Healthcare is a broad term for the medical services we receive through emergency room visits, hospital stays, doctor visits, dental visits, or visits to any other specialized medical professional.  There are three levels of health care: primary, secondary, and tertiary.  Primary care is defined as visits to urgent care or a primary care provider, secondary care is defined as specialists in a medical area such as audiologists or oncologists. Tertiary care refers to healthcare within a hospital setting like major surgeries.  With such a wide network of healthcare options, one might think it can be difficult for a Deaf patient to navigate their individual health care experience so that they are receiving equal access to not only effective communication but to appropriate treatment.  The Americans with Disability Act (ADA) has very specific guidelines for both public and private health care providers when dealing with Deaf and hard of hearing individuals to guarantee these individuals receive the same level of care as all other patients. 

Meeting the needs of Deaf Patients at the primary level.

There are many considerations that need to be made when a Deaf patient goes to see their primary care physician, the first being that the physician and patient have an established, effective method of communication.  This is paramount to making sure that a Deaf or hard of hearing patient can communicate what type of ailment or illness they are currently experiencing and that the doctor fully comprehends the patient’s medical concerns.  Titles II and III of the ADA address what a medical provider, whether public or private health care, must provide so that the patient can communicate regarding their health concern.  So how is this accomplished? Health care providers must provide appropriate auxiliary aids (communication tools) including sign language interpreters, real-time computer-generated speech to text, or at the very least written messages so that the patient can voice their concerns and the doctor can answer medical questions. It is worth noting that primary care physicians are not required to provide a sign language interpreter, just an effective method of communication, and that can be anything from written or typed messages to discuss medications to a computer access real-time translation (CART), or speech to text option.   If you are requesting a sign language interpreter it is important to note that you should contact your doctor in advance to make sure proper measures are taken to secure an interpreter and have them ready prior to your appointment.

Meeting the needs of Deaf Patients at the secondary level

When working with a secondary level healthcare provider, the amount of information becomes more specific to possibly diagnosis and treatment possibilities.  For instance, if a Deaf person finds out that they have cancer and must meet with an oncologist to discuss diagnosis and treatment, then the effective communication would not include note writing back and forth between patient and provider.  This is where auxiliary aids and services that are required by ADA would move towards qualified interpreters, who are familiar with medical terminology and able to communicate any questions the patient or their family might have regarding diagnosis to the doctor(s).  CART could still be an option as it is a more extensive level of interpretation, but captioning or assistive listening devices, depending on the level of Deafness experienced by the patient, may also be utilized. The end goal is not necessarily access to an interpreter, but that communication between the Deaf patient and health care provider is effective so there is no risk of misdiagnosing the patient’s symptoms or prescribing an inadequate treatment.  Patients have a say in their treatment plans, so there should be no room for error when discussing health options with providers. Again, if you are requesting an interpreter, it is the patient’s responsibility to make sure the doctor’s office is aware so they can make plans to have an interpreter available.  Do not hire an interpreter and expect your doctor to reimburse you. 

Meeting the needs of Deaf Patients at the tertiary level

When a patient receives care at the tertiary level, it is often with a team of professionals that are responsible for completing a care treatment, whether that be having heart surgery or giving birth.  For procedures that are scheduled out in advance, the hospital will be able to retain a sign language or oral interpreter to answer questions posed by the patient or their family members.  If a live ASL interpreter is unavailable, there are opportunities for video remote interpreters to aid in communication between the hospital team and patient. Again, these are not the patient’s responsibility beyond requesting them and should be provided at no cost to the patient.  If there is an emergency and time is of the essence, the hospital team can use other methods of effective communication, written notes, diagrams, while a sign language interpreter is secured. 

Conclusion

While the ADA has laid the foundation for health care professionals to provide equal access to quality health care, the healthcare sector as a whole has a long way to go in promoting equity to all patients regardless of whether they are Deaf or hearing.  Unfortunately, Deaf individuals must advocate for themselves to make sure they are receiving the best medical treatment available.  If at any time a Deaf person feels as though their civil rights have been violated by a health care professionals’ refusal to provide effective communication, they can always file a complaint with the ADA’s governing body, the Department of Justice.  Communication levels between Deaf individuals vary greatly, so don’t be afraid to find an effective communication level that works for you and request it whenever you find yourself in need of health care. 

If you have questions regarding finding qualified sign language interpreters, reach out to Unspoken Language Services, a professional ASL interpreting service provider, to bridge the communication gap and create an inclusive and accessible environment for all.