How Case Managers Can Work with Interpreters – Part III

This entry will conclude my three-part series on effective relations between the case manager and the interpreter.

Role Boundaries:  “The interpreter maintains the boundaries of the professional role, refraining from personal involvement.”  We discussed this a little, but another issue merits consideration.  Some case managers will ask the interpreter to relay messages if the patient has any questions or concerns.  Under this subject is a guideline that states, “The interpreter limits his or her professional activity to interpreting within an encounter.” Case managers, you might find that an interpreter refuses to transmit after the appointment. This guideline is the reason. For my part, I have no problem conveying messages; I deem that to be within my role boundaries with some of my clients. With other clients, I arrange teleconference conversations. Yet others choose to make their own arrangements. Please respect that different people will interpret the ethical code distinctly.

Occasionally, the case manager arranges for a prescription drop-off and pickup with the patient at the pharmacy. Some might regard that to be overstepping the limits of our job and becoming personally involved. I consider it as an interpreting service which enables the patient to communicate effectively with the pharmacist. Ultimately, the case manager or adjuster will decide who provides that service. Don’t be surprised if some interpreters feel it is inappropriate.  As a rule, we will not do this unless the case manager or adjuster requests it.

Professionalism:  “Interpreters at all times act in a professional and ethical manner.” That standard is a one-stop shop for any issue that might come up.  I will leave this as the subject of another blog as there is much ground to cover.  It might cause me to rant about my pet peeve of using bilingual people who are untrained and are unaware of the standards of practice.  Just know that if you are confused by a professional interpreter’s actions, you can always ask why.  You should receive some kind of logical answer, even if you disagree with it.

Advocacy:  This standard can often be the most misunderstood and controversial. “When the patient’s health, well-being or dignity is at risk, an interpreter may be justified in acting as an advocate.” Wait!  Wait! How can an interpreter stay impartial, remain within qualified limits, refrain from personal involvement, and at the same time be an advocate? Isn’t that a conflict of interest? Isn’t that wrong?

Case managers, there is a big difference between a professional interpreter’s advocacy and a bilingual person’s uneducated advocacy. What if the interpreter is aware of a serious life-threatening allergy that the patient has and observes that the doctor may have overlooked that fact?   Should he only interpret what is being said and stay quiet to the error?  Speaking up in this instance could save that person’s life. The interpreter should never argue with any medical personnel but under certain circumstances, he can clarify or make people aware of certain issues. Obviously good judgment is necessary.  Typically, it is best for the interpreter to simply state the facts as he knows them and avoid individual opinions and commentary. After that, the responsibility is out of the interpreter’s hands.

If you are a case manager and have any questions, issues, observations, or experiences to relate regarding working with interpreters, please comment below.