“I’m there just to interpret, not to give advice,” said Valdez, guest relations representative at Baylor University Medical Center in Dallas. “Translating medical terminology can be a tongue twister.”

Without her help, health care providers and Spanish-speaking patients with limited English proficiency would be at a loss for words.

Patients at other U.S. hospitals aren’t as fortunate. Fewer than a quarter of these facilities are staffed with skilled interpreters, the journal Pediatrics reported in 2003. And most of them don’t have adequate training.

The good news is hospitals, social service agencies and interpreter associations are taking steps to improve the numbers. They are determined to launch, sustain or expand interpreter services for an increasingly diverse pool of patients.

Almost one in five people, or 47 million of those age 5 and older, spoke a language other than English at home in 2000, up 15 million from 1990, according to the U.S. Census Bureau. Meanwhile, the number of Spanish speakers surged 62 percent, rising from 17.3 million in 1990 to 28.1 million in 2000.

“The need for interpreters in the health care setting is high,” said Elaine Quinn, administrator of cross-cultural programs at the Texas Department of State Health Services in Austin.

“Many people speak English to converse over the more mundane day-to-day stuff. However, it is often difficult to verbalize signs, symptoms and other concerns. … The vocabulary is not the everyday words people use,” explained Quinn, also treasurer of the National Council on Interpreting in Health Care in Santa Rosa.

Interpreters are more likely to be employed in hospitals, which are better able to afford their services and are also more legally bound to do so, said Charles Soltoff, associate vice president for marketing at Temple University Health System in Philadelphia. Temple is among 10 medical institutions in a program to demonstrate that hospitals can’t afford to operate without formally trained medical interpreters.

Other institutions use telephone-based interpreters and rely on employees who speak the same foreign languages as patients.

“Existing staff who can provide medical interpreter services on an as-needed basis — called dual-role interpreters — will become increasingly valuable,” Soltoff predicted.

To succeed, experts say, interpreters must be fluent and possess customer service skills along with knowledge of medical terminology.

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