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When Edgar Chinchilla became an interpreter for Einstein Healthcare Network, he lost 15 pounds the first month on the job.
“Sometimes they schedule the appointments so close that we literally run from one building to another,” Edgar says. “I can have two patients in my calendar for the day and I could end up with ten patients at the end of the day.”
Edgar’s waistline is a window into the Office of Language Services. It’s a busy place.
In 2011, the office handled over 30,000 interpretations in more than 50 languages, including sign language. More than half of them were in person; another 15,000 were provided over the phone by an agency contracted by the medical center.
Interpreters are available 24-hours-a-day at Einstein, as required by federal law. A provision in the Civil Rights Act of 1964 requires hospitals that receive federal funding to provide interpreters for patients with limited English proficiency.
While some are arranged in advance, other interpretation requests are spur-of-the-moment. Edgar can go from two appointments on the books when he shows up for work in the morning to ten by day’s end.
Sitting with a patient at Einstein Family Practice, Edgar carefully positions himself. A curtain overhead can be drawn if privacy is needed, so the doctor can continue an examination without the interpreter leaving the room.
Both patients and doctors tend to look at the interpreters instead of each other. So Edgar attempts to act as a shadow – sitting beside the patient instead of in between.
“You allow the patient and the doctor to identify, to create a bond between them,” Edgar says. “If we create a bond, we are doing our job.”
Staff interpreters cover the five most commonly spoken languages of Einstein patients (other than English): Spanish, Korean, Vietnamese, Cambodian and Russian, says Maria Dominguez, manager of the Office of Language Services. They receive special training and are certified to work in a medical setting. That means they need to understand more than just the language.
Medical terminology, privacy concerns and cultural differences are issues interpreters frequently encounter during their work.
“I always say that if there is no communication, it is not good care,” Maria says.
That can require a good deal of finesse, says Katie Kyle, a Spanish interpreter.
“It can be a very hectic job at times. Sometimes you have three patients in one department at once and you are trying to grab the doctor and say “don’t go in there yet until I finish with this patient”,” Katie says.
Katie says the staff interpreters help with paperwork, insurance issues and coordinate with reception. They also must be aware of differences springing from dialects.
“I could have six patients in one day from six different countries,” she said.
Laura Romano is the Director of the Office of Volunteers, Chaplaincy and Language Services at Einstein. Those areas may not seem to be related, but they are telling when it comes to Einstein’s approach to patient care, Laura says.
“We have a real commitment that we live every day to treating the whole patient as a whole person. It is body, mind and spirit. That is what healing is all about.”