BEYOND AWKWARD

I was recently asked to replace an interpreter whose job was running over the allotted time. When I arrived, the session had already begun and we quickly switched out. As the interpreter shut the door, the patient said, “Too bad that interpreter left so quickly! I was supposed to get her personal phone number! She wants me to paint her house and I told her I can do it for extra cheap!”

I rendered that into English, as required, and the surgeon and I locked eyes for a moment. The surgeon then shook his head and said, “Yeah… probably the less said about that the better.” I rendered that into the patient’s language, and then asked permission to add for the patient’s edification that we are not allowed to give out our personal phone number or hire patients to work, much less for substandard wages. We are only here to serve their medical needs, and happy to do so. Permission granted, this was conveyed. We were then able to get back to the patient’s health issue.

I am sure that if I ask this particular interpreter, I will be told that I have misunderstood. That it was never the interpreter’s intent to take advantage of a vulnerable patient, or get extra privileges or favors. That it was some kind of a misunderstanding. And if I take it to my boss, and they investigate it, and call the patient, he will say that the interpreter never asked for a discount, but rather he himself offered it, because he is so happy to get this medical care and to have an interpreter provided. I don’t doubt this. But it is still wrong. And I would hope this is obvious.

As awkward as it may feel to explain our ethical guidelines when these issues come up, it is imperative that we do so. Because it is the only way that patients can find out about our very strict policies and boundaries. If you are an inexperienced interpreter, and you do not do this, because you think it will be awkward, practice among your colleagues until you find some scripts that work for you. Here are a few ideas:

“Thank you for offering to give me this. But interpreters have very strict rules. We are not allowed to take any presents at all, or we can lose our certificate. We get paid to interpret, and the law says we cannot take anything extra. Believe me, we are paid for our work, and you do not need to compensate me on top of that. It is my pleasure to interpret for you! I love my job.”

“Oh, thank you for offering me your business card. I am sure you are great at what you do. And I appreciate your saying that you could give me a sweet deal. The thing is, I am not allowed to take any extra compensation for my work here, not even a discount, and if I see you outside of work, even to paint my house, I would have to tell my boss and then you would be on a list of patients I cannot interpret for. That makes it tough for our schedulers. So I really cannot hire you. But good luck getting work!”

If the offers persist, and sometimes they do, please explain that these rules have been established for the protection of the patients. We do not want patients to feel that they have to pay us off in order to get their medical appointments. We don’t need or want them to give us tips, discounts, or gifts. It is written into our regulations that interpreters may not “accept additional money, consideration, or favors” or “attempt to use their position to secure privileges or exemptions”. We consider it the anti-corruption section of our code of ethics, and take it seriously.

And for those few of you who may think you are “just” attending a wedding or baby shower, and not “getting anything for it” beyond friendship, remember that our code expressly requires disclosure of any “real or perceived conflicts of interest” that would affect our professional objectivity. And the code intentionally gives the very specific example of providing interpreting for a friend, because it “may violate the […] friend’s right to confidentiality, constitute a conflict of interest, or violate a contract.” So yes, you can make friends with your patients – you can just never interpret for them again.

The friendship offer script goes along the following lines: “I would love to come to your baby shower, but unfortunately, once I meet you outside of work, I am banned from interpreting for you ever again. And I so enjoy providing services for you here. Also, if I get a long list of patients I cannot interpret for, I will have lots of new friends, but I could lose my job! We don’t want that!”

I find patients are quite gracious and understanding. They may say it is too bad, but they are not personally offended, once they understand the framework. We want to avoid corruption and handouts, kickbacks and under the table dealings, special favors and unequal treatment, across the board. We want patients to have open, equal, and unhindered access to quality care, and they shouldn’t have to do us any favors to get it. We are service providers, not gatekeepers. This is vital for patients to understand.

Yes, if you are new to interpreting and just getting used to it, this may feel awkward at first. But believe me, it will be beyond awkward if you lose your certification because you wanted to be polite – and thus end up accused of taking a bribe, or appearing to have a conflict of interest. So we all have to be upfront about what interpreters can and cannot do.

There is nothing rude about letting our clients know that we will not take advantage of them and that they do not owe us anything. And it should be nothing short of the truth to add that it is our honor to serve them. So please, if the situation arises, take the opportunity to educate and empower our patients. They don’t have to come paint our house for cheap. They don’t have to take us out for a meal. They don’t have to give us extra compensation in order for us to do our job. That is what we get paid for.