Communication barrier between doctor and patient. A web of thread separates them.

Lost in Translation: Are Healthcare Providers Cutting Corners on Interpretation Services?

Lena Voss in Health & Wellness October 2026 • 4 min read.

"A new study uncovers the factors that lead medical staff to use untrained interpreters, potentially compromising patient care and safety."

In the United States, where linguistic diversity is a hallmark of its population, the healthcare sector faces a significant challenge: ensuring effective communication between providers and patients who have limited English proficiency (LEP). With sixty million people speaking a language other than English, it is imperative to bridge the communication gap to guarantee equitable access to care.

When patients struggle to articulate their symptoms or understand treatment instructions, the consequences can be severe. Misdiagnoses, unnecessary tests, and even hospital readmissions can stem from these linguistic barriers. Healthcare facilities often juggle two types of interpretation services: professional interpreters and ad hoc interpreters. Professional interpreters receive formal training and are versed in medical terminology and ethical standards, whereas ad hoc interpreters include family members, friends, or untrained staff who may not have the required expertise.

A study highlighted in Hispanic Health Care International sheds light on this critical issue, probing the perceptions of healthcare providers regarding interpretation services. The research assesses the factors influencing the use of ad hoc interpreters—individuals who, while often readily available, lack the formal training and expertise of professional interpreters. This exploration is crucial for healthcare organizations aiming to improve patient outcomes, ensure regulatory compliance, and mitigate risks associated with inadequate communication.

Why Are Healthcare Providers Choosing Ad Hoc Interpreters?

Communication barrier between doctor and patient. A web of thread separates them.

The study, conducted within a large regional health system in South Carolina, surveyed 150 health services providers. It aimed to understand the factors that contribute to the use of ad hoc interpreters—a practice often seen as 'cutting corners.' The findings reveal a hierarchy of concerns and challenges that providers weigh when deciding how to facilitate communication with LEP patients.

According to the study, healthcare providers place immense value on the ability to communicate effectively during clinical encounters. However, several practical challenges often lead them to opt for ad hoc interpreters:

Difficulty Locating Qualified Interpreters: In situations where finding a professional interpreter is challenging, healthcare providers may turn to whoever is available.
Wait Times: The delay in securing a qualified interpreter can disrupt the flow of patient care, prompting providers to seek immediate alternatives.
Technical Issues: Problems with phone or video interpretation technology can also push providers toward using ad hoc interpreters.

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Latest Research

What Reviews Reveal

A 2023 systematic review describes interpreter use as essential for quality care, while noting that use and policy vary widely and that the effects of different interpreter types are not fully known. Patient perspectives in qualitative reports identified barriers to professional interpreters in emergency departments and hospitals, particularly availability and time constraints. Together, these findings point to both uneven access and gaps in the evidence about interpreter services.

Counterpoints

Limits of the Evidence

In the LASI observational study, researchers could not compare interpretation modalities for the same patient, and noted that different modalities may suit different patients and clinical contexts. A systematic review of 39 interventions to increase professional interpreting found high heterogeneity in the behavior-change strategies targeted and in how outcomes were measured. These limitations make it difficult to draw simple conclusions about which modality or intervention works best across settings.

Comparison

Errors Across Interpreter Types

A study comparing professional, ad hoc, and no interpreters reported that the proportion of errors with potential clinical consequences was 12% for professional interpreters, 22% for ad hoc interpreters, and 20% when no interpreter was used. In that comparison, the professional-interpreter group had the lowest reported proportion. The figures concern errors with potential consequences, rather than a direct measure of overall patient outcomes.

These factors underscore the practical constraints that healthcare providers face daily. While professional interpretation is recognized as ideal, the immediate needs of patient care often take precedence, leading to compromises in service quality. The decision to use ad hoc interpreters is not necessarily a matter of undermining patient care but rather a response to systemic challenges that impede access to professional language services.

Moving Forward: Enhancing Language Access in Healthcare

To enhance language access and reduce reliance on ad hoc interpreters, healthcare organizations should focus on several key areas: increasing staff awareness of the risks associated with untrained interpreters, improving access to professional interpretation services, and addressing technical challenges that impede the use of remote interpretation technologies. By prioritizing these efforts, healthcare providers can ensure safer, more effective communication with all patients, regardless of their language proficiency.

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Future Outlook

Emerging Trends

TransLinguist’s October 3, 2025 article identifies telehealth expansion, AI integration, and specialized certification requirements as trends in medical interpreting. Boostlingo’s June 27, 2025 article also highlights technology as a way to help close the interpreter gap. These industry articles describe anticipated trends, not measured outcomes.

Real-World Impact

Care, Communication, and Access

A 2023 integrative review set out to examine how professional interpreter services affect hospital care outcomes and the associated cost of providing the service. A 2026 article on language access states that language barriers affect patient-provider communication, patient safety, and healthcare outcomes, and recommends professional interpreters or language-concordant care. It also notes that barriers to language access persist.

How the error findings relate to broader reports

A separate hospital pilot found that adverse events involving patients with limited English proficiency more often involved physical harm than adverse events involving English-speaking patients. This comparison describes the share of adverse events involving harm, not the proportion of all patients harmed.^[1]

A cost report put an enhanced interpreter service at $234 per Spanish-speaking intervention patient, or 1.5% of average hospital cost. The intervention was not randomized, so the cost figure alone does not establish what costs or outcomes would have been under a randomized comparison.^[2]

A systematic review cautions that mismanaged language barriers may worsen communication and reduce care quality. This frames the error comparisons as one part of a wider communication concern, rather than a complete account of care quality.^[3]

What remains unclear about training and harm

Would the training-related difference in interpreter errors translate into fewer adverse events or less physical harm for patients? The reported comparisons measure errors and adverse-event characteristics separately.^{[1] [4]}
How much of the apparent relationship between enhanced interpreting and hospital costs reflects the service itself, given that patients were not randomly assigned to the intervention?^[2]

Sources

Language proficiency and adverse events in US hospitals: a pilot study. (pubmed.ncbi.nlm.nih.gov)
The Impact of an Enhanced Interpreter Service Intervention on Hospital Costs and Patient Satisfaction (pmc.ncbi.nlm.nih.gov)
Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome (pmc.ncbi.nlm.nih.gov)
Errors of medical interpretation and their potential clinical consequences: a comparison of professional versus ad hoc versus no interpreters. (pubmed.ncbi.nlm.nih.gov)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

Everything You Need To Know

What are 'ad hoc' interpreters in healthcare, and why is using them potentially risky?

Ad hoc interpreters are individuals who are not formally trained in interpretation but are used to facilitate communication between healthcare providers and patients with limited English proficiency (LEP). This includes family members, friends or untrained staff. Using ad hoc interpreters can lead to misinterpretations, inaccurate medical histories, and compromised patient safety due to their lack of medical terminology knowledge and ethical training. Unlike professional interpreters, ad hoc interpreters may not understand the importance of confidentiality or the nuances of medical language.

Why do healthcare providers sometimes choose to use 'ad hoc' interpreters instead of professional interpreters?

Healthcare providers sometimes use ad hoc interpreters due to several factors. Difficulty locating qualified interpreters, long wait times for professional interpretation services, and technical issues with interpretation technology can all lead providers to rely on whoever is readily available, even if they lack proper training. These challenges highlight systemic issues in providing adequate language access within healthcare settings, potentially compromising the quality of care for LEP patients.

Why is it so important to use professional interpreters instead of untrained individuals?

The use of professional interpreters is crucial for ensuring effective and accurate communication between healthcare providers and patients with limited English proficiency (LEP). Professional interpreters have formal training in medical terminology, ethical standards, and interpretation techniques. This ensures that medical information is conveyed accurately, reducing the risk of misdiagnoses, treatment errors, and other adverse outcomes. Their expertise helps bridge linguistic barriers and promotes patient safety and understanding.

Why is effective communication so important, specifically when dealing with patients who have limited English proficiency?

Effective communication in healthcare is especially important for patients with limited English proficiency (LEP) as miscommunication can lead to misdiagnoses, incorrect treatments, and other adverse health outcomes. When patients cannot understand their treatment plans or articulate their symptoms clearly, the quality of care is significantly compromised. Ensuring clear and accurate communication is essential for patient safety, adherence to treatment, and overall well-being. This is why using Professional Interpreters is so important.

What can be done to make language access better and rely less on 'ad hoc' interpreters in healthcare settings?

To improve language access in healthcare, several steps can be taken. Increasing staff awareness about the risks of using untrained ad hoc interpreters is important. Improving access to professional interpretation services through better scheduling systems and technology. Addressing technical challenges such as improving the reliability of phone or video interpretation services. By focusing on these areas, healthcare organizations can reduce their reliance on ad hoc interpreters and ensure safer, more effective communication with all patients.