Don’t just depend on written notes for deaf patients
June 1, 1999 2 minutes read
Don’t just depend on written notes for deaf patients
Exchanging notes is prohibitively slow
The recent ruling against Mount Sinai Medical Center in New York City does not mean you have to provide sign language interpreters for every situation involving a deaf person or relative, says Alan Rich, JD, the New York attorney who represented the plaintiff in the case. For some routine matters such as taking blood, it may be acceptable to communicate in writing, especially if the patient is familiar with the routine. But Rich does caution that you should not depend too much on using written notes with deaf patients — a common mistake that can have deadly consequences.
"Writing notes back and forth is going to be 25 times slower than conversation," he says. "If you want to discuss a patient’s heart condition, the diagnosis, treatment opportunities, and informed consent, that 20-minute conversation is going to take 25 times longer if you write notes. Think any doctor is going to stand around for eight hours writing notes back and forth?"
Information exchange suffers
The result often is that patients are ill-informed and the doctor does not receive adequate information about the patient’s condition. Consider the typical, rapid-fire conversation between doctor and patient: "Where does it hurt? More here or less there? Is it a sharp pain or a dull pain?" That long give-and-take may be boiled down to a couple of notes asking where the pain is, amounting to an incomplete assessment.
And a poor assessment can lead to malpractice claims, Rich notes. "It seems to me that hospitals should want to provide effective communication, if only to avoid the malpractice lawsuits that will follow when the staff does not communicate," he says.
The attorney also cautions that health care facilities must be careful in setting up "language banks," which usually are lists of hospital employees, volunteers, and professional interpreters who can be called to interpret different languages, including sign language. Rich notes that most facilities do not require certification in sign language skills, just accepting volunteers’ claims that they are proficient enough to interpret in a clinical situation. That, he says, is a mistake. "Would it be OK to have a hospital administrator just say, By the way, I also can perform orthopedic surgery?’"
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