importance of spanish

[modelslashactor]

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hey all,

given that there are a lot of hospitals where half or more of the patients do not speak a word of english, i was curious if spanish is a de facto requirement at their residency programs, or do you just have to rely on translators all the time?

and even if you do learn spanish, is it enough to get by on? i've talked to students who were 'fluent' in spanish, but still needed translators because the history was just too difficult to translate. im thinking of trying to learn this summer while i still have free time before starting med school next year, and was wondering if it would be a waste of time. thanks!

 

[Mumpu]

Here, I'll condense this whole thread for you into two camps.

1) Those damn illegal immigrants should learn English. Why should I have to learn their language to practice in my own country.

2) Those damn illegal immigrants are already here and they are not learning English any time soon. Might as well make your life easier and learn Spanish.

FWIW, I'm in the second camp. H&Ps done via interpreter phones take absolutely forever. I can almost always get the information I need with my four years of high school Spanish plus the time I spent working at the county hospital. So yes, take some Spanish.

 

[EtOHWithdrawal]

Learn spanish...

Interpreters are like police officers, they are never there when you need them

 

[colbgw02]

I used to do some interpretting at a county health clinic in my pre-clinical years, and I can tell you that this is also somewhat of a legal matter. If you don't use an interpreter and you mess up the story, then you could be held liable if it ends with an adverse outcome. For simple things, like asking if someone is in pain, then you'll be fine, but if you're getting a full H&P on a complex patient, then you should use the interpreter anyway. Even fluent physicians need to be certified by their hospital as an interpreter in order to avoid problems.

 

[mlw03]

it's location depedent - probably more of an issue at University of Arizona than University of Kansas. i would agree with those that if you're in an area with a large Hispanic population, it's worth it to try and get some basic skills. but you're not going to learn a foreign language in 1 summer. unless you're going into path or radiology, knowing some Spanish will definately make your life a bit easier.

 

[Medical123]

Spanish would definitely have made my life easier as a medical student, especially on OB where almost none of my patients spoke any English! When I was interviewing for residency, a certain program director stated that knowing Spanish was definitely worth "bonus points" in her opinion!

 

[Llenroc]

hey all,

given that there are a lot of hospitals where half or more of the patients do not speak a word of english, i was curious if spanish is a de facto requirement at their residency programs, or do you just have to rely on translators all the time?

and even if you do learn spanish, is it enough to get by on? i've talked to students who were 'fluent' in spanish, but still needed translators because the history was just too difficult to translate. im thinking of trying to learn this summer while i still have free time before starting med school next year, and was wondering if it would be a waste of time. thanks!

Anyone who says that you can't get a (professional) job if you don't speak Spanish is going to get crucified here in America, but I've heard that in places like Los Angeles and Miami there's a huge preference for people who are bilingual in residency programs. Maybe not so much Surgery and Radiology, but definitely things like Medicine and Psychiatry.

As rotten as that is, when I look at it from the point of view of the residency program, what choice do they have? Their hospitals were set up decades ago, and are now in cities where a majority of the people are recent immigrants from Latin America and speak little to no English. It's just not practical to hire someone who would need an interpreter for half the patients. And any resident who went to these programs would have a tough time getting the work done if they needed to use an interpreter with half the patients.

Those are the facts.

 

[McDoctor]

Learning spanish definitely is not a waste of time. There will always be some clowns who say don't learn it, "they" should just learn english. But last time I checked, healthcare was still a business in this country. And when you learn spanish, you automatically open yourself up to a significant portion of the market. Spanish patients preferentially will come to you. It doesn't matter where you stand on the immigration issue.

That guy in Philadelphia who wouldn't sell cheesesteaks to spanish speaking customers, he's not exactly a wiz at running a business IMHO. He sacrificed selling alot of cheesesteaks for "making a point" that got him maybe 5 minutes of media notoriety. Hmm...let's see...making money for your family vs. making a point for the media...Hmm...tough call...🙄

 

[Faebinder]

Sheesh I picked up enough spanish on the floor to almost think that I was darn good at it. A spanish class will go far for you... especially in NY, Miami, ALL TEXAS AND ARIZONA AND CALIFORNIA.

I wonder if sign language gets useful... have yet to see it needed.

 

[LADoc00]

Spanish is worthless in Radiology and Path.

my 2 cents

 

[DiveMD]

Spanish is worthless in Radiology and Path.

my 2 cents

Any spanish speaking cadavers? ¿Qué?😀

 

[Rain Elizabeth]

I think it's worth it even if you sometimes need an interpreter anyway. You'll have better relationships with your patients if you can even have very basic conversation than you would if you never said a word directly to them. They will instantly feel more comfortable and trust you more if they feel you are trying to connect with them. Plus, if you learn some Spanish in a class this summer you will be able to pick up a lot more during residency cuz you will have a framework for it. Plus it's fun learning a new language!🙂

 

[drtx]

"Quantos poundos?"
- drtx asking a spanish speaking patient how much he weighed ( I can't remember why I was asking this) right before an appy causing my chief to have to run out of the room because she couldn't hold back her laughter!

Moral of the story: learn spanish

 

[tr]

i would agree with those that if you're in an area with a large Hispanic population, it's worth it to try and get some basic skills. but you're not going to learn a foreign language in 1 summer.

Actually Spanish is an incredibly simple and clear language to learn. Anyone who knows any other Romance language (French, Italian, Portuguese, Latin) is already more than halfway there. Even someone who does not know a Romance language but is literate in English can do quite well with medical Spanish, as many of the terms are cognates.

I know a number of residents who picked up sufficient Spanish in a single summer abroad - or even by self-study - to be able to take simple medical histories.

I would say anything you can do is worthwhile. If you do end up in a hospital with a large Hispanic patient population, starting with a simple base of introductory Spanish will enable you to build on and improve that base with every patient interaction. I took a lot of Spanish before med school (four years in HS and two semesters in college), but I really learned how to speak it on the hospital floors. At this point I'm able to fool most non-Hispanics and - depending on the length and topic of the conversation, the acuity of the listener, and whether I'm feeling my avena that day - some native speakers as well into thinking it's a native tongue for me.

Re the bad-translations thing:
It's definitely a problem. I can't tell you how many patients I've seen who had inaccurate histories propagated through generations of computer notes because the first resident who saw them spoke very poor Spanish and couldn't/didn't find a translator. So yes, unless you are confident of your language skills you should still use a translator or language line for intakes.

But I still think poor Spanish is better than none at all. Something as simple as a post-op check can be done accurately with only a very few necessary words; but if you have to hunt down a translator every time it could take hours. And it's true about the impact on patient-relations. You should see a patient's eyes light up when you are the first person he's seen who can talk to him.

 

[mdphd2b]

I remember interviewing for med school at USC back in '99 (from Boston). My impression was that Spanish was a must in the LA County Hosptial. They gave us a tour and that's when I realized my 4yr of HS French was useless (other than passing me out of my undergrad language requirement!).

On the other hand, I'm fluent in Pushto, which very few ppl speak, so might come in handy sometime... 🙄

 

[tr]

On the other hand, I'm fluent in Pushto, which very few ppl speak, so might come in handy sometime... 🙄

You never know. I'm fluent in Modern Greek, which has come in handy in the hospital exactly once (but it was very handy). Actually translators for uncommon languages get paid at higher rates than those for common ones like Spanish. And you'd be great on a medical mission to Afghanistan/Pakistan.

 

[modelslashactor]

thanks for the help everybody. i'm actually in the same position as you, tr, in that i took a bit in high school and college but can't yet keep up with telemundo, so i'm glad to hear that it can come quickly if you have a foundation! so i guess in the meantime i'll just try to not forget everything.

 

[DiveMD]

thanks for the help everybody. i'm actually in the same position as you, tr, in that i took a bit in high school and college but can't yet keep up with telemundo, so i'm glad to hear that it can come quickly if you have a foundation! so i guess in the meantime i'll just try to not forget everything.

Do you watch Telemundo for the chicks? I do...😎

 

[southerndoc]

I used to do some interpretting at a county health clinic in my pre-clinical years, and I can tell you that this is also somewhat of a legal matter. If you don't use an interpreter and you mess up the story, then you could be held liable if it ends with an adverse outcome. For simple things, like asking if someone is in pain, then you'll be fine, but if you're getting a full H&P on a complex patient, then you should use the interpreter anyway. Even fluent physicians need to be certified by their hospital as an interpreter in order to avoid problems.

It's more than being held liable if something goes wrong. You can be fined by the government for not providing a translator.

It is a federal law that healthcare facilities must provide translators to all non-English speaking and sign language patients, at the healthcare facility's expense. Patients cannot be charged for translator services.

Healthcare providers who are not certified translators by the institution cannot translate. Even if you grew up in a Spanish-speaking country where it was your primary language, you still cannot translate unless the healthcare facility for which you work has certified you as a translator.

 

[Mumpu]

Legally -- no, practically -- everyone does it. I speak another language and my English is better than that of 100% of hospital-certified interpreters for that language (I tend to play dumb and let them work until they completely "interpret" what I said, then I butt in in the other language). The amount of time hospital-certified medical interpreters provide incorrect translation is staggering.

Hospitals are effing cheapskates. The county hospital where I used to work had one Spanish interpreter available during the normal business hours for the patient population that's 2/3 SSO. And no thank, I won't use the interpreter phone (well, maybe send in a med student to use one) -- that's two hours shot right there. The stupid phone is the cheap way out for the hospitals and like all decisions affecting patient care, this one is made without actually bothering to consult people who take care of patients (designing POE systems without MD input is the other triumph of ******edness).

 

[gstrub]

Tell your patients "Welcome to America...now learn some English!"

 

[kchan99]

It's more than being held liable if something goes wrong. You can be fined by the government for not providing a translator.

It is a federal law that healthcare facilities must provide translators to all non-English speaking and sign language patients, at the healthcare facility's expense. Patients cannot be charged for translator services.

Healthcare providers who are not certified translators by the institution cannot translate. Even if you grew up in a Spanish-speaking country where it was your primary language, you still cannot translate unless the healthcare facility for which you work has certified you as a translator.

Do you know which department in hospital usually does that certification? I speak a dialect of a language that is not commonly spoken in the area where I am located.

Thanks!

 

[southerndoc]

Do you know which department in hospital usually does that certification? I speak a dialect of a language that is not commonly spoken in the area where I am located.

Thanks!

We actually have a separate hospital department (Interpreter Services). We maintain Spanish interpreters in-house 24/7 now.

I think I was mistaken. I think certification occurs from universities, and the hospital only recognizes that certification for credentialling. Here is a link to one certification program I found on the web: http://www.georgiacenter.uga.edu/conferences/2003/Dec/07/medinterp.phtml.

 

[Dianyla]

Get fluent, then get certified to interpret. 👍

Your local community college/vocational type of institution should have some sort of interpreter certification program.

 

[Mephisto]

Get fluent, then get certified to interpret. 👍

Your local community college/vocational type of institution should have some sort of interpreter certification program.

😎 It's that easy! 🙄

 

[eastcoastyall]

I think there are two levels of spanish:
1. Saying what you are thinking (easy)
2. Understanding what patients are saying (really hard)

All I'm going to be able to do is the first. Oh well.

 

[dpmd]

I think there are two levels of spanish:
1. Saying what you are thinking (easy)
2. Understanding what patients are saying (really hard)

All I'm going to be able to do is the first. Oh well.

Odd. I actually find the opposite is true. My mom is a native spanish speaker, but we didn't use it in the house really, so I didn't learn until high school spanish (where I got sucky grades whenever my mom would help me with homework). Where I really got better was at LAC-USC medical center. I started out being able to understand the gist of what people were saying (as long as they slowed down and clarified words I didn't know), but had absurd difficulty expressing basic stuff. Part of it was trying to translate from english to spanish in my head (now I go into spanish mode when I am conversing), and part of it was a lack of vocabulary. My favorite was a post partum check when I was trying to talk about the nipple, but didn't know the word for it. Instead I said in spanish "the thing where the baby sucks milk from on your chest". Ridiculous, but she got what I was talking about (pezon in case the need arises for you). Plus, many of my patients have a similar problem. They can understand some english, but aren't able to express themselves well. Some of my more bilingual patients will still prefer to speak in spanish if I am around instead of a non spanish speaker.

As far as the translator issue goes, I have called one only once. This was for a rectal cancer patient that I had just informed of his prognosis (death, and soon-somehow the oncology team had neglected to mention that to him, or they did and he forgot). I called a translator in for a meeting where his options were presented (dialysis and continued hospitalization, hospice, home hospice). I didn't want to be fumbling for words during that discussion. Other than that I have done the translating for the team many times, including getting consent for procedures, and doing H+P's. I would have gotten a translator if the patient didn't feel comfortable, or if I didn't understand, but it is much simpler to just do it rather than wait a few hours for a translator. I always made sure to clarify any words I wasn't sure of and confirm stuff with the patient. A couple of times I would just write down a word I was unfamiliar with, look it up later, and check with the patient later to make sure I got it right. You would be surprised how grateful people are to have someone speak their language, even if they butcher it.

 

[Shinken]

¡El saber Español es muy importante! Ya sé que mucha gente piensa que todos deben saber Inglés, pero ¿cómo se sentiría usted si fuera a Argentina, le pasara un accidente y todos los médicos hablaran solamente Español? Y cuando usted se queje todos los médicos lo miran feo y dicen "¡Pues este Gringo debería aprender Español, si no que se vaya de nuestro país!"

 

[DiveMD]

¡El saber Español es muy importante! Ya sé que mucha gente piensa que todos deben saber Inglés, pero ¿cómo se sentiría usted si fuera a Argentina, le pasara un accidente y todos los médicos hablaran solamente Español? Y cuando usted se queje todos los médicos lo miran feo y dicen "¡Pues este Gringo debería aprender Español, si no que se vaya de nuestro país!"

Me quedé muy impresionado con tu domino del idioma. Ojalá todo el mundo tiviese tu perspectiva a la hora de aprender múltiples idiomas. No es solamente beneficioso aprender otros idiomas desde el punto de vista médico; si no que también es extremadamente gratificante poder comunicarse con personas de diferentes culturas y orígenes. Keep it up...👍

 

[Shinken]

No es solamente beneficioso aprender otros idiomas desde el punto de vista médico; si no que también es extremadamente gratificante poder comunicarse con personas de diferentes culturas y orígenes.

Absolutely! Couldn't have said it better myself! Just yesterday I had a couple from Serbia and the husband spoke English and Spanish! We had a most wonderful conversation in Spanish. The nurses were awfully amused but at 3:00 AM in the ER there's nothing more uplifting than making a "connection" with a tired and scared patient.

 

[Bitsy3221]

I wonder if sign language gets useful... have yet to see it needed.

I took ASL (American Sign Language) as my foreign language requirement in college. Once in the Trauma Bay the paramedics and trauma team were perplexed and getting increasingly concerned about a woman involved in an MVC who was awake but not responding appropriately. No one could get her to respond until on a whim I started signing to her and she responded appropriately--she couldn't read lips well (since we weren't exactly talking face-to-face with her anyway) and couldn't sign well since her upper arms were strapped to to board. A rare occurance, I know, but at least I can say my ASL came in useful at least once! 😀

 

[LADoc00]

interesting post, I cant help but thinking that those who dont speak English are also those less likely to pay for your services...great idea if you want to be poor tho. Although there are bums at the beach in Santa Monica who have figured out an easier way to do that.

Universal Translating Device=Dead Presidents.

nuff said.

 

[LADoc00]

Tell your patients "Welcome to America...now learn some English!"

I see a structure...one of metal...and brick in the future for America...

 

[Winged Scapula]

Just a friendly reminder that this is not the thread or the forum to discuss or post sociopolitical thoughts on immigration or immigrants speaking English.

Please keep the discussion to the use of Spanish during residency.