A recent study says language barriers are causing problems in U.S. hospitals as the population gets more diverse. 

Pilar Garcia is a medical interpreter in Spanish.  She says she is busier than she's ever been in the two years since she began working at the INOVA Fairfax Hospital in the U.S. state of Virginia.

"I work a 12-hour shift and I am here on a pager and a phone,? says Ms. Garcia. ?When a doctor needs me they just call me and tell me to come into the room."

Interpreters trained in medical terminology are in high demand in the U.S. as the country's population becomes more and more diverse.  The boom in the Hispanic population has led some hospitals to hire full-time Spanish interpreters.  

Martine Charles is the director of Cultural Competence at the INOVA Health System, which has five hospitals in Virginia.  She says the hospitals are paying bonuses to volunteers who complete language and cultural competence training.

"We also have trained hundreds of our bilingual staff who serve as volunteer interpreters.  They are called on in multiple languages when there is a need."

"I have somebody here who doesn't speak English.  Could you just ask her why she is here today," one staffer asks of another in an increasingly common conversation.

Some health care organizations hire contracted interpreters and have telephone services that work 24 hours a day in 150 languages.

Laura Pfeifer is with Fern, a non-profit organization that has more than 100 interpreters. They work for medical facilities in the eastern state of Maryland.  "Since I started a little over five years ago, each year there has been about 20 to 25 percent increase in demand for interpreters."

Census data says the number of U.S. residents with limited English proficiency has grown to 22 million -- eight percent of the population.  Federal rules require medical providers receiving federal funds [Medicaid or Medicare] to offer language assistance.  

But the rules have not been followed, says Marjory Bancroft. She is with the National Council on Interpreting in Health Care, an organization that promotes qualified medical interpreting services.

"In general a lot of (medical) organizations don't know about the law or they don't understand it.  This is a big problem," she says.

A recent study published in the New England Journal of Medicine shows no interpreter was used in 46 percent of emergency room cases involving patients with limited English proficiency.

"The consequences can be tragic,? says Bancroft. ?In many cases miscarriages have occurred. People have had amputations on the wrong limb or limbs cut off that they didn't know. A woman had an abortion without her knowledge." 

Advocates say health care workers throughout the world should be aware of diverse cultures. They say medical interpreters should be available everywhere in order to overcome language barriers and avoid tragic miscommunications.