The term ‘Qualified Interpreter’ is nothing more than a nice sounding catch phrase. You can say if you want to, and I hope you don’t want to, that a qualified interpreter is someone who can quack like a duck. The term ‘qualified’ in the world of interpreting, in reality, has no meaning. It is more of a marketing term more than anything else, and oh my has it been a success.
Section 1557 of the civil rights provision of the Affordable Care Act of 2010, which went into effect July 18, 2016, in a nut-shell says if you are receiving any Federal funds (Medicare, Medicaid, etc.), you must use a ‘qualified’ interpreter. In other words, little Johnny can’t interpret for his mother when she has a doctor’s appointment. A ‘qualified interpreter’ must be used. Sounds great, doesn’t it? But, what does it mean?
How is it determined if an interpreter is qualified? The answer to this question depends on who you ask. Some say it is an interpreter that is studying to become certified. Others say that it is an interpreter that has completed an interpreter training course and followed the interpreter’s code of ethics. The U.S. Department of Health and Human Services itself refuses to say what exactly is a qualified interpreter stating, “First, OCR [Office of Civil Rights] does not wish to unduly narrow the pool of qualified interpreters available to a covered entity by requiring certification or licensure; many interpreters who are currently unlicensed and uncertified are competent to translate at a level that would meet the requirements of Section 1557….”
What are the requirements of Section 1557? “A qualified interpreter must (1) adhere to ethics principles, including confidentiality, (2) demonstrate proficiency in speaking and understanding both spoken English, and at least one other spoken language, and (3) be able to interpret effectively, accurately, and impartially to and from such languages and English, using any necessary specialized vocabulary, terminology[,] and phraseology.”
And, precisely, who determines compliance with the above requirements? Is it the National Board of Certification for Medical Interpreters (NBCMI)? Nope. Okay, then is it the Certification Commission for Healthcare Interpreters (CCHI)? No, sorry, not them either. So, you are telling me that the only two recognized entities that test and certify medical interpreters don’t determine the requirements of a ‘qualified’ interpreter? Yes, I am. If it isn’t NBCMI or CCHI, then it must be the National Council on Interpreting in Health Care (NCIHC). Wrong!
I won’t leave you in suspense any longer. Are you ready? Drum roll, please. The answer is everyone and no one. Some states, but not all, have set criteria for an interpreter to be classified a qualified. Language agencies create their standards, some being stricter than others; however, it is used more as a marketing tool for attracting clients than actual compliance with Section 1557. I bet that is a surprise. If it weren’t such a travesty and insult to the profession, it would be laughable. And, last but not least, we have interpreters who classify themselves as qualified.
So, how does all of this play out? The refusal of the medical profession as a whole and the entities mentioned above to step up to the plate and take responsibility for setting a universal compliance standard to ‘qualify’ interpreters. It appears that this is intentional to suppress interpreting costs. Can I prove this? Nope. As the saying goes, however, if it walks like a duck and quacks like a duck, it must be a duck.
There is no reason that I can see, other than money, for not having standardized and universal compliance criteria to ensure that an interpreter is qualified. Think of it this way. A qualified interpreter is like someone who holds the equivalent to a Bachelor’s degree. They have the education that says yes, I know what I am doing. A certified interpreter is like someone who has a Master’s degree. They have, in addition to meeting the basic compliance standards, taken their education further.
If we were to set universal compliance testing for qualified interpreters (a step before certified), what would be the positive effect? What would be the adverse effect? One adverse effect is that it could reduce the number of interpreters thereby increasing costs due to supply and demand. Another adverse effect is testing for languages of less diffusion or in laymen’s terms those languages that are not requested all that often. I am sure some scholarly person can figure out a solution, and if they can’t –which they haven’t so far, then why not ask the interpreters how to do it? You know, the ones that make up this profession.
I have mentioned but a few possible negative aspects, so now I will share a few positive ones. First and foremost, something that everyone talks about but very few backs up with action is improved patient care. Would, in the long run, costs decrease because patients wouldn’t have to come back as often? Would having qualification criteria allow the interpreter to become part of the medical support team like a nurse or therapist? Just as an LPN (Licensed Practical Nurse) can do specific functions and an RN (Registered Nurse) more, could interpreters be classified the same, that is, a qualified interpreter equal to that of an LPN and a certified interpreter equal to that of an RN? Both are needed, and both invaluable to the medical profession. Oh, and of course this would mean that the interpreting costs, like that of the nurses, could be covered by insurance. Hmm?
So, who is against defining, testing and having universal standards to distinguish a ‘qualified’ interpreter from any bilingual off the street? Well, I can tell you this, it isn’t the professional interpreter. We have been fighting for years to be recognized. Who, then, is it? And, most importantly, which organization is going to get off of their laurels (that is polite for ass), step up to the plate, as the expression goes, and make a difference? So far, all we hear is talk. Now it is time to put some action behind your words.
David Martin Tucker, Certified Spanish Medical Interpreter, CHI™, or “Spanish David” as he is known, is a certified medical interpreter whose passion for Latin American culture and language is second only to his desire to become a voice for his Spanish speaking clients. Conveying more than words, David’s continuous thirst for knowledge thrusts him into the culture of his clients.
David is an honor’s graduate from the Southern California School of Interpreting’s Medical Interpreter Program and holds bachelor degrees in both Modern Languages (Spanish) and Business from Metropolitan State College of Denver and the University of Southern Indiana respectively.
A founding member of the El Puente Bilingual Toastmasters in Denver, David is also a contributor to the International Medical Interpreters Association (IMIA), the National Council on Interpreting in Health Care (NCIHC), and is a member of the Colorado Rocky Mountain Health Care Patient Advisory Board.