Interview with Liliana Crane, a professional Medical Interpreter

Eging team members had the privilege of speaking with Liliana Crane, a certified medical interpreter delivering medical interpretation services at the University of Rochester Medical Center.

Liliana is a native Spanish Speaker and has lived and studied in the USA since 2007. Throughout our meeting, Liliana described the challenges that she along with patients and doctors have experienced in her quest to help both parties understand each other.

We hope that the set of questions and answers below give you some insight into the world of medical interpretation and how that service has a crucial role in helping patients with limited English proficiency.

How did you get into medical interpretation?

I started out at as a translator, and I spent 3 years delivering Spanish translations geared towards the Latino audience for University of Rochester’s Healthy Living Program (Vida en Salud).    The program was aimed at helping African Americans and Latinos adopt healthy lifestyles.  Through my work as content creator and translator, people recognized that I had a strong grasp of communicating concepts to general Spanish speaking audiences which eventually lead me to deliver medical interpretation for Latino patients. I realized I loved helping the Latino population, with my native language and cultural background I had the skills and life experience to help with their communication.  I have been working as a certified medical interpreter for the Spanish language for 7 years at (URMC)

What do you like about being a professional interpreter?

I love being a medical interpreter because it gives me the opportunity to help people every day.  I like that every workday is different and that I get to see and understand both sides of each situation from the provider’s and patient’s point of view.

What is your training in language/interpretation and in the medical field?

I am a certified medical interpreter with “The National Board of Certification for Medical Interpreters”

My license is valid until 2021.  I took an oral and written exam to obtain this certification. We are trained in standards of practice, code of ethics, medical terms and in the art of interpretation. Language proficiency in both languages is validated to ensure the interpreter’s proficiency.

I have been working in the medical setting for 10 years as a translator and interpreter. I received my master’s degree in business administration medical management in 2011 from Simon School of Business at the University of Rochester. I recently graduated from Genesee community college with an associate degree in Physical Therapist Assistant.

What are the challenges of Medical Interpretation?

The most common challenge that we encounter every day, is the misconception that every person that speaks Spanish is a qualified Spanish interpreter. I’ve come across family members, friends, even minors involved in the process of interpreting and it is never a good situation since these individuals are not trained and have an emotional involvement with the patient. Most importantly, none of these individuals have attested to their level of proficiency in the language nor their capacity for understanding medical vocabulary.

Another challenge is taking control of the interpretation process when there are several parties involved. In some cases, I have had the doctor, a minor patient, the mother, family member and even police on site. You must take leadership and control to facilitate the communication, be the moderator of the process without changing the content or siding with the client or with the doctor or any other party involved.

Sometimes, when there are several requests for interpretation services coming at the same time, you have to prioritize among several critical ones. Trauma patients are urgent and cannot wait, they automatically have first priority.

An example of a challenge is handling a patient that has had other interpreters during their stay at the hospital or no interpretation at all. At the discharge moment, those patients can take more time because interpreters are working with limited information, and there’s a need to revise medications, follow up appointments, and other conditions where the communication was limited.

All of my interactions with patients are through consecutive interpretation, which is the most common form of interpretation in the medical field. Patients and providers need to take turns, and I need to control the pace and exchange so I can have time to relay the information, between their turns.

How do you think the field of interpretation has changed since you started working in the field?

The arrival of new interpretation technology provides patients and their providers with more options for medical interpretation.  There is phone interpretation and then there is video interpretation.

But all the users must be mindful of using the technology in the right setting to help the communication and see how patients and doctors adapt to use of the technology.

What, in your experience, has been the most common mistake or misunderstanding that users of your services have? 

For healthcare providers, it is that the patient’s family members can serve as a replacement for professional interpreters.  Or, that their own limited knowledge of the Spanish language is enough for them to communicate well with their patients.

With the availability of phone interpretation, a newer misconception is that phone interpretation can be used for any situation.  While it is easy to arrange, phone interpretation is not suitable for patients who are hard of hearing or have some other impairment that prevents them from being able to use the phone service effectively.

How has your perception and understanding of human communication evolved or changed since you started as an interpreter?

I’ve faced some stressful and highly emotional situations, including one in which I had to communicate news to a mother regarding the death of her child.  I was affected by the situation – but I had to push those emotions aside to calm down the parent in order to deliver information and manage communication through that traumatic event.

In another difficult situation, I was interpreting for a mother of a patient who was in critical care, and the rest of her family were telling her the opposite of what I was interpreting. The child was dying, and the family members were trying to manage the information to prevent despair in the mother.

Both cases showed me how human emotion can have a large impact on human communication, especially in the field of medical interpretation.  Even in a critical situation and especially then, accurate, non-biased and transparent information must be conveyed between all parties.

What do you recommend to users of interpretation services?

Use it!  Medical interpreters help enable patients to advocate for themselves to receive the best care possible.

Given that medical interpretation needs to be very specific and accurate, how do you deal with a situation in which you are not sure about the right term to use? 

I always ask the patient’s doctor for any clarification that I may need in order to help me help the patient understand exactly what the doctor is saying.  There have been situations in which I myself was not completely sure about what the doctor was conveying to a patient, and I needed to ask for more details or explanations.  It is always better to ask and never a good idea to guess!

After the interpretation is completed, I study the unfamiliar term or condition further in order to research, learn and gain a deeper understanding of the subject matter. Learning and improving vocabulary is a never-ending process in the quest to becoming a better medical interpreter. Being a medical interpreter is rewarding, and it requires a great sense of responsibility and ethical behavior.

Closing Remarks from the Interviewers

Our conversation with Liliana reinforced our appreciation for the services that professional interpreters deliver and the experiences and efforts they make to become better professionals. It also helped reaffirm the importance of specialized training and the skill sets required to deliver reliable medical interpretation services during high-pressure situations.

We left the meeting with a renewed desire to ensure that patients of all cultures and languages have access to language services that support their needs. We are even more motivated to continue our role in advocating for quality Interpretation services in medical and legal settings.

Finally, we would like to stress the importance of recognizing that no matter the technology used, the most important resource in the equation is the interpreter.

Thank you, Liliana, for your time and your candid and enriching interview.

Patients rely on medical interpreters to communicate effectively what their provider is saying to help them make important health-related decisions.  Nothing related to someone’s health should ever be left to chance.  Patients of all cultures and languages have the right to be their own advocate when it comes to receiving quality healthcare.  Use Medical Interpretation Services to help your patients and their doctors create an effective circle of communication that improves and saves lives.