Introduction

It is an accepted belief in the United States Healthcare System that a language barrier between a provider and patient can affect the appropriateness, effectiveness, and equity of that patients medical care.   Due to the complexity of medicine, good communication between a provider and patient can be difficult even when there is a common language and culture.  When there exist only a few common words or gestures for communication, the risk of misdiagnosis increases dramatically.   The U.S. Health Services system has an obligation to provide quality and equal care to all its patients.  The U. S.  Department of Health and Human Services Office for Civil Rights has classified inadequate interpretation in the healthcare setting as a form of discrimination Baker et al. (1996).

The demographics of the United States emphasize the necessity for improving our communication capabilities with ethnic minorities.  According to the 1990 census, 32 million non-English-speaking people reside in the country.  Of those people, nearly 14 million rate their English language ability as less than well and more than 1.8 million cannot speak English at all.  These numbers are projected to increase.  The Asian population is increasing faster than the total US population and the Hispanic population is growing 53% faster than the total population. Dreger, V. & Tremback, T. (2002). These numbers emphasize the magnitude of the issue.