Contracting

Contracting with Medical Interpreters

The TRANSLATE mnemonic device was developed to assist providers in contracting with their medical interpreters, both when becoming more familiar with the services available to them and immediately before their patient encounters. Julie can use TRANSLATE to develop an effective working relationship with the interpreter that will complement her Spanish language abilities to provide this family with appropriate genetic counseling.

T: TRUST
    -How will trust be developed in the patient-clinician-interpreter triadic relationship? What    
    about developing trust in relationships with the patient’s family and other health care
    professionals?

R: ROLES
    -What role(s) will the interpreter play in the clinical care process (e.g., language translator,
    cultural broker/informant, cultural broker/interpreter of biomedical culture, advocate)?

A: ADVOCACY
    -How will advocacy and support for patient - and family- centered care occur? How will
    power and loyalty issues be handled?

N: NON-JUDGEMENTAL
    -How can a non-judgemental attitude be maintained during health care encounters? How will
    personal beliefs, values, opinions, biases and stereotypes be dealt with?

S: SETTING
    -Where and how will medical interpretation occur during health care encounters (e.g., use of on-site salaried interpreters,
    contract interpreters, telephone interpreters, video interpreters)?

L: LANGUAGE
    -What methods of communication will be employed? How will linguistic appropriateness and
    competence be assessed?

A: ACCURACY
    -How will knowledge and information be exchanged in an accurate, thorough, and complete
    manner during health care encounters?

T: TIME
    -How will time be appropriately managed during health care encounters?

E: ETHICAL ISSUES
    -How will potential ethical issues be handled during health care encounters? How will
    confidentiality of clinical information be maintained?

Like, RC. “Appendix: Useful clinical interviewing mnemonics.” Patient Care Special Issue, “Caring for diverse populations: breaking down barriers,” eds. JR Betancourt, RC Like, BR Gottlieb, May 15, 2000, p. 189.

The use of the TRANSLATE mnemonic is even more important if, like Julie, you will be meeting with a new family who may have already established rapport and a working relationship with this particular interpreter. Proper contracting, whether guided by TRANSLATE or not, will ensure that Julie is comfortable with the provider-interpreter-patient relationship dynamic so she can focus on building rapport with Alejandro’s family and providing care for the new patient. Julie’s interest in conducting genetic counseling sessions in Spanish is reputable, and she should continue to work towards the goal of becoming a bilingual genetic counselor. However, until Julie is confident in her language abilities, and her Spanish speaking skills have been formally assessed, she should take advantage of the medical interpreter resources that are available at her center.

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