Stop using AI to translate
Before get too far into it, let’s start with some basic terminology. Interpretation is spoken or signed language. Translation is written language. Interpreters and translators are not the same, and require very different skill sets. Linguists will often refer to L1 as the first language you learned and then after that it goes L2, L3, L4….Ln.
I get it, you want to provide your discharge instructions in Spanish. You're thinking, "Look at me being so helpful, putting this through Google Translate." And meanwhile, I'm here wondering how to coddle your feelings about a road made with good intentions that violates patients' civil rights and that your AI translation s frankly awful to read and fails to convey meaning clearly.
If you wanted to simultaneously upset your medical-legal team, your risk and compliance folks, and a Chicana linguist PhD dedicated to meaningful communication for her community of patients... well, you just did.
The Legal Reality
Your compliance and legal team would tell you this is a violation of ACA Section 1557 , Civil Rights Act of 1964, Title VI, Joint Commission accreditation expectations for 2026. The general legal requirement is that you must use a qualified human translator for oversight. You my dear, are most likely not a qualified medical translator (written word).
If you are asking why you can use AI for transcription and not translation, one good reason is they aren’t the same. You used your words, and most likely have a level of proficiency in medical English, with the ability to look over your own work and catch errors, in English. Do you have that same high level ability in medical Spanish?
But beyond the legal requirements, it's also culturally, and therefore ethically, a bad way to communicate with your patients.
The Cultural Gap
Sure, you use transcription software in English. But you also have the ability to review it, edit it at a high level in English. Do you have that same capacity in Spanish—or any other L2, L3, L4?
Translation is never word-for-word. Syntax and word order are the most superficial cultural layer. Communication runs deeper than shared language. If communication were just about shared language, you'd probably have fewer divorces.
Stop using AI. Respect your patients by realizing you lack understanding of literacy in other languages—not all literacy is written (think of the khipu literacy of the Quechua), and not all communication is written or spoken (consider the communication exchange between these two women with shared Black-American culture).
What Can You Actually Do Instead?
Here's the question I always remind people to ask: What if this were an English-speaking person who wasn't literate the way you are?
Would you use teach-back methods? Would you encourage them to record your discharge instructions with their phones so they could play it back? Would you ask them about their support system (caregivers, family that helps with prescription pick-up)?
Would you use teach-back methods? Would you encourage recording discharge instructions on a phone for playback? Would you ask about their support system, who helps with prescriptions?
Recording with an interpreter creates a dual-language record. Patients can play it back in English and Spanish and share it with caregivers. Suddenly, the people at home aren't just guessing; they have the exact instructions you reviewed in English.
A real game changer is the pre-session. Before you enter the room, chat outside the room with the interpreter. Together you can share context on the case, but more importantly, the interpreter might be able tell you about cultural nuances, the patient's literacy level and communication style. If it’s an on-site staff interpreter, they might already know the patient and their family dynamics. Why rely on personal assumptions or implicit bias, when you can walk in prepared?
