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Language Barriers in Medicine-Reply

Steven Woloshin, MD; Lisa M. Schwartz, MD; H. Gilbert Welch, MD, MPH; Nina A. Bickell, MD, MPH
JAMA. 1995;274(9):684. doi:10.1001/jama.1995.03530090013011.
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In Reply.  —Dr Auerback reports success distributing information sheets in various languages explaining common medical problems to his non—English-speaking patients. His efforts are commendable and worthy of emulation. However, we offer two important caveats. First, translated information sheets should be used with caution because many patients who are not proficient in English are also unable to read in their native language.1 Second, there is more to communication than preparing a well-translated information sheet. Transfer of information across languages is complex and requires both linguistic and cultural fluency to ensure that literal and cultural sense is achieved. This is a time-consuming process that necessitates iterative exchanges and clarifications. Preprepared documents are not likely to be an adequate substitute for real-time interpretation in most settings.We applaud the Opening Doors program and its efforts to make health care more user-friendly. As they point out, the use of telephone interpretation is an


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