Bilingual Staff vs. Professional Interpreters: When Can You Use Your Employees?
The "I Have a Nurse Who Speaks Spanish" Trap
It is a common scenario in hospitals, banks, and schools across the country. A non-English speaking client walks in, and the front desk manager calls out: “Hey, Maria! Can you come here for a second? This gentleman speaks Spanish.”
Maria, who might be a billing specialist or a dental hygienist, steps away from her actual job to help interpret. On the surface, this looks like a win-win: the client gets help, and the organization saves money on professional interpreting fees.
However, beneath the surface, this practice—often called “ad hoc” interpreting—is fraught with legal liability, ethical dilemmas, and quality control nightmares. Being bilingual is not the same as being a qualified interpreter. Understanding the difference can save your organization from a costly lawsuit.
The Legal Standard: What Does Section 1557 Say?
Under Section 1557 of the Affordable Care Act (ACA), covered entities are prohibited from requiring an individual with Limited English Proficiency (LEP) to provide their own interpreter. More importantly, the law restricts when you can use your own staff.
You cannot rely on a bilingual staff member to interpret unless that staff member is “qualified.” The law defines a qualified interpreter as someone who:
- Adheres to generally accepted interpreter ethics principles (like impartiality and confidentiality).
- Has demonstrated proficiency in speaking and understanding both spoken English and at least one other spoken language.
- Is able to interpret effectively, accurately, and impartially.
Simply growing up speaking a language at home does not automatically meet this rigorous standard.
The 3 Main Risks of Using Untrained Staff
1. Lack of Specialized Terminology
Maria might speak fluent conversational Spanish, but does she know the precise medical term for “laparoscopic cholecystectomy” or the legal equivalent for “indemnification”? Untrained bilinguals often summarize or guess when they hear complex terms, leading to dangerous omissions.
2. Role Confusion and Conflict of Interest
A professional interpreter is a neutral party. An employee is not. If a patient complains about the wait time or a nurse’s attitude, will the employee feel comfortable interpreting that complaint to their own boss? Often, staff members will filter information to protect their colleagues or themselves, violating the core ethic of accuracy.
3. Lost Productivity
When you pull a bilingual employee away from their assigned duties to interpret, you are paying them to do a job they weren’t hired for, while their actual work piles up. It is often less efficient than calling a dedicated interpreter who can handle the task immediately.
When IS it Okay to Use Bilingual Staff?
Does this mean you can never use your bilingual team? Absolutely not. They are a huge asset, but they must be used correctly.
Direct Communication (The Green Light)
If a bilingual doctor speaks directly to a patient in their shared language, no interpreter is needed. This is direct care, not interpreting. This is the gold standard and should be encouraged.
Dual-Role Interpreters (The Caution Light)
You can use staff as interpreters if you formalize it. This means:
- Vetting: Testing their language proficiency through a third-party agency.
- Training: Sending them to a 40-hour training course (like Bridging the Gap).
- Job Description: Adding “Interpreting” to their official job description and perhaps offering a pay differential.
If you haven’t taken these steps, that staff member should strictly stick to their primary role.
Conclusion: Invest in Qualification
Using “Maria from billing” as an ad hoc interpreter is a gamble with patient safety and legal compliance. The safest route is to partner with a professional Language Service Provider (LSP) for complex interactions, or to invest in formally testing and training your bilingual staff so they meet the legal definition of “qualified.” At MHMS, we can help you with both—providing on-demand professionals and training your internal team to the highest industry standards.