RE: medical interpreter and non compliant pt.

March 23, 2006

You are obligated to provide and pay for

an interpreter. In our area it means that you lose about $5 to see a Medicare

patient with an interpreter. You cannot discriminate based on their need for

an interpreter.

From:

[mailto: ]

On Behalf Of mandanamd@...

Sent: Tuesday, March 21, 2006 8:00

PM

To:

Subject:

medical interpreter and non compliant pt.

Hi group

I would like to know if as physician we are obligated to provide and

pay fro interpreter or patient has to do it? and the second question is what is

the best way to document or track or get the pt. to follow up and what is the

best way to protect the practice from the legal consequences? Thanks

Mandana

-------------- Original message --------------

> Health care is a basic human need, depends on how you define it.

> Certain christian sects would say wrong. It is not food and water.

> It is not shelter from the elements. How far do you take it?

>

> We are all in this to help people be the best they can be. You have

> to be careful of how you define the patient relationship nowadays

> also. Much is being done in chiropractor offices, mall clinics ,

> and in the Emergency Room.

>

> Just stirring the pot a little to see what floats to the top.

> Brent

>

> >

> > i've been reading about the social burden of being a doctor and

> how it relates to low overhead practice with great interest.

> >

> > there are some underlying fundamental precepts i like to keep in

> mind when discussing these things.

> >

> > they are:

> >

> > health care is not a right or privilege; it is a basic human

> need, just like food, clothing and shelter. everybody needs it.

> >

> > good health care arises from a healthy doctor-patient

> relationship. the relationship facilitates healthy choices

> resulting in good outcomes.

> >

> > any framework surrounding the doctor-patient relationship must

> be defined by the needs of the doctor-patient relationship. form

> follows function.

> >

> > just my thoughts.

> >

> > LL

> >

> > ---------------------------------

> > Yahoo! Travel

> > Find great deals to the top 10 hottest destinations!

> >

>

March 23, 2006

You are obligated to provide and pay for

an interpreter. In our area it means that you lose about $5 to see a Medicare

patient with an interpreter. You cannot discriminate based on their need for

an interpreter.

From:

[mailto: ]

On Behalf Of mandanamd@...

Sent: Tuesday, March 21, 2006 8:00

PM

To:

Subject:

medical interpreter and non compliant pt.

Hi group

I would like to know if as physician we are obligated to provide and

pay fro interpreter or patient has to do it? and the second question is what is

the best way to document or track or get the pt. to follow up and what is the

best way to protect the practice from the legal consequences? Thanks

Mandana

-------------- Original message --------------

> Health care is a basic human need, depends on how you define it.

> Certain christian sects would say wrong. It is not food and water.

> It is not shelter from the elements. How far do you take it?

>

> We are all in this to help people be the best they can be. You have

> to be careful of how you define the patient relationship nowadays

> also. Much is being done in chiropractor offices, mall clinics ,

> and in the Emergency Room.

>

> Just stirring the pot a little to see what floats to the top.

> Brent

>

> >

> > i've been reading about the social burden of being a doctor and

> how it relates to low overhead practice with great interest.

> >

> > there are some underlying fundamental precepts i like to keep in

> mind when discussing these things.

> >

> > they are:

> >

> > health care is not a right or privilege; it is a basic human

> need, just like food, clothing and shelter. everybody needs it.

> >

> > good health care arises from a healthy doctor-patient

> relationship. the relationship facilitates healthy choices

> resulting in good outcomes.

> >

> > any framework surrounding the doctor-patient relationship must

> be defined by the needs of the doctor-patient relationship. form

> follows function.

> >

> > just my thoughts.

> >

> > LL

> >

> > ---------------------------------

> > Yahoo! Travel

> > Find great deals to the top 10 hottest destinations!

> >

>

March 23, 2006

Do you have anything in writing regarding this rule ? I do not think it

applies to small offices. After all, where are you going to find an

interpreter ?

>

> You are obligated to provide and pay for an interpreter.Â In our area

> it means that you lose about $5 to see a Medicare patient with an

> interpreter.Â You cannot discriminate based on their need for an

> interpreter.

>

> Â

>

> From:

> [mailto: ] On Behalf Of

> mandanamd@...

> Sent: Tuesday, March 21, 2006 8:00 PM

> To:

> Subject: medical interpreter and non compliant

> pt.

>

> Â

>

> Hi group

>

> I would like to know if as physician we are obligated to provide and

> pay fro interpreter or patient has to do it? and the second question

> is what is the best way to document or track or get the pt. to follow

> up and what is the best way to protect the practice from the legal

> consequences? Thanks

>

> Mandana

>

> Â

>> -------------- Original message --------------

>>

>> > Health care is a basic human need, depends on how you define it.

>> > Certain christian sects would say wrong. It is not food and water.

>> > It is not shelter from the elements. How far do you take it?

>> >

>> > We are all in this to help people be the best they can be. You have

>> > to be careful of how you define the patient relationship nowadays

>> > also. Much is being done in chiropractor offices, mall clinics ,

>> > and in the Emergency Room.

>> >

>> > Just stirring the pot a little to see what floats to the top.

>> > Brent

>> >

>> > >

>> > > i've been reading about the social burden of being a doctor and

>> > how it relates to low overhead practice with great interest.

>> > >

>> > > there are some underlying fundamental precepts i like to keep in

>> > mind when discussing these things.

>> > >

>> > > they are:

>> > >

>> > > health care is not a right or privilege; it is a basic human

>> > need, just like food, clothing and shelter. everybody needs it.

>> > >

>> > > good health care arises from a healthy doctor-patient

>> > relationship. the relationship facilitates healthy choices

>> > resulting in good outcomes.

>> > >

>> > > any framework surrounding the doctor-patient relationship must

>> > be defined by the needs of the doctor-patient relationship. form

>> > follows function.

>> > >

>> > > just my thoughts.

>> > >

>> > > LL

>> > >

>> > > ---------------------------------

>> > > Yahoo! Travel

>> > > Find great deals to the top 10 hottest destinations!

>> > >

>> >

March 23, 2006

Do you have anything in writing regarding this rule ? I do not think it

applies to small offices. After all, where are you going to find an

interpreter ?

>

> You are obligated to provide and pay for an interpreter.Â In our area

> it means that you lose about $5 to see a Medicare patient with an

> interpreter.Â You cannot discriminate based on their need for an

> interpreter.

>

> Â

>

> From:

> [mailto: ] On Behalf Of

> mandanamd@...

> Sent: Tuesday, March 21, 2006 8:00 PM

> To:

> Subject: medical interpreter and non compliant

> pt.

>

> Â

>

> Hi group

>

> I would like to know if as physician we are obligated to provide and

> pay fro interpreter or patient has to do it? and the second question

> is what is the best way to document or track or get the pt. to follow

> up and what is the best way to protect the practice from the legal

> consequences? Thanks

>

> Mandana

>

> Â

>> -------------- Original message --------------

>>

>> > Health care is a basic human need, depends on how you define it.

>> > Certain christian sects would say wrong. It is not food and water.

>> > It is not shelter from the elements. How far do you take it?

>> >

>> > We are all in this to help people be the best they can be. You have

>> > to be careful of how you define the patient relationship nowadays

>> > also. Much is being done in chiropractor offices, mall clinics ,

>> > and in the Emergency Room.

>> >

>> > Just stirring the pot a little to see what floats to the top.

>> > Brent

>> >

>> > >

>> > > i've been reading about the social burden of being a doctor and

>> > how it relates to low overhead practice with great interest.

>> > >

>> > > there are some underlying fundamental precepts i like to keep in

>> > mind when discussing these things.

>> > >

>> > > they are:

>> > >

>> > > health care is not a right or privilege; it is a basic human

>> > need, just like food, clothing and shelter. everybody needs it.

>> > >

>> > > good health care arises from a healthy doctor-patient

>> > relationship. the relationship facilitates healthy choices

>> > resulting in good outcomes.

>> > >

>> > > any framework surrounding the doctor-patient relationship must

>> > be defined by the needs of the doctor-patient relationship. form

>> > follows function.

>> > >

>> > > just my thoughts.

>> > >

>> > > LL

>> > >

>> > > ---------------------------------

>> > > Yahoo! Travel

>> > > Find great deals to the top 10 hottest destinations!

>> > >

>> >

March 23, 2006

Not true, at least not totally true.

You are obligated to make REASONABLE ACCOMODATIONS for them IF INDICATED.

To me this means that if you can get the same info etc by writing, gesturing,

etc then that is all you are required to do. I’m sorry, but I am

just not going to see a patient at a loss. If a deaf/nonspeaking person

is trying to come in I will just insist that they bring an interpretor with

them or I can not see them. I am running a business & will not be

forced to see anyone that I do not wish to see (at least not as a new

patient). That is very rude in my opinion for a deaf patient to come in

with no interpretor or other plan & just expect you to take care of it,

regardless of what any law says. In the end though, it has been a moot

issue for me because the situation has not came up so far in 2 years.

medical interpreter and non compliant pt.

Hi group

I would like to know if

as physician we are obligated to provide and pay fro interpreter or patient has

to do it? and the second question is what is the best way to document or track

or get the pt. to follow up and what is the best way to protect the practice

from the legal consequences? Thanks

Mandana

--------------

Original message --------------

From:

" brenthrabik "

> Health care is a

basic human need, depends on how you define it.

>

Certain christian sects would say wrong. It is not food and water.

>

It is not shelter from the elements. How far do you take it?

>

We are all in this to help people be the best they can be. You have

>

to be careful of how you define the patient relationship nowadays

>

also. Much is being done in chiropractor offices, mall clinics ,

>

and in the Emergency Room.

>

Just stirring the pot a little to see what floats to the top.

>

Brent

>

> i've been reading about the social burden of being a doctor and

>

how it relates to low overhead practice with great interest.

>

> there are some underlying fundamental precepts i like to keep in

>

mind when discussing these things.

>

> they are:

>

> health care is not a right or privilege; it is a basic human

>

need, just like food, clothing and shelter. everybody needs it.

>

> good health care arises from a healthy doctor-patient

>

relationship. the relationship facilitates healthy choices

>

resulting in good outcomes.

>

> any framework surrounding the doctor-patient relationship must

>

be defined by the needs of the doctor-patient relationship. form

>

follows function.

>

> just my thoughts.

>

> LL

>

> ---------------------------------

>

> Yahoo! Travel

>

> Find great deals to the top 10 hottest destinations!

>

March 23, 2006

The ADA does not mandate the use of interpreters in every instance. The health care professional can choose alternatives to interpreters as long as the result is effective communication. Alternatives to interpreters should be discussed with hearing impaired patients, especially those not aware that such alternatives are permissible under the Act. Acceptable alternatives may include: note taking; written materials; or, if viable, lip reading. A health care professional or facility is not required to provide an interpreter when:

it would present an undue burden. An undue burden is a significant expense or difficulty to the operation of the facility. Factors courts use to determine whether providing an interpreter would present an undue burden include the practice or facility's operating income and eligibility for tax credits, and whether it has sources of outside funding or a parent company. Courts also consider the frequency of visits that would require the services of an interpreter. However, the single factor of the cost of an interpreter exceeding the cost of a medical consultation generally has not been found by the courts to be an undue burden.

Source: http://www.ama-assn.org/ama/pub/category/4616.html

Brett

RE: medical interpreter and non compliant pt.

Not true, at least not totally true. You are obligated to make REASONABLE ACCOMODATIONS for them IF INDICATED. To me this means that if you can get the same info etc by writing, gesturing, etc then that is all you are required to do. I’m sorry, but I am just not going to see a patient at a loss. If a deaf/nonspeaking person is trying to come in I will just insist that they bring an interpretor with them or I can not see them. I am running a business & will not be forced to see anyone that I do not wish to see (at least not as a new patient). That is very rude in my opinion for a deaf patient to come in with no interpretor or other plan & just expect you to take care of it, regardless of what any law says. In the end though, it has been a moot issue for me because the situation has not came up so far in 2 years.

-----Original Message-----From: [mailto: ] On Behalf Of Anemaria LutasSent: Thursday, March 23, 2006 7:03 AMTo: Subject: Re: medical interpreter and non compliant pt.

Do you have anything in writing regarding this rule ? I do not think it applies to small offices. After all, where are you going to find an interpreter ?

You are obligated to provide and pay for an interpreter. In our area it means that you lose about $5 to see a Medicare patient with an interpreter. You cannot discriminate based on their need for an interpreter. From: [mailto: ] On Behalf Of mandanamd@...Sent: Tuesday, March 21, 2006 8:00 PMTo: Subject: medical interpreter and non compliant pt. Hi groupI would like to know if as physician we are obligated to provide and pay fro interpreter or patient has to do it? and the second question is what is the best way to document or track or get the pt. to follow up and what is the best way to protect the practice from the legal consequences? ThanksMandana

-------------- Original message --------------> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong. It is not food and water.> It is not shelter from the elements. How far do you take it?>> We are all in this to help people be the best they can be. You have> to be careful of how you define the patient relationship nowadays> also. Much is being done in chiropractor offices, mall clinics ,> and in the Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Brent> > >> > i've been reading about the social burden of being a doctor and> how it relates to low overhead practice with great interest.> >> > there are some underlying fundamental precepts i like to keep in> mind when discussing these things.> >> > they are:> >> > health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter. everybody needs it.> >> > good health care arises from a healthy doctor-patient> relationship. the relationship facilitates healthy choices> resulting in good outcomes.> >> > any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship. form> follows function.> >> > just my thoughts.> >> > LL> >> >> > ---------------------------------> > Yahoo! Travel> > Find great deals to the top 10 hottest destinations!> >>>>>>>>>

March 23, 2006

The ADA does not mandate the use of interpreters in every instance. The health care professional can choose alternatives to interpreters as long as the result is effective communication. Alternatives to interpreters should be discussed with hearing impaired patients, especially those not aware that such alternatives are permissible under the Act. Acceptable alternatives may include: note taking; written materials; or, if viable, lip reading. A health care professional or facility is not required to provide an interpreter when:

it would present an undue burden. An undue burden is a significant expense or difficulty to the operation of the facility. Factors courts use to determine whether providing an interpreter would present an undue burden include the practice or facility's operating income and eligibility for tax credits, and whether it has sources of outside funding or a parent company. Courts also consider the frequency of visits that would require the services of an interpreter. However, the single factor of the cost of an interpreter exceeding the cost of a medical consultation generally has not been found by the courts to be an undue burden.

Source: http://www.ama-assn.org/ama/pub/category/4616.html

Brett

RE: medical interpreter and non compliant pt.

Not true, at least not totally true. You are obligated to make REASONABLE ACCOMODATIONS for them IF INDICATED. To me this means that if you can get the same info etc by writing, gesturing, etc then that is all you are required to do. I’m sorry, but I am just not going to see a patient at a loss. If a deaf/nonspeaking person is trying to come in I will just insist that they bring an interpretor with them or I can not see them. I am running a business & will not be forced to see anyone that I do not wish to see (at least not as a new patient). That is very rude in my opinion for a deaf patient to come in with no interpretor or other plan & just expect you to take care of it, regardless of what any law says. In the end though, it has been a moot issue for me because the situation has not came up so far in 2 years.

-----Original Message-----From: [mailto: ] On Behalf Of Anemaria LutasSent: Thursday, March 23, 2006 7:03 AMTo: Subject: Re: medical interpreter and non compliant pt.

Do you have anything in writing regarding this rule ? I do not think it applies to small offices. After all, where are you going to find an interpreter ?

You are obligated to provide and pay for an interpreter. In our area it means that you lose about $5 to see a Medicare patient with an interpreter. You cannot discriminate based on their need for an interpreter. From: [mailto: ] On Behalf Of mandanamd@...Sent: Tuesday, March 21, 2006 8:00 PMTo: Subject: medical interpreter and non compliant pt. Hi groupI would like to know if as physician we are obligated to provide and pay fro interpreter or patient has to do it? and the second question is what is the best way to document or track or get the pt. to follow up and what is the best way to protect the practice from the legal consequences? ThanksMandana

-------------- Original message --------------> Health care is a basic human need, depends on how you define it.> Certain christian sects would say wrong. It is not food and water.> It is not shelter from the elements. How far do you take it?>> We are all in this to help people be the best they can be. You have> to be careful of how you define the patient relationship nowadays> also. Much is being done in chiropractor offices, mall clinics ,> and in the Emergency Room.>> Just stirring the pot a little to see what floats to the top.> Brent> > >> > i've been reading about the social burden of being a doctor and> how it relates to low overhead practice with great interest.> >> > there are some underlying fundamental precepts i like to keep in> mind when discussing these things.> >> > they are:> >> > health care is not a right or privilege; it is a basic human> need, just like food, clothing and shelter. everybody needs it.> >> > good health care arises from a healthy doctor-patient> relationship. the relationship facilitates healthy choices> resulting in good outcomes.> >> > any framework surrounding the doctor-patient relationship must> be defined by the needs of the doctor-patient relationship. form> follows function.> >> > just my thoughts.> >> > LL> >> >> > ---------------------------------> > Yahoo! Travel> > Find great deals to the top 10 hottest destinations!> >>>>>>>>>

March 23, 2006

Good info. And chances are that if a potential patient is going to be that

adamant about following the letter of the ADA law right from the start

by waving the requirements in your face, then most likely they will not be a

good fit anyways & will not last long (will be dismissed for other reasons

probably).

Re:

medical interpreter and non compliant pt.

The ADA does not mandate the use of interpreters in

every instance. The health care professional can choose alternatives to

interpreters as long as the result is effective communication. Alternatives to

interpreters should be discussed with hearing impaired patients, especially

those not aware that such alternatives are permissible under the Act.

Acceptable alternatives may include: note taking; written materials; or, if

viable, lip reading. A health care professional or facility is not required to

provide an interpreter when:

·

it would present an undue

burden. An undue burden is a significant expense or difficulty to

the operation of the facility. Factors courts use to determine whether

providing an interpreter would present an undue burden include the practice or

facility's operating income and eligibility for tax credits, and whether it has

sources of outside funding or a parent company. Courts also consider the

frequency of visits that would require the services of an interpreter. However,

the single factor of the cost of an interpreter exceeding the cost of a medical

consultation generally has not been found by the courts to be an undue burden.

Source: http://www.ama-assn.org/ama/pub/category/4616.html

Brett

medical interpreter and non compliant pt.

Hi group

I would like to know if as physician we are obligated to provide and pay fro

interpreter or patient has to do it? and the second question is what is the

best way to document or track or get the pt. to follow up and what is the best

way to protect the practice from the legal consequences? Thanks

Mandana

-------------- Original message --------------

> Health care is a basic human need, depends on how you define it.

> Certain christian sects would say wrong. It is not food and water.

> It is not shelter from the elements. How far do you take it?

>

> We are all in this to help people be the best they can be. You have

> to be careful of how you define the patient relationship nowadays

> also. Much is being done in chiropractor offices, mall clinics ,

> and in the Emergency Room.

>

> Just stirring the pot a little to see what floats to the top.

> Brent

>

> >

> > i've been reading about the social burden of being a doctor and

> how it relates to low overhead practice with great interest.

> >

> > there are some underlying fundamental precepts i like to keep in

> mind when discussing these things.

> >

> > they are:

> >

> > health care is not a right or privilege; it is a basic human

> need, just like food, clothing and shelter. everybody needs it.

> >

> > good health care arises from a healthy doctor-patient

> relationship. the relationship facilitates healthy choices

> resulting in good outcomes.

> >

> > any framework surrounding the doctor-patient relationship must

> be defined by the needs of the doctor-patient relationship. form

> follows function.

> >

> > just my thoughts.

> >

> > LL

> >

> > ---------------------------------

> > Yahoo! Travel

> > Find great deals to the top 10 hottest destinations!

> >

>

March 25, 2006

I wanted to remain quiet on this, but I think I have to step in now. This

is very close to my area of expertise. I know sign language and work with

a few hundred deaf patients here in Rochester, New York. I have served as

an expert witness in legal cases, and presented both locally and

nationally on the issue and have served on panels for HCFA (now called

CMS) regarding services for the deaf.

First off, I will make clear that my personal preference would be that

interpreters could bill directly to insurance companies. My second

preference would be that doctors could pay interpreters and then have a

code to receive payment (at least partial) through the insurance companies

with the in regular charges. This would respect the extra work that is

inherently needed for the great majority of deaf patients we see.

Regarding the discussion so far I want to make a clear there really is no

" urban legend " about the requirements for interpreters for the deaf in

medical care. Just because not many cases are brought before the courts

does not mean that this is not a reality.

Also, understand there are cases that have made it through the courts but

most often these are settled out-of-court. I believe most of the

challenges to ADA have been regarding the jurisdiction of the law and

whether they apply to state hospitals or other subtle situations.

Whether we think it's fair or not we are obligated to follow laws of the

land and the contracts we sign with the insurance companies.

Also, when considering the need for interpreters for the deaf we must

understand how medical professionalism is interpreted by our society as

well as the limited English skills of most deaf patients and the

difference of American sign language from English.

Whether we feel we are simply running a business are not, the truth is our

society has established high standards for our behaviors and expects us to

live up to them. This has been supported for many decades by professional

organizations outlining medical ethics and professionalism. These are so

ingrained in our society that they have a legal standing. Our actions

cannot be considered the same as hairdressers, auto mechanics or other

laborers. We have an obligation to our society, our patients and our

colleagues to maintain a professionalism when providing care.

Also, financially the ADA is clear in stating the overall financial burden

is not judged by an individual event but on our total financial status.

The ADA has many parts to it and each must be considered in relationship

to the others. Be careful in pulling on single sections or clauses. See

below regarding certain sections of the law than cover the financial

issues.

Most deaf patients have far weaker English skills than hearing patients.

Trying to communicate with them with written English in most situations

could be argued as close to malpractice as we are potentially jeopardizing

our ability to gather the medical information needed to make proper

decisions and to be sure the information we communicate may be understood.

I will offer one example. If we write, " your test was negative for

anemia " that could be understood by a sign language user as meaning, " your

test was bad. You have anemia. " Now, I recommend we do not speak that

way but the truth is we physicians often do. What is written in English

by using the word " negative " suggests the absence of anemia. But the sign

for " negative " is not used in that way. Rather, it suggests a " bad "

condition. Thus, by depending on the written English we may be

communicating the exact opposite of what is intended.

I know of many, many situations where doctors communication with patients

has been misunderstood because of the lack of interpretation. Often, I

need to re-explain to my patients what the specialist believed had been

communicate at an appointment.

Finally, please see below for an excerpt of something I have written

regarding the ADA and the use of sign language interpreters.

Thank you for considering this issue. I do beg you to use interpreters

when working with deaf patients.

Tim

..... excerpt from my writing...

To safeguard the rights of American citizens with disabilities to access

services throughout our society on as equal terms as possible with

non-disabled citizens, the United States Congress passed, and President

Bush signed into law, the Americans With Disabilities Act of 1990

(commonly referred to as the ADA). The ADA addresses the issue of

accessibility for our citizens with disabilities in all aspects of our

society. There are pertinent details in the ADA as it relates to an

initial doctor-patient consultation when a Deaf person requests an ASL

interpreter but then must use pen-and-paper for communication.

Section 2 of ADA finds that “discrimination against individuals with

disabilities persists in such critical areas as ... health services” and

that “the Nation's proper goals regarding individuals with disabilities

are to assure equality of opportunity, full participation, independent

living, and economic self-sufficiency for such individuals.”

Section 3 of ADA includes within its definition of an auxiliary aid and

service “qualified interpreters or other effective methods of making

aurally delivered materials available to individuals with hearing

impairments.”

Section 301 of ADA states “the following private entities are considered

public accommodations for purposes of this title, if the operations of

such entities affect commerce ... professional office of a health care

provider, hospital, or other service establishment.” It also defines

“commercial facilities (as) facilities (which) ... are intended for

nonresidential use; and ... whose operations will affect commerce.

The same section also states “the term " readily achievable " means easily

accomplishable and able to be carried out without much difficulty or

expense. In determining whether an action is readily achievable, factors

to be considered include-- (A) the nature and cost of the action needed

under this Act; ( the overall financial resources of the facility or

facilities involved in the action...”

Section 302 of ADA states, “Goods, services, facilities, privileges,

advantages, and accommodations shall be afforded to an individual with a

disability in the most integrated setting appropriate to the needs of the

individual.”

Also, Section 302 of ADA includes in the definition of discrimination “a

failure to take such steps as may be necessary to ensure that no

individual with a disability is excluded, denied services, segregated or

otherwise treated differently than other individuals because of the

absence of auxiliary aids and services, unless the entity can demonstrate

that taking such steps would fundamentally alter the nature of the good,

service, facility, privilege, advantage, or accommodation being offered or

would result in an undue burden.”

> Yes, I think you are correct. The whole ADA interprtor thing persists

> in " urbal legend " form despite no such law.

>

>>

>> Date: 2006/03/25 Sat AM 08:17:47 EST

>> To:

>> Subject: Re: medical interpreter and non

>> compliant pt.

>>

>> There may be such a law in Washington, I am sure there is none in

>> Indiana and I will check about Illinois. The federal law they are

>> talking about applies to state agencies or " receivers of federal

>> funding " , which we are not.

>>

>> >

>> > My information came from my malpractice insurance company. Here is

>> the link:

>> >

>> > http://www.phyins.com/pi/risk/faq.html

>> >

>> > It specifically addresses requiring people to bring their own

>> interpreter, and suggests against it.

>> >

>> > We also find our patients that require interpreters (about 7) are

>> pleasant to deal with, even if we don?t make money on their visits.

>> Don?t get me wrong, I think the law is stupid and that it should

>> provide funds and a limited time for those who do not speak English

>> but do speak other languages (so they are forced to learn the

>> language of the country they live in). Sign language does not

>> include articles, which makes it difficult to have an appointment

>> with a note pad. It is hard to read and difficult for them to

>> understand. It also seems to be difficult have a detailed

>> conversation about managing diabetes through gesturing. But I have

>> called our legislators about it as well as crummy Medicare

>> reimbursement, but they haven?t changed the law yet. I keep

>> holding my breath.

>> >

>> > And I hate to say it, but if your defense is you?re a doctor and

>> can?t afford a $60 bill for an interpreter, I wish you luck. I

>> don?t think you would fare well in open court.

>> >

>> > Ernie

>> >

>> > From:

>> > [mailto: ] On Behalf Of

>> Brock DO

>> > Sent: Thursday, March 23, 2006 7:17 AM

>> > To:

>> > Subject: RE: medical interpreter and non

>> compliant pt.

>> >

>> > Good info. And chances are that if a potential patient is going to

>> be that adamant about following the letter of the ADA law right

>> from the start by waving the requirements in your face, then most

>> likely they will not be a good fit anyways & will not last long

>> (will be dismissed for other reasons probably).

>> >

>> > Re: medical interpreter and non

>> compliant pt.

>> >

>> > The ADA does not mandate the use of interpreters in every instance.

>> The health care professional can choose alternatives to interpreters

>> as long as the result is effective communication. Alternatives to

>> interpreters should be discussed with hearing impaired patients,

>> especially those not aware that such alternatives are permissible

>> under the Act. Acceptable alternatives may include: note taking;

>> written materials; or, if viable, lip reading. A health care

>> > professional or facility is not required to provide an interpreter

>> when:

>> >

>> > · it would present an undue burden. An undue burden is a

>> significant expense or difficulty to the operation of the facility.

>> Factors courts use to determine whether providing an interpreter

>> would present an undue burden include the practice or facility's

>> operating income and eligibility for tax credits, and whether it

>> has sources of outside funding or a parent company. Courts also

>> consider the frequency of visits that would require the services of

>> an interpreter. However, the single factor of the cost of an

>> interpreter exceeding the cost of a medical consultation generally

>> has not been found by the courts to be an undue burden.

>> >

>> > Source: http://www.ama-assn.org/ama/pub/category/4616.html

>> >

>> > Brett

>> >> medical interpreter and non

>> compliant pt.

>> >>

>> >> Hi group

>> >>

>> >> I would like to know if as physician we are obligated to provide

>> and

>> >> pay fro interpreter or patient has to do it? and the second

>> question is what is the best way to document or track or get the

>> pt. to follow up and what is the best way to protect the practice

>> from the legal consequences? Thanks

>> >>

>> >> Mandana

>> >>

>> >> -------------- Original message --------------

>> >>

>> >> > Health care is a basic human need, depends on how you define it.

>> Certain christian sects would say wrong. It is not food and

>> water. It is not shelter from the elements. How far do you take

>> it?

>> >> >

>> >> > We are all in this to help people be the best they can be. You

>> have to be careful of how you define the patient relationship

>> nowadays also. Much is being done in chiropractor offices, mall

>> clinics , and in the Emergency Room.

>> >> >

>> >> > Just stirring the pot a little to see what floats to the top.

>> Brent

>> >> >

>> >> > >

>> >> > > i've been reading about the social burden of being a doctor

>> and

>> >> > how it relates to low overhead practice with great interest.

>> >> > >

>> >> > > there are some underlying fundamental precepts i like to keep

>> in

>> >> > mind when discussing these things.

>> >> > >

>> >> > > they are:

>> >> > >

>> >> > > health care is not a right or privilege; it is a basic human

>> >> > need, just like food, clothing and shelter. everybody needs it.

>> >> > >

>> >> > > good health care arises from a healthy doctor-patient

>> >> > relationship. the relationship facilitates healthy choices

>> resulting in good outcomes.

>> >> > >

>> >> > > any framework surrounding the doctor-patient relationship must

>> >> > be defined by the needs of the doctor-patient relationship. form

>> follows function.

>> >> > >

>> >> > > just my thoughts.

>> >> > >

>> >> > > LL

>> >> > >

>> >> > > ---------------------------------

>> >> > > Yahoo! Travel

>> >> > > Find great deals to the top 10 hottest destinations!

>> >> > >

>> >> >

March 25, 2006