Breaking Language Barriers

I should have practiced my Chinese before I came to Philadelphia. We see a diverse patient population my host site, Health Center 2, the Philadelphia Department of Public Health’s ambulatory health center in South Philly. Many are recent immigrants. Most of the pages that come through the PA system are for interpreters called to different parts of the clinic. Four in-house interpreters help the staff communicate with patients who speak Vietnamese, Indonesian, Spanish, and Khmer, the official language of Cambodia. Our Chinese interpreter, however, is a volunteer. On days when she is out, I sometimes get paged to exam rooms or the nurses station to help interpret, or receive visits from patients who don’t come to my office for prescription assistance services but instead come with letters they need help reading. I’ve called a Jefferson Health billing representative on behalf of a patient who could not read English to add his insurance information onto his account. I’ve called the County Assistance Office on behalf of another patient to confirm that her Access card for her Pennsylvania Medicaid plan was active. I once interpreted for a whole doctor’s visit when the Interpretalk language service was unavailable.

None of these actions are part of my position description. Like the other Patient Advocates at PDPH clinics, my main role is to help uninsured patients apply to receive medications from assistance programs. But I’m glad I’m able to help with interpretation when I can. Language is one of the many barriers to accessing care, and I’m thankful that the health department has invested in resources to bridge language gaps between patients and staff.

Interpreters often also act as cultural brokers. I’ve encountered this both when interacting with patients through interpreters and first-hand when I do my best to help Chinese patients. After I helped the middle-aged man call Jefferson Health about his bill, he stayed for another half an hour and we talked about where we came from and where to get Chinese food in Philadelphia. I once directed a patient who wanted enroll in the insurance Marketplace to one of the clinic’s insurance specialists whose office was down the hall. I heard my colleague Jillian explain in English that enrollment was closed for the year and that he should return in November, and then saw him back to my office where I explained the same information in Mandarin. When I speak to patients who do come in for prescription assistance in the language they are more familiar with, I see them immediately relax and smile.

PDPH Health Centers have interpreters on-hand to assist patients who do not speak English. If an in-house interpreter does not speak the patient’s preferred language, health center staff have access to telephone interpretation services. 

Although I grew up learning both Mandarin and Cantonese, since leaving home for college I haven’t had much occasion to speak either. My skills are certainly rusty, and patients will sometimes correct me. Every time I speak to a patient in Chinese, I find myself wishing I was more practiced and knew more medical terminology. That way I could do a better job of explaining the process of applying for medication assistance programs, or helping patients fill out medical history forms before their mammograms, or directing them to return for a walk-in appointment to get their prescriptions refilled. One of the many things that has been reinforced during my service term is the importance of effective communication when delivering services to a diverse population. Language is just one barrier to overcome. I’ve realized that I was lucky to learn a second and third language at a young age. I’ve been inspired to strengthen the resource that I have — language skills — to better serve the people I care for. In the meantime, I will be honored to use my mostly grammatically and tonally correct Chinese to serve my patients and our community in the best way that I can.

This blog was posted by NHC Philadelphia member Michelle Wan.
Michelle serves as a Patient Advocate at Philadelphia Department of Public Health Ambulatory Health Services - Health Center 2.