How Case Managers Can Work with Interpreters, Part I

Over the years, I have worked with many insurance company and independent case managers. Case managers coordinate medical care for patients that include doctors’ appointments, exams, therapy, surgery, blood tests, transportation, and interpreters. Whatever a patient might need for medical treatment, the case manager takes care of it. Money is a different issue; if a workers’ compensation patient has a question about payments and reimbursement, the patient needs to speak to the adjuster.

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Needless to say, if I am assigned to interpret for a workers’ compensation patient, it is also most likely that I will be working closely with a case manager.  Some case managers have asked me to do all kinds of things for them to make work easier for them, while others would have me do absolutely nothing except interpret.

In view of the foregoing, I would like to share some of the interpreter code of ethics. Interestingly, the code of ethics is very basic and can be open to different levels of interpretation, causing confusion for people working with interpreters.  In my case, I will share some things I do and will not do, as well as some gray areas upon which I will make a judgment call.  Not everyone will agree with me on some of my judgment calls.

Let me just illustrate how different the code of ethics can be interpreted. The code of ethics says that “interpreters strive to maintain impartiality and refrain from counseling, advising, or projecting personal biases or beliefs.”  Some hospitals that I know, in an effort to follow that principle, have guidelines to prevent the interpreter from getting to personally know a patient, even for a few minutes. Every time a medical professional enters to speak to the patient, the interpreter enters with them. Every time they leave the room, the interpreter will also leave and wait outside. This is in order to avoid any kind of personal conversation that could lead to the interpreter becoming emotionally compromised. Often workers compensation interpreters are assigned to a patient from the beginning of the care until the end. They accompany patients to all medical appointments, including therapy several times a week. They sit with the patient in the waiting rooms and stay with them in the rooms when medical professionals exit. In addition, many workers compensation interpreters also provide transportation, allowing even more time for personal discussion in the automobile. Based on the hospitals guidelines just described, workers’ compensation interpreters are committing a serious breach of ethics.

However, the ethical code simply emphasizes impartiality. It says nothing about stepping outside the room or conversing. Can a professional interpreter spend time with a patient and speak with that person from time to time and still be unbiased? That is open for debate. There is no doubt that it is more challenging for the workers’ compensation interpreter to maintain professional standards.

As a case manager, if you run into an interpreter that limits his conversation and seems strictly business, he is probably making a great effort to apply the ethical standard of impartiality. The only one who really knows if this principle has been compromised is the interpreter himself. Some interpreters might follow stricter guidelines because they know they must, just like an alcoholic knows that he has to be strict about never touching the bottle. Professionalism also means that the interpreter will always be friendly and respectful.

Part II will consider other circumstances that often occur when dealing with interpreters.