Going to the doctor can make many people nervous. But when patients cannot communicate with their health care providers because they don't speak the same language, the situation is not only stressful and frustrating, it becomes potentially life-threatening. As Faiza Elmasry tells us, while some sort of translation services are available in hospitals across the United States, there is a growing need for professional medical interpreters.

For more than a quarter of a century, Language Line Services, LLS, has provided trained interpreters to help doctors and caregivers communicate with non-English-speaking patients. Company president Louis Provenzano says the demand for interpreting services is on the rise.

"Every 19 seconds, another immigrant comes into the United States," he says. "According to our census, the U.S. census data, there is almost 23 million people in the country that are called 'limited-English proficient,' which means that they don't speak English well or don't speak English at all. There are almost 176 languages spoken in the United States today."

Communicating with clients whose first language is not English, Provenzano says, is an issue for all service-oriented institutions. And in hospitals, he adds, the language barrier can pose a serious challenge.

"A typical urban hospital, they may treat patients who speak 40 to 60 different language," he says. "So it's almost impossible for staff internally to meet those interpreting needs. Some hospitals provide professional interpreters or just rely on a family member or even a janitorial staff.

But because their knowledge of medical terminology is not been verified by any regulating authority, the quality of communication can differ traumatically and, in the case of diagnosis and treatment decisions, it could have a tragic consequences."

To make it easier for the health care industry to find professional interpreters who understand the technical jargon, LLS recently launched the International Registry of Certified Medical Interpreters.

"It's the first industry resource of its kind to give health care organizations a free online resource for identifying those professionals, medical interpreters, and reviewing their language skills and credentials," Provenzano says.

Certified Spanish interpreter Susan Avila provides over-the-phone medical translations. For almost 10 years, she says, she has facilitated communication in a wide variety of cases.

"It could be anywhere from a little child getting his shots updated to something very elaborate, as the explanation of a surgery," says Avila. "Or maybe we have a psychological evaluation on a patient, and we have to be very careful. Perhaps, we'll be in a delivery room where a mother is having contractions, and we have to calm her down and give her the instructions on how she is supposed to breath."

Avila also trains other Spanish interpreters. She says becoming a certified medical interpreter requires more than just fluency in a language.

"In order to receive medical calls, you have to meet very high standards," she says. "You have to pass an exam after you have gone through the training. We are also provided with medical, with glossaries. We visit Internet links that have a lot of info.

"And then, we are constantly evaluated. We are supervised to see that we are adhering to the terminology, to the protocol that we're managing the challenging situations the way we're supposed to manage them."

Linguistic skills and knowledge of medical terminology is just one component of what it takes to be a professional medical interpreter. Other aspects, Avila adds, include an understanding of different cultural backgrounds and the ability to deal with tough situations.

"We can soften our tone a little bit to give bad news, which we have to give many times," Avila says. "I always tell interpreters our voice is our biggest tool. It has to convey compassion. It has to convey kindness. It has to tell the patient, 'We're here to help you.' We have to hug them, let's say, over the phone."

According to LLS President Louis Provenzano, regulating medical interpreting services is essential to improving the health care system and ensuring equal opportunity for all patients.

"I think a number of interpreter associations, a number of different organizations like the Language Line Services, are really pushing Congress and legislators to put various regulation on a national basis. I think there is a lot of work, a lot of standards that are being developed so we can, in fact, have a unified approach."

Provenzano says he hopes that will allow health care professionals to focus on the medical services without worrying about important bits of information getting lost in translation.