Doctors who use Google Translate to talk to patients want a better option(statnews.com)
statnews.com
Doctors who use Google Translate to talk to patients want a better option
https://www.statnews.com/2022/03/16/google-translate-health-care-english/
160 comments
It has become an absolute joke. I have had 6 surgeries for Crohns, a back surgery due to wear and tear from high level athletics, and am a long term sufferer of an aggressive leukaemia. Despite using opioids responsibly for over a decade, I am regarded as nothing more than a drug seeking pest the very few times I have actively sought pain relief during in-patient hospital stays. Prior to being dropped entirely from my Oxycodone IR script (30 10mg pills a month, truly not a large amount) without any warning due to my pain doctor finally simply giving up on the system, I had never asked for an increase in a dose ever - despite still having plenty of untreated pain.
Legitimate chronic pain patients are being abused at this point in order to save face for the broken, rent-seeking pharmaceutical system that enabled the prescription opioid 'crisis' in the first place.
Legitimate chronic pain patients are being abused at this point in order to save face for the broken, rent-seeking pharmaceutical system that enabled the prescription opioid 'crisis' in the first place.
Yep, absolutely. My doctor of 10+ years recently retired, leaving me in search of a new doc. I've been managing my pain for 15+ years just fine with 10mg Hydrocodone. In 15 years I only once asked to increase the dose, and it was only from two pills per day to three to help me get through the afternoon/evening better. A minuscule dose.
After doing "new patient" appointments (which by the way were like $200 to $300 each) and not having a doc willing to take me on as a patient unless I dropped the opioids, and making several calls (who refused to tell me over the phone whether the doctor was even open to controlled substances without that $300 "new patient" appointment) I gave up. Since coming off the opioids my quality of life has plunged. I struggle with depression and thoughts of suicide now, especially when I'm unable to leave the house or my bed. I went from stable and productive and what doctors used to say is the model patient, to being miserable. Every doc has offered to give me additional antidepressants or crank up the doses of those, but none are willing to treat the pain that is exacerbating it.
I absolutely believe that what the medical establishment is doing to people like us (withholding treatment that we know works) is cruel and borders on torture. It is the epitome of taking macro-level stats and explanations and applying them broadly on the micro-level, regardless of the harm caused.
I believe Hippocrates would be rolling over in his grave to hear that these people took an oath to "do no harm."
For the record. I mostly don't blame the doctors. They are protecting their medical licenses, which the DEA and FDA have proven they are willing to revoke over the slightest anomaly. When the feds started throwing pain specialists in federal prison because some tiny percent of their patients were abusers, it really drove home that individual doctors are not allowed to think anymore. You implement government policy, or you risk financial ruin and even jail time. I don't blame them for being cowards. I probably wouldn't risk imprisonment on a stranger either.
After doing "new patient" appointments (which by the way were like $200 to $300 each) and not having a doc willing to take me on as a patient unless I dropped the opioids, and making several calls (who refused to tell me over the phone whether the doctor was even open to controlled substances without that $300 "new patient" appointment) I gave up. Since coming off the opioids my quality of life has plunged. I struggle with depression and thoughts of suicide now, especially when I'm unable to leave the house or my bed. I went from stable and productive and what doctors used to say is the model patient, to being miserable. Every doc has offered to give me additional antidepressants or crank up the doses of those, but none are willing to treat the pain that is exacerbating it.
I absolutely believe that what the medical establishment is doing to people like us (withholding treatment that we know works) is cruel and borders on torture. It is the epitome of taking macro-level stats and explanations and applying them broadly on the micro-level, regardless of the harm caused.
I believe Hippocrates would be rolling over in his grave to hear that these people took an oath to "do no harm."
For the record. I mostly don't blame the doctors. They are protecting their medical licenses, which the DEA and FDA have proven they are willing to revoke over the slightest anomaly. When the feds started throwing pain specialists in federal prison because some tiny percent of their patients were abusers, it really drove home that individual doctors are not allowed to think anymore. You implement government policy, or you risk financial ruin and even jail time. I don't blame them for being cowards. I probably wouldn't risk imprisonment on a stranger either.
I don't blame the doctors either. My pain doctor was a rural boy from my hometown who made good, graduated from Berkeley and finished medical school and finished desirable postdocs at Harvard. He simply straight up quit pain management as a specialty rather than be forced to provide his patients with what he considered subpar care. The loss of doctors like him hurts particularly badly, as it leaves us with pain specialists who either knowingly ignore the decades of successfully treated patients who used opioids or the remaining (and they do still exist) pill mill operations, who have simply gotten more sophisticated in their execution. Regardless of which doctor archetype chronic pain patients end up with, they're going to suffer.
We also now know that those treatments kill people and users gain dependence and tolerance to opioids. It’s more than just protecting their medical license.
The proportion of patients who become addicted from properly prescribed opioids is extremely small. The majority of addicts created were provided with opioids that were not appropriate for their particular medical situation, in doses that were too high, and on a regimen that exceeded in length what was supported by the medical evidence. The proportion of new cancer patients who go on to receive palliative care that includes opioids who end up becoming addicted has always been, and remains, in the low single digits. For patients with a genuine need and who are properly inducted and maintained on them, opioids are a powerful and useful medical tool.
Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point.
Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd
Further, the bulk of use in illegal opioids stateside, such as fentanyl and its analogues, is not (at least today) driven by the conversion of the legal opioid user to an illegal drug user. Fentanyl is now commonly found in drugs that never previously would have contained an opioid, such as counterfeit benzos and MDMA. Further, the majority of fentanyl users on the street arrive at its use after consuming other illegal/street drugs. For those who started on other opioids, their first opioid will tend to be the illegally diverted pills or liquid cough treatments containing codeine/hydrocodone called "lean". Very few new users of fentanyl and fentanyl analogues come from legal opioid users, mainly because very few new users are now inducted on reckless prescriptions such as an immediate script for 180 Oxycontin and 240 benzodiazepene pills a month. Your narrative is about a decade out of date at this point.
Thomas Kline is a superb resource if you want to take a deeper dive into the actual statistics and how the narrative of a crisis was used to systematically deny law abiding patients the pain treatment they should receive. https://twitter.com/thomasklinemd
A meta study of 38 studies from 7 years ago on patients using opioids for chronic pain found that 21-29% of the patients misuse the drugs and 8-12% of the patients are addicted to them. That doesn't seem "extremely small" like you said, though maybe it's better now. I think there are reasons why opioids are no longer recommended for the treatment of most patients with chronic pain that you aren't fairly acknowledging.
https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_o...
https://journals.lww.com/pain/Abstract/2015/04000/Rates_of_o...
https://www.nejm.org/doi/full/10.1056/NEJMra1507771 Volkow is a mainstream researcher, using data from the peak of the crisis, and cites the rate at just under 8%. It is not at all unreasonable to assume that with proper prescribing (unlike what happened in the 90s and 2000s) that chronic pain patients can have opioid misuse and addiction numbers near or matching that of palliative care patients, where addiction rates are closer to 1% than 10%.
I’ll agree I wouldn’t describe that as extremely small. The misuse stat is pretty bad. The addiction though…essentially for every 10 people who are treated for chronic pain, 1 of them gets addicted? With 9/10 of those people getting to live a more pleasant life…Chronic pain is awful, and the good done by alleviating it might be worth that cost.
Just to be clear - the cohort in his paper is not all opioid users. It is the subset most likely to become addicts, for the following reasons:
1. The meta-analysis occurred during the period of time that pill mills and other unscrupulous prescribing was rampant. See that there was no note regarding patients' (legal) polydrug use or by morphine equivalent dosing, nor was there any modification to the analysis of the data to see how this period in the legal drug market impacted patient outcomes.
2. This analysis selects for chronic pain patients, which tends to mean the long term users of opioids while excluding the acute patients who, particularly among the in-patient subset, pretty much never become addicts during their course of use - which is what we'd expect if these compounds were as addictive as claimed.
3. These cohort selections often do not include some or all palliative care patients. I won't accuse them of doing this to sensationalize their numbers but it does have a significant impact on results, as again palliative care patients very rarely cease their use and carry forward afterwards an opioid misuse disorder.
4. They do not control for or look at the specific impact of the main problematic legal opioid - Purdue Pharma's original OxyContin formula. Because this drug did not have the pharmacodynamic profile claimed by the firm and represented in the safety studies, it was considerably more likely to cause opioid use disorder, as patients would be much more likely to take extra doses to cover the shortfall in the dosing window. This would lead to patients who otherwise would exist on a steady dose asking for increasing doses - or, worse, turning to the street to acquire diverted doses.
1. The meta-analysis occurred during the period of time that pill mills and other unscrupulous prescribing was rampant. See that there was no note regarding patients' (legal) polydrug use or by morphine equivalent dosing, nor was there any modification to the analysis of the data to see how this period in the legal drug market impacted patient outcomes.
2. This analysis selects for chronic pain patients, which tends to mean the long term users of opioids while excluding the acute patients who, particularly among the in-patient subset, pretty much never become addicts during their course of use - which is what we'd expect if these compounds were as addictive as claimed.
3. These cohort selections often do not include some or all palliative care patients. I won't accuse them of doing this to sensationalize their numbers but it does have a significant impact on results, as again palliative care patients very rarely cease their use and carry forward afterwards an opioid misuse disorder.
4. They do not control for or look at the specific impact of the main problematic legal opioid - Purdue Pharma's original OxyContin formula. Because this drug did not have the pharmacodynamic profile claimed by the firm and represented in the safety studies, it was considerably more likely to cause opioid use disorder, as patients would be much more likely to take extra doses to cover the shortfall in the dosing window. This would lead to patients who otherwise would exist on a steady dose asking for increasing doses - or, worse, turning to the street to acquire diverted doses.
And let's not forget the 1/10 very likely would be in extreme pain bordering on torture instead of addiction. It's lose lose for them.
I’m not sure how you figure that this hypothesis is “very likely” true. It’s actually very likely not. The papers don’t mention this at all.
> properly prescribed opioids
They were incentivised to not properly prescribe opioids. Don't be so quick to let the doctors off the hook. They're pleading ignorance isn't going to work. These were highly intelligent people who knew what they were doing and did it anyway in exchange for bribes from "Big Pharma".
They were incentivised to not properly prescribe opioids. Don't be so quick to let the doctors off the hook. They're pleading ignorance isn't going to work. These were highly intelligent people who knew what they were doing and did it anyway in exchange for bribes from "Big Pharma".
Who fucking cares? This wouldn't be nearly as huge of a problem if people with a physical dependency — inclusive of addicts, but by NO MEANS exclusively addicts — could reliably access safe, reliably dosed opioids instead of getting pushed to street drugs.
If these people have access to a doctor/health care then there they definitely have options to treat their addition. Any family physician would be happy to discuss treatment options.
The problem of people without health care is a bigger and separate issue.
The problem of people without health care is a bigger and separate issue.
Sorry if i sound blatantly stupid with my question, maybe In your case this could not be a sufficient solution for pain but did you ever tried with something like Marijuana and if it's illegal in you state considered migrating where it's legal?
Or even considered to relocate to somewhere where you can get access to proper medication ?
Anecdotally, with N being roughly 5 people, THC/CBD do nothing for several types of chronic pain, short of getting high enough that you stop caring about the fact that you are in pain.
Worth a shot, but I wouldn't recommend anyone getting their hopes up trying it.
Tiger balm, on the other hand, is nothing short of magic.
Worth a shot, but I wouldn't recommend anyone getting their hopes up trying it.
Tiger balm, on the other hand, is nothing short of magic.
Weed is a joke medication for many (most, I'd argue) types of pain. And yes it is condescending to suggest it to a longtime sufferer of chronic pain. It's akin to asking a suicidal person if they've tried exercising.
You can buy oxy on the street. Super expensive. $1/mg.
And 50/50 odds it's actually an unknown dosage of fentanyl.
Not true! They’re real pills sold by people who have an rx in my case.
Be smart and learn how to identify fakes. I can spot fake m30s by texture.
Be smart and learn how to identify fakes. I can spot fake m30s by texture.
If it is a 30mg pill, it is likely a synthetic analog.
the actual probability depends on your location,
but in general:
the kids are FUCKED
the actual probability depends on your location,
but in general:
the kids are FUCKED
[deleted]
you can get research chemical opiod derivatives legally OTC such as ODSMT or Kratom however I would be extremely careful regarding addicition potential, not all opiods are created equal, e.g. tianeptine sulfate should never be attempted
Thank you for another reason when people ask why I don't go to doctors.
Sorry to hear you have this problem. Chronic pain understanding and management is medieval, and seemingly getting worse rather than better over time.
I really appreciate your kind thoughts. Thankfully Vipassana meditation has helped keep me sane in spite of the inane restrictions my doctors have been put under and also just so happens to help reduce the pain to a somewhat more manageable level. It's funny that a lot of the patients most aggressively hurt by simplistic one-size-fits-all reforms like the 90 MME cap are the patients most likely to support, and already be utilizing, integrative medicine. Such patients have been dealing with pain for years, decades often - they're not going to turn down any potential solutions that might help. All they ask is for their doctors to be given the autonomy necessary to prescribe legal, needed medications when called for.
I’m curious what the situation is outside the US. My personal experience has always been that I’ve been able to access whatever drugs I’ve needed in the UK, but I also am white and don’t look like a “Drug user™”. I’ve never heard the words opioid crisis in a European context (but have of course heard it in a US context).
A patient who is mentally challenged or who is unconscious may or won't have the vocabulary that would permit a physician to take a history.
Veterinarians deal with this daily as well.
In both cases, there are professional protocols to deal with the situation.
Veterinarians deal with this daily as well.
In both cases, there are professional protocols to deal with the situation.
In multi-cultural American this is 100% NORMAL for most immigrants. And has been for 100-200 years. I've heard stories from my grandparents and relatives. My ex's Spanish-only-speaking relatives would talk about it.
This is why immigrants bringing minor children to doctor's appointments as translators is so utterly stereotypical: it actually happens.
It's the next best thing to the alternative by self-preservation - you get creative and put in the work. There's no way to have translators available for any arbitrary doctor - it's too expensive and the language of medical interaction is generally the highest language complexity activity the average person will have to deal with.
I've experienced this while traveling overseas. And you have to prepare for doctor's visits far more than "back home" if you want to get the best care. When I was living in a non-English-speaking neighborhood, I'd have to spend time translating my symptoms to the local language. Without computers, I'd probably need to hand-copy it from a paper dictionary instead. 50 years ago it would be very much a pantomime/charades scenario.
And here's the kicker: talking symptoms is SUPER inaccurate even with both doctor and patient speaking the same language unless the doctor has time and skills for teasing out things the patient doesn't know are relevant. And the doctors on a bell curve of that skill - plenty don't know what they don't know because they are on the low side of the curve so they miss things also.
This is why immigrants bringing minor children to doctor's appointments as translators is so utterly stereotypical: it actually happens.
It's the next best thing to the alternative by self-preservation - you get creative and put in the work. There's no way to have translators available for any arbitrary doctor - it's too expensive and the language of medical interaction is generally the highest language complexity activity the average person will have to deal with.
I've experienced this while traveling overseas. And you have to prepare for doctor's visits far more than "back home" if you want to get the best care. When I was living in a non-English-speaking neighborhood, I'd have to spend time translating my symptoms to the local language. Without computers, I'd probably need to hand-copy it from a paper dictionary instead. 50 years ago it would be very much a pantomime/charades scenario.
And here's the kicker: talking symptoms is SUPER inaccurate even with both doctor and patient speaking the same language unless the doctor has time and skills for teasing out things the patient doesn't know are relevant. And the doctors on a bell curve of that skill - plenty don't know what they don't know because they are on the low side of the curve so they miss things also.
I and some others in the healthcare/healthcare tech spaces volunteered to create a discharge templating system for many of the top non-English and non-Spanish languages used in the United States - specifically the top languages in the Northwest to start. Our offering utilized data from, and would have been integrated with, an EMR whose name means "particularly impressive" even if their response was anything but. After openly communicating our plans with this firm for many, many months (over two years for some of us) we were informed right before our intended trial that we would be denied from providing our services to the patients (and their providers) who truly needed it. We were never given a reason and I've not seen any product released by this firm in the interim to make me think we were potential competition to any part of their EMR suite.
It was a truly perplexing and depressing outcome. Worse, as some of our team hadn't yet had their sense of possibility and belief in the US medical system destroyed, I saw first hand a number of talented persons simply walk away from doing any work in health or healthcare tech. It was a double blow that went beyond just the loss of the software that was being created; people who otherwise would have dedicated their lives to improving patient outcomes instead went elsewhere with their careers or volunteering lives.
It was a truly perplexing and depressing outcome. Worse, as some of our team hadn't yet had their sense of possibility and belief in the US medical system destroyed, I saw first hand a number of talented persons simply walk away from doing any work in health or healthcare tech. It was a double blow that went beyond just the loss of the software that was being created; people who otherwise would have dedicated their lives to improving patient outcomes instead went elsewhere with their careers or volunteering lives.
I’m curious for more details on what your templating system was and how it worked. If you’re up for sharing, I’d love to hear about it.
I know the aforementioned EMR puts a lot of emphasis on their After Visit Summaries, which sounds somewhat similar to what you describe.
I know the aforementioned EMR puts a lot of emphasis on their After Visit Summaries, which sounds somewhat similar to what you describe.
Feel free to email me. I'm dealing with a death close to me and some estate related issues so I may take some time to get back to you but I will.
For what it is worth, we never saw ourselves as a replacement for the After Visit Summaries but rather an adjunct that ensured said Summaries could be understood and utilized by non-speakers or ESL patients who perhaps are not as confident in their skills.
For what it is worth, we never saw ourselves as a replacement for the After Visit Summaries but rather an adjunct that ensured said Summaries could be understood and utilized by non-speakers or ESL patients who perhaps are not as confident in their skills.
Doubt your company is large enough to partner with them.
The issue with discharge templating is that EVERY single client under that company gets customized support from them until you are able to guarantee providing that level of custom support you don't have a shot in partnering with them.
There's a reason why Caregility is the solution instead.
https://www.healthcareitnews.com/news/mount-sinai-eases-tran...
Touching the templates themselves is never going to scale.
The issue with discharge templating is that EVERY single client under that company gets customized support from them until you are able to guarantee providing that level of custom support you don't have a shot in partnering with them.
There's a reason why Caregility is the solution instead.
https://www.healthcareitnews.com/news/mount-sinai-eases-tran...
Touching the templates themselves is never going to scale.
It wasn't a company - there was zero profit motive here - and we had received very helpful advice from them and strong support until we got close to starting a trial, at which point communication suddenly ceased and it became clear something had changed with regards to our relationship with them.
Perhaps when they actually got serious, they escalated it to legal, and the lawyers shot it down due to your entity not being able to take enough liability off of their hands (conjecture). I can see the execution side stringing you along but no one having actually done the legal due diligence first, who may have shot it down early enough to prevent you wasting your time.
My partner has used an EMR called Epic in her work and it, like all EMRs it seems, is trash. Government protections and a moat of network effects, they’re untouchable.
EMR software, like all medical software, suffers from a variation of the Dead Sea Effect.
Those who are truly invested in EMR software are not developers and developers are not invested in EMR software. So, as a developer, it's a job you take because you need a job. And if you're competent, you can get a job elsewhere eventually. If you're not, well, it's not like medical software has a deep talent pool to draw from. You can coast for a long time.
Combined with that, you have to work with doctors and nurses. Doctors especially operate under the belief that demonstrated competence in one area correlates to expertise in all areas. No one bikesheds harder than a doctor. Except a doctor who fancies himself a programmer as well.
Those who are truly invested in EMR software are not developers and developers are not invested in EMR software. So, as a developer, it's a job you take because you need a job. And if you're competent, you can get a job elsewhere eventually. If you're not, well, it's not like medical software has a deep talent pool to draw from. You can coast for a long time.
Combined with that, you have to work with doctors and nurses. Doctors especially operate under the belief that demonstrated competence in one area correlates to expertise in all areas. No one bikesheds harder than a doctor. Except a doctor who fancies himself a programmer as well.
> developers are not invested in EMR software
I know a handful of companies that went through YC trying to build EMR software and have met many more people since who are interested in this problem. It is not a lack of interest from engineers.
I know a handful of companies that went through YC trying to build EMR software and have met many more people since who are interested in this problem. It is not a lack of interest from engineers.
Hey! I'm one of those people. I'm building an Ophthalmology EMR. But I do have a question for you at your past job. At Curative were the labs/exams handled on site, or was it partnered with a lab to handle them?
Does your product just cram an ophthalmology scribe into an old sun e10k chassis?
No... but we've beamed a scribe into AWS!
I was trying to be diplomatic. There are adjectives I wouldn't use to describe developers interested in EMR software. Or at least from my experience from working in that space.
Besides pay, is there any reason a dev would be more invested in any other B2B app? A few people I know work in medical software, and a lot of them think it's meaningful work.
Doctors are hard to work with. For various reasons. Some understandable, they're often busy all day if they're running a practice. And they need and like days off just as much as anyone. So getting feedback can be tricky.
Then, most of them have superiority complexes. All users think using things makes them usability experts, doctors included. Couple that with the ego that comes with being in a profession where some number are responsible for life and death situations and you wind up with a user who truly believes that making the button cornflower blue is the single most important thing to take this thing over the top.
So you wind up basically with an absent, yet micromanaging, manager who also doesn't know how to develop software. That's kind of soul-crushing.
Then, most of them have superiority complexes. All users think using things makes them usability experts, doctors included. Couple that with the ego that comes with being in a profession where some number are responsible for life and death situations and you wind up with a user who truly believes that making the button cornflower blue is the single most important thing to take this thing over the top.
So you wind up basically with an absent, yet micromanaging, manager who also doesn't know how to develop software. That's kind of soul-crushing.
It's hard to design software that's both flexible and reliable enough to meet the needs of these medical users. In an ideal world imo, hospitals could plug in various modules into an overarching health IT framework -- that way they could pick and choose what works the best for them. However, that would mean they're now working with dozens of systems/companies instead of just one.
I'm building an EMR right now. Can I ask what sub-surgical field your partner works in?
I agree, the EMR implementation/enhancements were a giant handout to consultancies, hospitals, maybe clinics that's now enshrined in law. It was a travesty and likely ended up costing more for lesser benefit. The effects were of course felt in impoverished areas more than in suburbia, as hospitals clinics and are poorer, consultancies are (almost) not existent. It was a grift -- even academia got in on the money training!
There has been a better option for a long time, called on-staff Medical Interpreters. In fact, my spouse worked as one for approximately seven years. Unfortunately due to hospitals consolidating into medical networks and cutting costs wherever they could, this went from on-staff interpreters, to contract interpreters, to on-call phone interpreters (works incredibly poorly), to google translate.
Blame the beurocrats running your hospital. The systems were in place, just have been absolutely gutted.
Blame the beurocrats running your hospital. The systems were in place, just have been absolutely gutted.
My SO had to seek medical attention in rural southern France (we were visiting Carcassone) - she initially sought care at the local emerg where there was not a translator available, she speaks high-school french but most of the conversation was carried out through miming and charades. A few days later, as instructed, she followed up with a local clinic where she prepared a written version of her condition and brought it in to show the doctor, they consulted that and again went through a song and dance to try and mime out the response.
I think it'd probably be nice if there was an english fluent person on staff at the emerg but I think it's unreasonable to expect local clinics to have support for translating especially when English is a rather unlikely language to be spoken in that area - having someone German and Italian literate would be nice and having someone Spanish literate (and, ideally, Basque literate) would be much more important.
If you're running a hospital in Vancouver you better have a French[1], Punjabi and Mandarin translator on staff - outside of those I think it's reasonable to rely on tools like Google Translate, it sucks but full language coverage isn't reasonable.
1. I think a French translator might be legally required due to the bilingual nature of Canada but it's honestly much less common on the west coast compared to Punjabi and Mandarin.
I think it'd probably be nice if there was an english fluent person on staff at the emerg but I think it's unreasonable to expect local clinics to have support for translating especially when English is a rather unlikely language to be spoken in that area - having someone German and Italian literate would be nice and having someone Spanish literate (and, ideally, Basque literate) would be much more important.
If you're running a hospital in Vancouver you better have a French[1], Punjabi and Mandarin translator on staff - outside of those I think it's reasonable to rely on tools like Google Translate, it sucks but full language coverage isn't reasonable.
1. I think a French translator might be legally required due to the bilingual nature of Canada but it's honestly much less common on the west coast compared to Punjabi and Mandarin.
Really? A lot of our hospitals in Ontario make use of a tablet on a stick that can very quickly connect with a live translator on camera in their language. I am surprised Vancouver would be using Google translate and not an option like this. I've used it and it works fairly decently. Obviously it's still slower than speaking their language, but even having a translator in person still incurs such a delay.
The only real benefit I found to in person is that it's a bit more personal feeling and you don't have as many issues with the patient not hearing what they said on the tablet and vice-versa.
I found the language barriers are not a huge deal with options like this. I've also worked for a 911 call center taking ambulance calls and it's much harder to manage language barriers there as it can be hard to tell someone who speaks none of your language that you're getting a translation service on the line.
The only real benefit I found to in person is that it's a bit more personal feeling and you don't have as many issues with the patient not hearing what they said on the tablet and vice-versa.
I found the language barriers are not a huge deal with options like this. I've also worked for a 911 call center taking ambulance calls and it's much harder to manage language barriers there as it can be hard to tell someone who speaks none of your language that you're getting a translation service on the line.
Oh sorry, I'd clarify - I've never actually needed ESL assistance in a Vancouver hospital so I have no idea what they're equipped with - I was just offering a more local language selection to those of us on the west coast.
Usually your staff comes from the local population which gives you staff members who speak the languages you would need.
Unless a recent immigrant or tourist has a medical emergency right?
Or even a longer-term immigrant who never quite learned much medical vocabulary.
Or even a longer-term immigrant who never quite learned much medical vocabulary.
There are relatively few native French speakers in Vancouver..
They have plenty of employment opportunities though - having fluent french on your resume opens up a whole lot of opportunities with companies that are required to offer some french language support (i.e. train stations, government offices)
I had experience with the charades act. Got food poisoning or a stomach bug in Sofia, Bulgaria and had to act out vomiting and diarrhea at the chemists desk. Eventually they got the drift, opened a box of pills and gave me a sheet of them with no further instruction.
I think I could have been successful if I knew some French, but alas, I opted for Spanish in high school. At the time it seemed Bulgarians over a certain age had French for their second (or third) language, and the younger folks had English.
I think I could have been successful if I knew some French, but alas, I opted for Spanish in high school. At the time it seemed Bulgarians over a certain age had French for their second (or third) language, and the younger folks had English.
> At the time it seemed Bulgarians over a certain age had French for their second (or third) language, and the younger folks had English.
Yes this happens in Spain too. People over 50 or 55 or so were taught French at school but younger people were taught English.
However don’t expect most of them to speak much of it.
Yes this happens in Spain too. People over 50 or 55 or so were taught French at school but younger people were taught English.
However don’t expect most of them to speak much of it.
> Eventually they got the drift, opened a box of pills and gave me a sheet of them with no further instruction.
This isn't too far off how prescriptions work in many places in europe, east or west. If you're lucky, they'll hand-write instructions on the box (that are incomprehensible to me).
For added confusion, the chemists don't count pills/break packages. So if your order is for 7 doses, but they come in boxes of 5, you'll get 10 doses.
This isn't too far off how prescriptions work in many places in europe, east or west. If you're lucky, they'll hand-write instructions on the box (that are incomprehensible to me).
For added confusion, the chemists don't count pills/break packages. So if your order is for 7 doses, but they come in boxes of 5, you'll get 10 doses.
> I think it's reasonable to rely on tools like Google Translate, it sucks but full language coverage isn't reasonable.
Far better than what was possible before, when as a tourist you maybe had a phrasebook or something similar.
This is part of the risk of travel into an area where you don't know the language.
Also if you are going to permanently move to such a place, it's incumbent on you to become functionally fluent in the local language. Nobody there owes you a special accomodation.
Far better than what was possible before, when as a tourist you maybe had a phrasebook or something similar.
This is part of the risk of travel into an area where you don't know the language.
Also if you are going to permanently move to such a place, it's incumbent on you to become functionally fluent in the local language. Nobody there owes you a special accomodation.
> Also if you are going to permanently move to such a place, it's incumbent on you to become functionally fluent in the local language. Nobody there owes you a special accomodation.
Functional fluency doesn't really cover hospital interactions though, right? I can live for decades in Paris without knowing what the word for chest pains or sprained ankle are.
Functional fluency doesn't really cover hospital interactions though, right? I can live for decades in Paris without knowing what the word for chest pains or sprained ankle are.
I've spoken English my whole life and still struggle to express the exact sensation I'm feeling to a doctor.
No, I doubt you could - 'pain' and it's synonyms, as well as basic body parts like 'chest' are pretty basic words for someone who's spent decades immersed in a language...
I’ve lived in a foreign country where I learned the local language and was hospitalised twice during the time I lived there. My vocabulary certainly didn’t contain very much medical vocabulary, and it wasn’t an issue at all. At worst you’re Google translating one or two words, or explaining things in a slightly odd way.
I could certainly say “chest pain” though.
I could certainly say “chest pain” though.
The difficulty with "functional fluency" is that medical terms are extremely specific. On top of that you have to deal with "doctors in X recognize this illness, but doctors in Y recognize it as something entirely different"-style stuff. Alergies can be a scary one to get wrong, too!
Of course nobody owes anybody anything. I do think that in countries with nationalized health care, at the very least having a call center to help out with language difficulties around this feels like almost a no brainer though.
There are doctors with specialized dictionaries and the like as well, of course.
And... yeah honestly, Google Translate (or my favorite solution of "go to wikipedia page and find the linked article in local language") can help a lot.
Of course nobody owes anybody anything. I do think that in countries with nationalized health care, at the very least having a call center to help out with language difficulties around this feels like almost a no brainer though.
There are doctors with specialized dictionaries and the like as well, of course.
And... yeah honestly, Google Translate (or my favorite solution of "go to wikipedia page and find the linked article in local language") can help a lot.
That approach is best for cases where it works, for example in areas where there is a large minority of speakers of a given language (Spanish in the US, for example). But if the patient speaks a language that is unusual for the area, finding an interpreter is going to be more difficult, or maybe not possible in some cases.
You have a similar problem with respect to criminal trials of defendants who speak minority languages. You can find a Khmer interpreter easily enough in Los Angeles, but good luck in Miami.
I’ve heard anecdotally from lawyer friends that despite how fucked up the US justice system is in so many ways, one bright spot is the lengths to which they’ll go to find interpreters.
One Guatemalan defendant who natively spoke a Mayan language had to go through a chain of three court-appointed interpreters: one from his language to a different, more widely-spoken Mayan language, one to go from that to Spanish, and one from Spanish to English. He told my friend (his lawyer) something like: “this is amazing; in Guatemala they’d have just told me ‘sorry, the national language is Spanish’ and I’ve had been out of luck!”
I don’t believe it would be legally possible in the US to convict a monolingual Khmer speaker of a crime without providing an interpreter, in Miami or anywhere else.
One Guatemalan defendant who natively spoke a Mayan language had to go through a chain of three court-appointed interpreters: one from his language to a different, more widely-spoken Mayan language, one to go from that to Spanish, and one from Spanish to English. He told my friend (his lawyer) something like: “this is amazing; in Guatemala they’d have just told me ‘sorry, the national language is Spanish’ and I’ve had been out of luck!”
I don’t believe it would be legally possible in the US to convict a monolingual Khmer speaker of a crime without providing an interpreter, in Miami or anywhere else.
> By 2028, it is expected that health care spending in the U.S. will reach nearly one fifth of the nation's gross domestic product
It is a balance of features vs price. Right now, we need to do absolutely everything we can to keep the price of medical care as low as possible.
In the US it might make sense for most hospitals to have people on staff for Spanish. I don't think we as a country can afford 270 other languages of full time staff. We should use tech in any way possible to cut this cost.
It is a balance of features vs price. Right now, we need to do absolutely everything we can to keep the price of medical care as low as possible.
In the US it might make sense for most hospitals to have people on staff for Spanish. I don't think we as a country can afford 270 other languages of full time staff. We should use tech in any way possible to cut this cost.
Bluntly speaking, this is not a problem that tech can solve. Because nothing, no video calls, no vr, no phone calls, can replace an on-site professional. There are approximately top 10 languages you want to have staff for, and then the rest can be handled by contractors. But you have to remember that most "staff" are actually 1099 contractors now because they can be paid submarket wages that way.
Thanks, monopolies.
Thanks, monopolies.
> Bluntly speaking, this is not a problem that tech can solve. Because nothing, no video calls, no vr, no phone calls, can replace an on-site professional.
AFAICT, over the past 150+ years, a qualitative argument like this is made every time a skilled job can be replaced by automation, but the automation wins anyway. The automation quality ends up improving to the point where the economics are inescapable.
AFAICT, over the past 150+ years, a qualitative argument like this is made every time a skilled job can be replaced by automation, but the automation wins anyway. The automation quality ends up improving to the point where the economics are inescapable.
What are countries with more functional healthcare systems doing differently?
When it comes to comparisons with other countries, much of the dialogue in the US is centered on insurance coverage. That said, I'm curious if other countries have found better solutions to similarly fundamental issues, such as doctors working long hours, doctors being forced to maximize the number of patients, continued medical education, and patient education about the doctor-patient relationship.
When it comes to comparisons with other countries, much of the dialogue in the US is centered on insurance coverage. That said, I'm curious if other countries have found better solutions to similarly fundamental issues, such as doctors working long hours, doctors being forced to maximize the number of patients, continued medical education, and patient education about the doctor-patient relationship.
Aaron Carroll did a Youtube Series back in 2014 on the topic, even if you don't want to watch the videos there's a lot of good links in the description of each one: https://www.youtube.com/watch?v=yN-MkRcOJjY&list=PLkfBg8ML-g...
From what I remember: Insurance is one reason, Hospitals not engaging in collective bargaining (e.g. vs. NHS in England which makes decisions about what to spend money on and makes companies bid on contracts for the whole country), wasteful premium care that adds little to patient outcomes (e.g. vs Singapore which has a privatised tiered healthcare system but heavily regulates healthcare so this doesn't happen), and simply paying Doctors far more money.
From what I remember: Insurance is one reason, Hospitals not engaging in collective bargaining (e.g. vs. NHS in England which makes decisions about what to spend money on and makes companies bid on contracts for the whole country), wasteful premium care that adds little to patient outcomes (e.g. vs Singapore which has a privatised tiered healthcare system but heavily regulates healthcare so this doesn't happen), and simply paying Doctors far more money.
Career healthtech worker; opinions are my own; focusing only on the provider-specific questions you're asking:
Biggest problem (w.r.t. provider overwork and availability) is regulatory capture by AMA and hospital groups. The AMA has for decades induced an artificial shortage of MDs by limiting the number of available residency slots. In particular, there's an acute shortage of slots for primary care providers (gen practice, family med, internal medicine, OBGYN) - which combined with financial incentive, leads to an oversupply of specialists.
AMA is also very assertive about keeping alternative providers (e.g. nurse practitioners) from having the rights to perform certain procedures - again as a form of financial protectionism. I'm picking the worst possible example, because it goes wrong all the time, but in many LatAm countries for example, routine x-rays and ultrasounds are often read by technologists rather than radiologists. Broadly speaking, there's a chilling effect of provider liability, in that your PCP may not be a dermatologist, so instead of doing a mole screen themselves during your annual office visit, they send you for a specialist visit instead of doing it in house (to avoid the unlikely chance they miss something subtle the derm might've caught) - costing more money, fueling the oversupply of specialty care, and letting the "general" skills of GPs atrophy even further.
TLDR: The American Medical Association kills people.
Biggest problem (w.r.t. provider overwork and availability) is regulatory capture by AMA and hospital groups. The AMA has for decades induced an artificial shortage of MDs by limiting the number of available residency slots. In particular, there's an acute shortage of slots for primary care providers (gen practice, family med, internal medicine, OBGYN) - which combined with financial incentive, leads to an oversupply of specialists.
AMA is also very assertive about keeping alternative providers (e.g. nurse practitioners) from having the rights to perform certain procedures - again as a form of financial protectionism. I'm picking the worst possible example, because it goes wrong all the time, but in many LatAm countries for example, routine x-rays and ultrasounds are often read by technologists rather than radiologists. Broadly speaking, there's a chilling effect of provider liability, in that your PCP may not be a dermatologist, so instead of doing a mole screen themselves during your annual office visit, they send you for a specialist visit instead of doing it in house (to avoid the unlikely chance they miss something subtle the derm might've caught) - costing more money, fueling the oversupply of specialty care, and letting the "general" skills of GPs atrophy even further.
TLDR: The American Medical Association kills people.
I initially thought this was a fringe comment, but I was surprised to learn that your criticisms have basis, with adherents like Milton Friedman [1]. It certainly toppled my presumptive association of the AMA with putting patient care first.
P.S. I found this tidbit on tobacco particularly troublesome [2].
[1] - https://en.wikipedia.org/wiki/American_Medical_Association#C...
[2] - https://www.sourcewatch.org/index.php/American_Medical_Assoc...
P.S. I found this tidbit on tobacco particularly troublesome [2].
[1] - https://en.wikipedia.org/wiki/American_Medical_Association#C...
[2] - https://www.sourcewatch.org/index.php/American_Medical_Assoc...
This is a better option in quality, but seems more difficult to handle at any significant scale. Having a wide availability of highly trained, on premise professionals in every single location looks unrealistic to me.
What would be your middle-ground proposition for the large swath of doctor cabinets and hospitals who won't win/can't afford enough of the on-staff interpreters lottery and still get patients that need support in different languages ?
What would be your middle-ground proposition for the large swath of doctor cabinets and hospitals who won't win/can't afford enough of the on-staff interpreters lottery and still get patients that need support in different languages ?
Having multiple full-time paid translators on hand 24/7 at every hospital in the country would be nice, but probably not realistic.
Medicare and most private insurers will pay for medical translation or interpretation services when necessary. It's HCPCS billing code T1013. Generally hospitals would make a small gross profit on it, so I'm puzzled why they would eliminate those positions if there is enough demand to keep them busy.
It is so hard to provide a similar level of care when I'm taking care of a patient who does not speak the same language as me. So much of what we do in medicine depends on pre-test probability which in turn is hugely influenced by the history that we obtain from our patients. Good interpreters are wonderful assets but unforunately it's an area where some hospitals cut corners. We have only video translators at my hospital. Trying to communicate with a patient with dementia, hard of hearing, and WiFi connection/lag issues is all but impossible.
Although Taiwanese Mandarin and Mainland Mandarin are almost perfectly intelligible to each other, they have diverged from each other when it comes to modern nouns, especially in the fields of technology and medical science, etc.
To make the problem even worse, Google Translate only provides "Chinese (Simplified)" and "Chinese (Traditional)" instead of "Taiwanese Mandarin" or "Mainland Mandarin". While these two character sets can one to one map with each other, the result could be confusing for the user.
To make the problem even worse, Google Translate only provides "Chinese (Simplified)" and "Chinese (Traditional)" instead of "Taiwanese Mandarin" or "Mainland Mandarin". While these two character sets can one to one map with each other, the result could be confusing for the user.
The article is not explicit about it - just saying "Taiwanese", which may or may not refer to Taiwanese Mandarin - but maybe the patients native tongue was not Mandarin but Taigi/Hokkien (which is what IME people most often mean when they say just "Taiwanese" without qualifier) or even Hakka.
While Taiwanese people not speaking Mandarin natively are somewhat rare abroad, it would explain the difficulties in interpretation.
https://en.wikipedia.org/wiki/Taiwanese_Hokkien
https://en.wikipedia.org/wiki/Languages_of_Taiwan
While Taiwanese people not speaking Mandarin natively are somewhat rare abroad, it would explain the difficulties in interpretation.
https://en.wikipedia.org/wiki/Taiwanese_Hokkien
https://en.wikipedia.org/wiki/Languages_of_Taiwan
This article says they used Google Translate for "Taiwanese to English, English to Taiwanese", but Google Translate doesn't list 'Taiwanese' as a language.
It does list 'Chinese (Traditional)' and I guess that's what they were using.
It does list 'Chinese (Traditional)' and I guess that's what they were using.
Fun fact: Disney movies get separate dubs for Taiwan and for mainland China.
I'm going to try this next time my son watches a Disney movie, and see if he notices.
If he's already familiar with the movie, he's pretty certain to notice if you switch the version. The song lyrics are completely different.
I tend to feel that the Taiwan lyrics are better, but I'm not a native or even fluent speaker. I'd be interested in native opinions.
I tend to feel that the Taiwan lyrics are better, but I'm not a native or even fluent speaker. I'd be interested in native opinions.
"Taiwanese" is an ambiguous term. The official language of Taiwan is Mandarin Chinese, same as spoken on the mainland, which Google Translate does speak. However, many Taiwanese speak Hokkien (Fujianese/Min Nan) or Hakka (Kejia), both "dialects" (languages) of Chinese that Google Translate does not support.
Deepl is a better option. It feels several years ahead of Google Translate in quality. I know enough Japanese to hurt myself, and Deepl is definitely giving the superior translations, by far, which is great for my studies. As an analogy, it’s like going from 144p to 360p (a good human translation ranges from 720p to 4k+). Yeah 360p video is still blurry but it’s in a different league than 144p.
The problem with machine translation is not the obvious general mediocrity, but the occasional undetected catastrophic failure, especially in medical context. I don't think DeepL (or any other fully automated system) is any more reliable in this sense.
Can any automated solution be reliable enough? I don't think so unless you can prove it does less harm than a professional medical translator.
We should pay more for translators. But translation is an area where people like to cut costs. The translation industry simply doesn't pay enough to attract the volume of people required, at the level of skill required. And with machine translation getting better, not worse, I don't see this trend reversing without regulation... even if machine translation is still nowhere near human level.
Mediocre human translation can be catastrophically wrong as well. Mediocrity just isn't good enough when a mistake can cost someone's life. The worse the translator (machine or human), the more catastrophic mistakes it makes per 1000 lines of text. If a professional human translator isn't available, it makes sense to use the best alternative available. Deepl has a free web interface.
Sometimes Google translate is better. Sometimes it's the same. Sometimes both fail to translate correctly. DeepL is only better on average. I've found deepl to leave out sentences from the source text and sometimes it gets bugged and starts translating inaccurately and you have to refresh the page.
I find Deepl to be far superior to Google Translate.
The key is of course to use grammatically correct, unambiguous language to begin with.
If it's electronic communication, you can always reverse the translation to check it translates back to your original.
The key is of course to use grammatically correct, unambiguous language to begin with.
If it's electronic communication, you can always reverse the translation to check it translates back to your original.
Telemedicine is now a "thing," it is not that difficult to find a medical professional in another country who is fluent in English as well as the target language. Just as X-Rays are now commonly sent overseas to be read, you can set up a Zoom call with a medical colleague who is bilingual.
On the other hand, if you are complaining about the quality of Google Translate, that is another matter. Deepl.com's translations are better, but they support fewer languages. Google Translate works on the amount of source material available in the foreign language and what kind of source material. Mandarin can be quite good. Legal Arabic isn't that bad either, after a United Nations project to translate all Iraqi laws into English. There's not that much Burmese; Thai translations are uniformly horrible and as for Mizo? Forget it.
On the other hand, if you are complaining about the quality of Google Translate, that is another matter. Deepl.com's translations are better, but they support fewer languages. Google Translate works on the amount of source material available in the foreign language and what kind of source material. Mandarin can be quite good. Legal Arabic isn't that bad either, after a United Nations project to translate all Iraqi laws into English. There's not that much Burmese; Thai translations are uniformly horrible and as for Mizo? Forget it.
As with anything in US healthcare, it's never that simple, e.g. Telehealth providers outside of the US can't bill Medicare (https://mhealthintelligence.com/news/doctors-outside-us-cann...) which covers about 1/5 of the population.
I'm sure it's possible to make their discharge instruction template, but it seems inevitable they're hand out instructions to people who won't understand them.
Even with native speakers, medical instructions can be difficult. You can find lists of commonly confused English medical terms: https://www.antidote.me/blog/medical-terms-a-to-z-common-and... https://www.2ascribe.com/articles/health-wellness/40-words-t...
And, of course, there are still plenty of illiterate people.
Even with native speakers, medical instructions can be difficult. You can find lists of commonly confused English medical terms: https://www.antidote.me/blog/medical-terms-a-to-z-common-and... https://www.2ascribe.com/articles/health-wellness/40-words-t...
And, of course, there are still plenty of illiterate people.
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here is my side project: a catalog of duckduckgo !bang operators; a script is using google translate to autotranslate the UI strings and site descriptions into several languages; it is better than nothing, but it is not an ideal solution.
You can see the results here: https://github.com/MoserMichael/duckduckbang/blob/master/REA...
I didn't manage to automate the use of DeepL in python; The translators pypi package (https://pypi.org/project/translators/) tries to automate the REST api of DeepL, but it doesn't seem to work. Are there any alternative solutions for automating DeepL? (Well, i could probably give it a try with selenium)
On the other hand: when you take short descriptions - like labels that appear in a UI, then that's a very hard thing to translate, it is very easy to pick up the wrong synonym, to begin with... It would probably have an easier job with the site descriptions, these tend to be longer texts.
You can see the results here: https://github.com/MoserMichael/duckduckbang/blob/master/REA...
I didn't manage to automate the use of DeepL in python; The translators pypi package (https://pypi.org/project/translators/) tries to automate the REST api of DeepL, but it doesn't seem to work. Are there any alternative solutions for automating DeepL? (Well, i could probably give it a try with selenium)
On the other hand: when you take short descriptions - like labels that appear in a UI, then that's a very hard thing to translate, it is very easy to pick up the wrong synonym, to begin with... It would probably have an easier job with the site descriptions, these tend to be longer texts.
A relative of mine is deaf, and relies on Google voice recognition in order to comprehend her doctors. The doctors are all amazed that such a thing exists.
For those who know better than I - does this article, when saying Taiwanese, refer to Taiwanese Mandarin or the language also known as Taigi/Taigu?
Considering they were using google translate, I assume they meant Taiwanese Mandarin. Though usually when I hear taiwanese as a language in english it's tai-gi.
I was doing some research on Hokkien in general the other day and that's when I noticed some using the endonym Taigu instead. I'm not sure what the difference, if any, is.
Taigu is a Taiwanese-specific dialect of Hokkien.
Hokkien is spoken outside Taiwan (e.g. Fujian).
Hokkien is spoken outside Taiwan (e.g. Fujian).
I'm aware of that, so apologies if that wasn't clear. I was referring to the Taigu/Taigi distinction as the source of my uncertainty.
> Hokkien is spoken outside Taiwan (e.g. Fujian).
It would be pretty shocking if that wasn't the case, since Hokkien is spelled 福建.
It would be pretty shocking if that wasn't the case, since Hokkien is spelled 福建.
Right, but when people say "Hokkien" in English they generally mean 閩南語 - though I've also heard the term "Southern Min" used.
OK? I don't see why that would make it less shocking for Hokkien not to be spoken in the region that shares its name. It's like saying "they speak English in England, too". Of course they do; that's what "English" means.
Yeah fair enough. Just pointing out the word Hokkien in English does not really mean 福建, even if that's where the word comes from.
I've only heard 'gi', but it looks like alternate pronunciations[0].
I've only really dabbled in the language, but I quickly got the impression it's not exactly standardised. Even something as simple as 'I' seems to have two pronunciations (gua and wa).
[0] https://www.mkdict.net/results?query=%E8%AA%9E+&page=1&q_typ...
I've only really dabbled in the language, but I quickly got the impression it's not exactly standardised. Even something as simple as 'I' seems to have two pronunciations (gua and wa).
[0] https://www.mkdict.net/results?query=%E8%AA%9E+&page=1&q_typ...
Ah, now that you've highlighted the specific pronunciation divergence the two separate transliterations now make sense. I really appreciate the reply, given the relatively low stakes here.
When speaking: probably not Mandarin, as in that case they would have no difficulty finding an interpreter.
When writing: not a relevant question, as Google Translate is for the written form, not spoken dialects.
When writing: not a relevant question, as Google Translate is for the written form, not spoken dialects.
[deleted]
a human?
Shocking right?
I mean services have existed for on-demand language translation by phone for a long time. You call them up, tell them what language and they connect with a translator.
Hell, they probably have cool apps and stuff now.
No doubt not cheap, but hey let's keep using Google Translate for life-and-death issues.
I mean services have existed for on-demand language translation by phone for a long time. You call them up, tell them what language and they connect with a translator.
Hell, they probably have cool apps and stuff now.
No doubt not cheap, but hey let's keep using Google Translate for life-and-death issues.
Is no one going to address the elephant in the room? If you're in a country where the lingua franca is X, you need to be able to speak X or life will be difficult. I'm not sure why the onus is on every hospital to become a kind of mini united nations here.
Many hospitals advertise internationally and rely on medical tourism of various sorts. You can't expect a 70 year old heart patient flown in from Taiwan to Phoenix to learn English for their surgery.
I think if you're advertising internationally for international patients, it becomes reasonable to expect you to have translators on staff.
Tourism (including medical tourism) is a thing, as is telemedicine. In general, doctors and hospitals aren't in the business of turning away people just because they speak the "wrong" language.
To be fair, most the people only speaking Spanish in the US aren’t here for tourism.
People travel recreationally, for business, and sometimes out of necessity to places where they don't speak the local language - perhaps you, friends, or family have, or will in future, experience those kinds of travel.
Medical emergencies (or, to be honest, routine medical care) can be required for anyone, anywhere, for no particular reason. Care workers are no doubt familiar with that.
For people to want to improve the situation for hospitals doesn't seem bad if it's possible. Do you think that we cannot achieve better?
Medical emergencies (or, to be honest, routine medical care) can be required for anyone, anywhere, for no particular reason. Care workers are no doubt familiar with that.
For people to want to improve the situation for hospitals doesn't seem bad if it's possible. Do you think that we cannot achieve better?
People travel recreationally, for business, and sometimes out of necessity to places where they don't speak the local language - perhaps you, friends, or family have, or will in future, experience those kinds of travel.
Sure, my wifes English is very good but not perfect. I accompany her so I can give quick translations to medical terms she might not know.
If we ever bring her parents here to live, guess whose job it's going to be to make sure they understand doctors? Well, mostly hers... but you get my point. The onus is on us.
I have no expectation that every hospital should be able to communicate in every language on earth.
Sure, my wifes English is very good but not perfect. I accompany her so I can give quick translations to medical terms she might not know.
If we ever bring her parents here to live, guess whose job it's going to be to make sure they understand doctors? Well, mostly hers... but you get my point. The onus is on us.
I have no expectation that every hospital should be able to communicate in every language on earth.
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Thanks - that all makes sense, and I agree that generally it makes sense to navigate life with realistic expectations.
Having optimism, and deciding to challenge existing limitations can both be useful too, though.
> I have no expectation that every hospital should be able to communicate in every language on earth.
I like the way you stated that. At first it made me think about how to improve translations. Now it's making me wonder whether there is a more universal common medical language (in many situations, I think that human care for each other doesn't require much communication at all).
Having optimism, and deciding to challenge existing limitations can both be useful too, though.
> I have no expectation that every hospital should be able to communicate in every language on earth.
I like the way you stated that. At first it made me think about how to improve translations. Now it's making me wonder whether there is a more universal common medical language (in many situations, I think that human care for each other doesn't require much communication at all).
I recently went to Poland for a quick 2 day holiday. Felt great before I left. Felt great while I was there. Tested positive for covid the morning I was supposed to fly home. Fast forward a bit and I'm in the back of an ambulance while my partner was on the plane back home.
They put me up in a hotel for 10 days. Fed me 3 times a day. Checked on me twice a day. And on day 10, opened the door and I was on my own.
How I could have managed that without Google translate, I don't know. None of the doctors or nurses spoke more than a few words of English. And I could barely say hello, goodbye or thank you. (I can now!)
As you say, life would have been difficult. It was difficult even with google translate. But it made the interactions much easier on both parties involved.
I would hope that if someone was visiting my country on holiday, or to visit their relatives, and happened to get sick, that the hospital would do all they could to communicate with them and not treat them like they shouldn't even be there.
They put me up in a hotel for 10 days. Fed me 3 times a day. Checked on me twice a day. And on day 10, opened the door and I was on my own.
How I could have managed that without Google translate, I don't know. None of the doctors or nurses spoke more than a few words of English. And I could barely say hello, goodbye or thank you. (I can now!)
As you say, life would have been difficult. It was difficult even with google translate. But it made the interactions much easier on both parties involved.
I would hope that if someone was visiting my country on holiday, or to visit their relatives, and happened to get sick, that the hospital would do all they could to communicate with them and not treat them like they shouldn't even be there.
Right, but if you decided to move to Poland - you'd realise you probably need to speak Polish, right?
Since you started by suggesting hospitals don't need this capability: So because one reason why people might turn up at a hospital not speaking the language isn't "valid" in your eyes, hospitals shouldn't prepare for any people that don't speak the language?
(And your example, Poland, has a pretty big influx of people right now who had different priorities than ensuring they speak the language first)
(And your example, Poland, has a pretty big influx of people right now who had different priorities than ensuring they speak the language first)
What a weirdly hostile response. Not only are you wielding scare quotes against me, but they're not even words I used - not once did I say "valid".
HN really is a stifling place whenever the discussion veers anywhere close to politics. I give up, you win.
HN really is a stifling place whenever the discussion veers anywhere close to politics. I give up, you win.
I don't know anything about the person in the article but if you still don't speak the language X years after immigrating to a country you have no one but yourself to blame for these kinds of situations.
I guess I know why the parent is downvoted
but in the end the responsibility is on both sides.
If you don't speak fluent English
you ask for interpreters in Spanish, Chinese, you name it.
You can't insists on speaking an unpopular dialect/accents,
can't even specify what best describe your dialect/accents,
and expect anything from the hospitals.
People don't choose their native languages and everyone should expect adequate care at a hospital when they need it.
They do choose to move somewhere where their language is not spoken.
As stated in this article, the woman was receiving service in Arizona. The official language in that state is English, so you should expect services to be offered in that language.
As stated in this article, the woman was receiving service in Arizona. The official language in that state is English, so you should expect services to be offered in that language.
What an ignorant, cruel, and infuriating position. I remember hearing my grandfather say this exact thing and realizing, at seven years old, that it was not how the world does or should work.
Frustrating that this continues to be an acceptable stance a half century later.
Frustrating that this continues to be an acceptable stance a half century later.
Why is Google translate still so bad?
I remember that when it was introduced many years ago it was horribly bad but it's badness was a hope that things will improve quickly.
And after so many years and so much data available to google it's still that bad.
I remember that when it was introduced many years ago it was horribly bad but it's badness was a hope that things will improve quickly.
And after so many years and so much data available to google it's still that bad.
It is amazing how quickly we go from not knowing how to do something to complaining that it is not good enough.
To be clear, I'm not suggesting that Google translate is good enough for medical translation; we should still be employing people for this job.
To be clear, I'm not suggesting that Google translate is good enough for medical translation; we should still be employing people for this job.
They rolled out a major upgrade in 2016 that switched to deep learning powered models, which in my experience made the translations far better. Still not perfect, of course, but for even remotely related languages (eg. most in Europe) it actually does a pretty amazing job now.
A - Is it terrible? In most cases it gives you a rough idea.
B - Getting better than rough is probably, like self-driving cars, pretty hard, requiring understanding of what texts actually mean.
Maybe it’s best it could without having consciousness and/or contexts. Translations only go so far by literal texts alone.
In US ALL doctors have to be trained in Spanish so that they can serve the hispanic population. This type of systemic racism against hispanics shouldn't be tolerated and we need put an end to it.
A doctor not knowing every language on earth is not racism. Learning a language takes a significant amount of time / money.
The article doesn't mention this as an issue? Actually, for Spanish it indicates the opposite.
As a native Spanish speaker who remembers not speaking English and whose mom makes silly English mistakes with her Dr. (I went to a restaurant and got “intoxicated” instead “food poisoned”)…
No.
We made the decision to move here. Why should Dr.s learn Spanish instead of us English?
Also, there are plenty of Dr. who speak Spanish (upper middle classes fetishize us and love to show off their basic Spanish)
Finally, Dr. training is brutal enough as it is without adding the burden of a new language. I want my family Dr. to focus their time on their cardiology classes. My mom can collect more funny anecdotes.
Im sure you feel well, but this suggestion is patronizing and reeks of what is now called “white savior complex”.
No.
We made the decision to move here. Why should Dr.s learn Spanish instead of us English?
Also, there are plenty of Dr. who speak Spanish (upper middle classes fetishize us and love to show off their basic Spanish)
Finally, Dr. training is brutal enough as it is without adding the burden of a new language. I want my family Dr. to focus their time on their cardiology classes. My mom can collect more funny anecdotes.
Im sure you feel well, but this suggestion is patronizing and reeks of what is now called “white savior complex”.
Why are translation services the issue here? Why isn’t the issue: non-English speakers allowed to practice medicine on people without being able to talk to them. I’m seriously fed up with this nonsense. If I’m moving to a country, I’m learning the damned language. Reply to me if you want to talk to someone who endured 5 years of university education delivered incoherently by non-English speakers. I wasted lots of money on poor education, but there are people dying because their doctor doesn’t even have to speak the same language as them in their own country. When did this become acceptable? How is this not gross negligence?
> Why isn’t the issue: non-English speakers allowed to practice medicine on people without being able to talk to them
... because that's not the scenario the article is about? First sentence:
> The patient had just undergone a cesarean section, and now was struggling to put words to her pain in her native Taiwanese.
... because that's not the scenario the article is about? First sentence:
> The patient had just undergone a cesarean section, and now was struggling to put words to her pain in her native Taiwanese.
Isn't the article about patients who don't speak English, not doctors?
Come to any Australian city and try to get into a GP (who isn’t booked out for a month). Odds are the language barrier will prevent a lot of meaningful communication and you won’t get good help.
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Only skimmed the article, it seems entirely about non-English speaking patients, not doctors.
The pendulum has fully swung from "pain is a vital sign" to "suck it up" and "anyone who complains about pain is a liar or a drug seeker unless they're older than 65 or have a visible external wound."[1] It's difficult even when you speak the same language. I'm sure it's nearly impossible when you don't.
[1]: https://rehabs.com/pro-talk/how-to-get-labeled-a-pill-seeker...