Imagine visiting with your doctor and receiving medication instructions without a solid understanding of what the doctor is saying. A patient with a complex medical history—and whose first language isn’t English—stopped taking an important diabetes medication after misunderstanding his doctor’s instructions. Thanks to Melissa Norton, SelectHealth care manager, he was followed up upon and communicated with in his native language to ensure he received the correct instructions.
Melissa Norton
“The patient had visited with a non-Intermountain provider who hadn’t used an interpreter and the patient didn’t understand his instructions,” says Melissa. “When I spoke to the patient and he mentioned he wasn’t feeling well, I soon learned it was because he’d stopped taking a diabetes medication that helps control blood sugar.”
When Melissa contacted the provider’s office to investigate, she discovered the patient was asked to follow up with his primary care provider to receive a different medication.
“He was very confused,” she says. “For some reason he thought his doctor had wanted him to use sodium to help manage his diabetes, and he didn’t know why he wasn’t feeling well. He didn’t realize that he needed to actually see another doctor and change his medication.”
Without his medication, Melissa says the patient would not only feel terrible, but very high blood sugar could potentially lead to problems like stroke, heart attack, kidney damage, or a coma. “It’s really scary what he was facing,” she says.
Working with an interpreter is a must for patients and families who need it, says Carlos Martinez-Morales, language services manager. “In fact, every patient has a legal right to a qualified interpreter,” he says. “Clinicians and caregivers have a responsibility, both legally and ethically, to communicate through a qualified interpreter when caring for any person whose preferred language is something other than English.”
Melissa says the first time she talked with this patient it was clear that English was not his first language. “While he was able to tell me his native language and answer a few basic questions, it was obvious he needed an interpreter,” she says. “I’m not sure why the provider’s office didn’t offer this to him. I asked them to please always do this in the future.”
“This is an example of why we must all champion equity. We can’t treat all patients the same and expect the same behaviors and outcomes,” Carlos says. “We must modify our care delivery to meet the needs of each individual, including providing timely access to qualified interpreters. You couldn’t just tell this patient the instructions in English without him being at a disadvantage and missing out on important information.”
Melissa says she feels the patient was doing what he was told based on what he understood. “It’s his right to have an interpreter and get the best care possible,” she says. “You can’t make assumptions that a patient understands. It’s better to err on the side of caution.”
Once the patient saw his primary care doctor to receive a new medication, Melissa found out that this time he’d had an interpreter and he was able to start his new medication. “He was feeling much improved and his blood sugars were better,” she says. “He was so sweet when I called him back and kept telling me how grateful he was that I cared.”
“Melissa is a fantastic example of the work we do in care management,” says Erin Evans, SelectHealth clinical services operations manager. “Her commitment to our members, identifying gaps, and advocating for health equity helps improve health outcomes for vulnerable members.”