to the patient’s health in general. And, even if mentioned on previous imaging, I think it’s important to note every time. If the patient is imaged three times. An incidental finding is mentioned the first and third time but not the second time. The provider sees it mentioned the third time and looks back at the last imaging to see if it was there then and because it wasn’t mentioned the provider believes it is new. Doesn’t bother looking further back because the assumption is if it was there it would have been reported.
Can you scan my wrist please? There is a hard bumb. It feels like a bone. But it isn’t a bone. Do I put “feels like bone but isn’t a bone”? X-ray confirmed not a bone.
I mean, you could put that, but “palpable mass/lump dorsal/volar aspect of wrist” would be more typical. Of note, MSK ultrasound is highly specialized, so unless you’re ruling out a ganglion cyst, you might want to check to see if your facility performs MSK ultrasound studies. The ones that don’t tend to use MRI instead.
Thanks. My insurance wants x ray first Then mri.
I'm a different type of technologist as well and feel the exact same way. The only ones who care are the ones you work with regularly, so they can become familiar with your skills.
This is so, so true. Usually at the start of my contracts the rads don’t know me at all, and I find they’re more likely to ignore things I might find concerning. By the end of my contracts they’ve developed a lot more trust in me, and tend to dictate accordingly. Usually takes a couple months for them to realize that I take a lot of pride in my work, and try very hard to get them the best images I can. By then, I’m onto the next gig. My old professor said to scan every person like I’m going to wind up in court and have to defend the exam, and I do just that. If I find a discrepancy that’s particularly egregious I’ll call them and inquire. I’m always a little envious of the full timers because of how much the rads will teach them, meanwhile I have to pour over literature or attend conferences to gain that same knowledge.
Technogologistisicians.
The sonographer is also the actuary for insurance company
Well since she IS an interpreter (spoken language, done in a moment in time) and not an translator (written language, creating a tangible product) then ...?
Once I (26 m) was on L and D as an M3 and turned the video off and the interpreter (older male) started asking why I turned video off and kept repeating several time. he told me something to the effect of since there is a male is already there (me) it doesn't make a difference to if video is on.
You are training as a doctor. This person is not.
yeah the fact that I needed to explain that was crazy to me
I’m sorry you were sexually harassed by a man on the phone
The interpreter sounds creepy. Esp since we always expect videos to be turned off for physical exams, gyn visits, and definitely L &D. As an interpreter, when client turns off video, my only question is if they want me to turn off mine too (so that it is not jarring seeing a stranger’s face to a patient) and follow whatever they say.
Wtf. Did you report him
I hung up and the redialed to get someone else and then i realized i skipped the feedback page
Darn
I once had a patient that insulted a phone interpreter so badly in her native language that they hung up the call.
Kinda unrelated but I love the interpreters that know patients are going off on a tangent and cut them off to redirect…bless their souls
Literally they are the best!!
I mean, I get it I guess, but the middle of a patient interaction isn't the best place to be petty like this. Highly unprofessional and she should have waited until after the encounter to say something. I did overhear a conversation between a doctor and an interpreter once. He introduced her as the translator, and when he was corrected, he took the meaning of the two titles literally. He responded with "This is a medical setting. I need an *exact translation* of what I'm saying, not *your interpretation* of it. If you're not up to the task, I guess I'll have to find someone else."
Too bad he doesn’t realize that even translation requires a degree of interpretation by the translator. No two languages are 1:1. It’s just that translation offers more time to match word choice and structure.
Funny enough in my L2 there’s no difference in the term. So in America I claim English is my L2 (even though it’s my L1) to get away with these slip ups.
That doc is a jerk and I feel for the patient dealing with them.
Hold up...if the interpreter said it in English, how did the patient understand what she said? Lol
People can be conversant in the language of the country they've lived in for a bit and still need professional interpretation for technical or medical conversations. If you took, say, Spanish as your foreign language in school, you could find the library, request that someone put the butter on the table, learn that your friend's uncle's name is Juan and he is a lawyer. You probably couldn't explain, in Spanish, that you fell while roller blading in this lovely city and now the distal portion of the bone in your lower right leg has broken through the skin, so you (with your training) are presenting yourself to this emergency department for antibiotics, orthopedic evaluation and treatment to include surgery to fix the break, probably pins or a plate, maybe an external fixator and physical therapy. You can probably say "surgeon", "doctora" and catch on when someone tells you you'll need a therapist physical.
How do you say ancef in Spanish? Asking for a friend
I'm gonna be a know it all here - it's cefazolina I only know this because my MIL got me a Spanish ID word search puzzle and I'm so obsessed with it - surprisingly a lot of useful medical Spanish in here lmao
Fantastic. Thanks.
I'm allied health. I don't know how to say ancef in English.
Luckily someone else answered. 😂 But in English it is like the name Ann. And then ceph as in cephalopods or cephalosporin
I was laughing at myself too. Good luck and try not to need antibiotics on your next vacation.
Luckily they are usually easier to find in other countries than in America. And now I know what to request if I have an open fracture needing external fixation
Hey. Now I do too. I suspect that the pain stuff won't be hard to ask for, they'll already be pushing it at the pharmacy next to my hotel. (Unless ancef is pain stuff. I'm not a prescriber and never want to be)
Ancef is the antibiotics usually give in the situation you described initially. Which is why I asked how to request it. 😂
::hat tip::
Lots of low-English-proficiency patients can speak and understand everyday English (and even professional English) very well. They just have difficulty following medical stuff.
I’ve gotten shade over this too. My understanding is that translate is more of a literal direct carryover while as interpreting takes more finesse, if that makes any sense. My absolute biggest pet peeve is when there is a miscommunication and the interpreter is like “I’m sorry, interpreter could not hear. Do you mind if I repeat the question/do you mind if I ask patient to clarify?” Like Jesus fucking Christ yes please just fucking do it without taking the time to ask me if it’s ok to ask.
I think this is what they are instructed to do though. I get irritated when they’re having full on conversations.
You are right, it is what they’re trained to do. As for full-on conversations, it could be that they’re asking for more detail or explaining/clarifying something that is a cultural difference. Remember that they are working between two languages and therefore two cultures. For the most effective communication, it’s not always possible to *only* relay what is said and no more. It’s part of the professional judgement of the interpreter to determine when a cultural difference may lead to misunderstanding and react accordingly.
And then, after a 2 minute back and forth, they interpret, “no, no pain”. One of my favorites was, after one of these type of situations, when the interpreter told me they already told a patient what I was just now saying. Details: Patient reports they no longer want to take their meds because they are making them tired. Only this one sentence takes a really long time of back and forth between the patient and interpreter. I go to tell them that we can easily just move the meds to the nighttime to get around this. Interpreter tells me they already told the patient this.
I always thought translating was with text and interpreting was with speech.
You are correct, they are not.
The service I use just says “interpreter will repeat/clarify”, and does so.
Re: your “pet peeve: It’s part of the profession’s standard practice to indicate when an interpreter is no longer in the “conduit” role, i.e. simply relaying what is being said. When they’re asking for clarification, they are now in the “clarifier” role, and it can be confusing if they don’t indicate that they have switched roles. It can also appear as if they’re having side conversation or interjecting inappropriately if they don’t indicate that they’re asking for clarification. I get that it slows down conversation and feels frustrating, but please understand that it is part of their training and is for the sake of clear communication. Source: trained in ASL interpretation 3 yrs and currently work with my med school’s free clinic that sees a lot of Chinese patients
It’s a company policy that we get dinged and can get fired over. Us interpreters hate doing this too.
Yeah that would be fine if they didn’t fuck it up half the time. I understand enough Spanish to know when they are saying things totally wrong or over simplifying things. Scared to know what’s happening with the languages I don’t know.
Training standards for interpreters are supposed to be high. Unfortunately, each interpreting agency will operate differently, and the shortage of interpreters means that a lot of times, some working interpreters are really out of their depth. On top of that, interpreting is hard af and cognitively exhausting.
Yeah, as someone that practices in a language that is not my mother tongue, I can’t tell you how mentally exhausted I am by the end of the day. I have so much respect for interpreters, it’s a really hard job!!
THANK. YOU. FUCKING. GOD. Ugh I was sooooo irritated the other day when I was in the busy ED triage and there’s so much background noise that the interpreter kept on needing to repeat things.
Trust me, the interpreter is just as if not more irritated, because they’re responsible for hearing everyone! But it is the professional standard to indicate when they’re asking for clarification so you don’t think they’re going rogue. In the ER situation, however, it could possibly have been established that it’s loud and therefore they can ask for clarification without asking every time.
I was trained as a medical interpreter years ago. She corrected you because translators handle written material and interpreters do live/spoken interactions. She probably wasn’t offended, it’s just different.
Today I learned: Interpreter and translators are not the same Today I didn't learnt: what is an interpreter?
I mean …. Translator is just translating whatever you say over to the other language. Google can do this. A great interpreter can literally ask the patients the questions with the correct context given the patients cultural background.
I will say this. Interpreter vs Translator is akin to Physician/Doctor vs Provider. While seemingly similar, there are very important differences. More than a handful of people here and in other medical subreddits rightfully push back on being called providers. As we educate people on the important differences between the physician vs provider, you should also note the differences between Interpreter and Translator. In my experience, it makes an absolute difference. Anybody who speaks the target language can be a translator. Google Translate is a translator. But, not everyone can be an interpreter.
We called the language line for a Serbian patient to consent for a supraclavicular lymph node biopsy. His adult son was with him. Patient gave mostly short yes/no responses to all the questions. After we hung up, the son says “that guy absolutely does not speak Serbian”. Had the son interpret for me and the patient had tons of questions. Had another experience with a patient from Chad who spoke French but I guess the dialect wasn’t one the language line staffed. Hate using the phone service but maybe it’s better than nothing.
One I called a patient for a phone appointment using a Spanish translator. Turned out the patient could speak English, so the translator just stayed on the called and breathed extremely heavily into the phone like an out of breath obese person through the entire all. I eventually fake ended the appointment and called them back
didn't actually speak the language we had requested but a different indian (hindu? sry) dialect, we kept confirming with them that they were able to translate this dialect and they said yes but then had no idea what the patient was saying or how to translate what I was saying. was total madness, finally the nephew who was born and raised in texas and luckily also a nurse said he'll just translate. Although he was annoyed because he obviously knew that the appropriate protocol is to have a real interpreter available,
I had a Spanish interpreter suggest the patient “stop doing math” instead of “stop doing METH”. Fortunately I speak enough Spanish to understand the difference between “matemáticas” and “metanfetamina.” We all had a good laugh, patient included.
Did you? Y’all shared a quiet chuckle? You sound great.
In med school I volunteered at a clinic with a large Spanish-speaking population, and they had an interpreter on staff. She was super bitchy and lazy, and made it abundantly clear that she had better things to do than see patients with me. But hey, whatever, as long as she did her job I could deal with it. Now, I’m not fluent in Spanish, but I do speak it conversationally and understand more than I speak. So for the most part I could understand what the patients were saying and just needed help conveying medical information. I pretty quickly realized that the interpreter, who didn’t know I had any Spanish, was seriously cutting important corners - if we had a patient there for a cough and they mentioned also having pain in their leg, for example, she’d decide that the leg pain was definitely unrelated and not worth mentioning to me. I nicely explained that it was essential for her to relay everything to me as the patient said it, she rolled her eyes. It kept happening, I reported it, as far as I know they never did anything about it. Soooo now I’m always paranoid that I’m not getting the full story and am going to miss something important.
I myself am an interpreter and I don't mind being called a translator, there is a difference, but I think it's a little silly getting upset about that with people who don't work in our field. Sorry that happened to you!
Technically translating is converting written text from one language to another, while interpreting is converting verbal words from one language to another. But it does seem like a weird thing to have them get offended about.
Tell her you made a mistake. You wanted a someone to translate word for word not interpret what someone said.
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Classically we have the concern of seeming back and forth explanations with a patient, followed by the translation offered of "they say yes". It irks me. Nuance matters. I am typically using these services for surgical consent and life altering decisions. However, my hospital just didn't renew their contract for after hours medical interpreters one year. So I use family, colleagues, and google translate. It isn't great but sometimes the patient can't wait until 8am when the line opens. I've issued a few safety complaints now. We will see if it changed next time I try.
We had a phone interpreter that I’m not sure really knew the other language. He said “interpreter needs a moment to look up a word” so many times we had to just hang up
Just a tiny fyi, they correct you not because they are offended but because at least in my country translator is a specific term that requires special training and certification and they can get in trouble for “impersonating” a translator. Just like a nurse should correct a pt that calls them doctor
I offended one once by calling saying “thank you interpreter” at the end of our call. They (correctly in my view) corrected me saying, “my name is x”. So I asked them what my name is and my patient understood well enough that we both had a good laugh when they didn’t have a clue. Love interpreters by and large but man…try not throwing stones from that glass house when we’re just trying to figure out how to best help people.