FAQs About Communication Barriers

• What translation services should I provide for my patients?
• What should I do if a seemingly impaired patient insists on driving?

• What translation services should I provide for my patients?

  Interpreter services are required by the Joint Commission on the Accreditation of Healthcare Organizations, the National Committee for Quality Assurance, and by the Office of Civil Rights. A medical practice that fails to accommodate hearing-impaired and non-English speaking patients could also be at risk under the ADA. Providers covered by the above organizations are required to provide professional services.

  If clinicians with interpreter skills are not part of your practice or department, professional medical interpreters can be hired on a daily basis through an interpreter service pool. Interpreter services for telephone conversations are also available through phone companies and private groups.

  Patients have the right to refuse and to use an interpreter of their own choosing.

  • Get documentation in the patient's language of the refusal of professional interpreter services.
  • Patients should be provided with informed consent that explains the treatment or procedure in their own language. Documentation should be included to substantiate the discussion in the patient's language, signed by the patient, and noting whether or not the interpreter was a professional or provided by the patient.
  • Include the signature and contact information for the interpreter.
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• What should I do if a seemingly impaired patient insists on driving?

  When a patient appears incapable of using good judgment, intervention by a responsible person in the health care setting is justified. The type of intervention depends on the circumstances and the clinician-patient relationship.

  Episodic Encounter

  If a drug or alcohol impaired patient encountered in an emergency setting refuses treatment and insists on driving, the least troublesome intervention is to detain the impaired patient while ordering a cab, finding a ride, or waiting for sobriety. Asking permission to call a friend or relative on the patient's behalf may also work. If all else fails, and the individual is so impaired as to present real risk to him/herself or others, the local police will place such a person in protective custody.

  Cognitively Impaired or Elderly Patients

  Clinicians often observe or are alerted to the fact that a patient under their care can no longer safely drive a car. Under these circumstances, you have a duty to the patient to reduce the risk that the patient will harm him or herself and a duty to take appropriate precautions to reduce risk of harm to potential victims.

  Schedule a counseling session with the patient and his or her family to discuss the gravity of risks associated with driving. An important objective of the meeting is to facilitate patient understanding of the continued risks of driving and to enlist family support to help the patient voluntarily give up the privilege. Document counseling measures in the patient's medical record. You may also refer patients and families to various community or hospital-based programs that are designed to ensure driving safety for people of all ages who have experienced neurological, psychological, or physical impairments.

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