RACGP releases new interpreter guidelines

Michelle Wisbey

2/08/2023 4:30:14 PM

As Australia becomes increasingly multicultural, the college has outlined how to best use interpreters in practice.

Doctor and patients speaking on couch.
Around one quarter of all Australians speak a language other than English at home and 3.4% don’t speak English at all.

The RACGP has created a new set of advice for accessing patient interpreters in an effort to boost GP uptake of the service.
It comes after research suggested GPs are underutilising the service in primary care for several reasons, including financial concerns, the burden of longer consultations, coordinating consent, and resourcing.
Currently, around one quarter of all Australians speak a language other than English at home, and 3.4% of the population say they don’t speak English at all.
Research shows culturally and linguistically diverse (CALD) patients often have higher rates of disease and experience poorer health outcomes, made worse throughout the COVID-19 pandemic.
Dr Rebecca Farley, Chair of RACGP Specific Interests Refugee Health, told newsGP effective communication was crucial for achieving equitable access to healthcare.
Engaging interpreters has been found to improve both healthcare provider and patient satisfaction with improved understanding of self-care and follow-up plans, reduced errors and better treatment adherence,’ Dr Farley said.
‘We see improved clinical outcomes, reductions in unnecessary tests and treatments, and deceased communication errors.’
As laid out in the guidelines, GPs can find interpreters through the Translating and Interpreting Service (TIS National), a specialist service provided by the Department of Home Affairs.
Medical practitioners are able to access the Free Interpreting Service when delivering services eligible for Medicare rebates in private practice.
The available interpreting services include immediate and pre-booked services both face to face and through telehealth.
‘Medical conversations often need to convey specific, complex information that must be strictly adhered to and require a sophisticated understanding of language to be properly understood,’ the guidelines said.
The RACGP guidelines warn that while patients may feel embarrassed or ashamed of their English language skills, involving a translator is often crucial to ensuring a patient provides informed consent before agreeing to a method of treatment.
Dr Farley said even though Australia has a rich cultural and linguistic diversity, much of the country’s health information is available only in English.
‘I think anyone who has ever tried to access information or a service that isn’t available in a language in which they are proficient knows how overwhelming and near impossible this can be,’ she said.
‘When we work effectively with interpreters, we have an opportunity to have a profound impact on our patients’ and communities’ ability to access safe, quality care.’
In the case of a patient refusing an interpreter, the guidelines say GPs should first address the patient’s concerns, including confidentiality, impartiality, cost, speaking with someone of the appropriate gender.
‘After the interpreter is introduced, the consultation can continue largely as normal. The GP should continue to address the patient, make eye contact if culturally appropriate, and use first-person pronouns,’ the guidelines say.
But one major concern continues to be the cost of longer appointments; with the College saying it will monitor new Federal Government funding dedicated to allowing the longer consultation needed to fulfil the service.
Explaining that when claiming for time-tiered MBS items, the total duration includes the time required to communicate effectively with the patient, this applies to both face-to-face and telehealth services.
‘Medicare rebates do not adequately support patients and GPs for the additional time needed when an interpreter is required during a consultation, as well as the accompanying administrative work,’ the guidelines state.
Dr Farley said being able to effectively communicate is fundamental to providing care, as well as meeting legal and professional obligations.
‘If we don't work with an interpreter when one is required, it is simply impossible for us to know and understand our patients’ questions and concern,’ she said.
The Interpreter guidelines are available on the RACGP website.
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