Friday, September 19, 2008

Language Barriers

Today was one of those days when every customer interaction felt like a struggle to make myself understood. I attempt to explain how to take a Medrol Dosepak or a PrevPac or use an Advair inhaler and the person (of Asian, Hispanic, East African, etc., origin) nods and (sometimes) smiles. We complete the transaction and I walk away feeling very uneasy.

Sometimes it feels like the number of prescriptions and the complexity of the directions is inversely proportional to the recipient's ability to understand English. It especially worries me when a small child or baby is involved --- I point to the "1.5 mL" mark on the syringe and hope it's sinking in. Some pharmacies have the ability to print labels in other languages but I'm uneasy not being able to independently verify what the label says. And even if a translator or other family member is present, how do I know they are correctly translating what I'm saying?

I know, people should learn English when they come to this country. It takes time, though, and for some it may never happen, for whatever reason. I try to imagine if I had to learn Mandarin, or Thai, or Arabic, and was uneducated to begin with. Pretty tall order. I don't know what the solution is, other than trying to do the best you can under the time constraints. Come to think of it, we all know how frequently good old American English-speakers can screw things up --- I guess it can't be too much worse.


BiteTheDust said...

There has been a study looking at "how frequently good old American English-speakers can screw things up"
Literacy and Misunderstanding Prescription Drug Labels -- Davis et al...

Setting: 3 primary care clinics serving mostly indigent populations in Shreveport, Louisiana; Jackson,
Michigan; and Chicago, Illinois.
Patients: 395 English-speaking adults waiting to see their providers.
Measurement: Correct understanding of instructions on 5 container labels; demonstration of 1 label's
dosage instructions.
Results: Correct understanding of the 5 labels ranged from 67.1% to 91.1%. Patients reading at or
below the sixth-grade level (low literacy) were less able to understand all 5 label instructions. Although
70.7% of patients with low literacy correctly stated the instructions, "Take two tablets by mouth twice
daily," only 34.7% could demonstrate the number of pills to be taken daily.

And it got worse with reduced literacy levels.


Anonymous said...

I've noticed that when mLs amounts are described to non-native American English speakers, the understanding level is considerably higher than indigents. One technique we learned in Pharmacy Communication (as part of pharmacognosy) was to have the patient repeat back in a different way than initially stated. (Who has time for this every time...and, am not always talking with the person that will be administering the medication...) Have to agree about that 'uneasy' feeling lingering long after the patient has left.