[HN Gopher] Doctors who use Google Translate to talk to patients...
       ___________________________________________________________________
        
       Doctors who use Google Translate to talk to patients want a better
       option
        
       Author : grogu88
       Score  : 47 points
       Date   : 2022-03-17 18:07 UTC (4 hours ago)
        
 (HTM) web link (www.statnews.com)
 (TXT) w3m dump (www.statnews.com)
        
       | rahimnathwani wrote:
       | This article says they used Google Translate for "Taiwanese to
       | English, English to Taiwanese", but Google Translate doesn't list
       | 'Taiwanese' as a language.
       | 
       | It _does_ list  'Chinese (Traditional)' and I guess that's what
       | they were using.
        
         | thaumasiotes wrote:
         | Fun fact: Disney movies get separate dubs for Taiwan and for
         | mainland China.
        
           | rahimnathwani wrote:
           | I'm going to try this next time my son watches a Disney
           | movie, and see if he notices.
        
             | thaumasiotes wrote:
             | If he's already familiar with the movie, he's pretty
             | certain to notice if you switch the version. The song
             | lyrics are completely different.
             | 
             | I tend to feel that the Taiwan lyrics are better, but I'm
             | not a native or even fluent speaker. I'd be interested in
             | native opinions.
        
       | johndfsgdgdfg wrote:
       | In US ALL doctors have to be trained in Spanish so that they can
       | serve the hispanic population. This type of systemic racism
       | against hispanics shouldn't be tolerated and we need put an end
       | to it.
        
       | hohoemi8 wrote:
       | I don't know anything about the person in the article but if you
       | still don't speak the language X years after immigrating to a
       | country you have no one but yourself to blame for these kinds of
       | situations.
        
       | freedomben wrote:
       | I can't imagine being a patient in pain trying to communicate
       | that to a doctor who didn't speak the same language, especially
       | when the pain was due to a different issue (as the article
       | describes).
       | 
       | The pendulum has fully swung from "pain is a vital sign" to "suck
       | it up" and "anyone who complains about pain is a liar or a drug
       | seeker unless they're older than 65 or have a visible external
       | wound."[1] It's difficult even when you speak the same language.
       | I'm sure it's nearly impossible when you don't.
       | 
       | [1]: https://rehabs.com/pro-talk/how-to-get-labeled-a-pill-
       | seeker...
        
         | pseingatl wrote:
         | A patient who is mentally challenged or who is unconscious may
         | or won't have the vocabulary that would permit a physician to
         | take a history.
         | 
         | Veterinarians deal with this daily as well.
         | 
         | In both cases, there are professional protocols to deal with
         | the situation.
        
         | atdrummond wrote:
         | It has become an absolute joke. I have had 6 surgeries for
         | Crohns, a back surgery due to wear and tear from high level
         | athletics, and am a long term sufferer of an aggressive
         | leukaemia. Despite using opioids responsibly for over a decade,
         | I am regarded as nothing more than a drug seeking pest the very
         | few times I have actively sought pain relief during in-patient
         | hospital stays. Prior to being dropped entirely from my
         | Oxycodone IR script (30 10mg pills a month, truly not a large
         | amount) without any warning due to my pain doctor finally
         | simply giving up on the system, I had never asked for an
         | increase in a dose ever - despite still having plenty of
         | untreated pain.
         | 
         | Legitimate chronic pain patients are being abused at this point
         | in order to save face for the broken, rent-seeking
         | pharmaceutical system that enabled the prescription opioid
         | 'crisis' in the first place.
        
           | BaronVonSteuben wrote:
           | Yep, absolutely. My doctor of 10+ years recently retired,
           | leaving me in search of a new doc. I've been managing my pain
           | for 15+ years just fine with 10mg Hydrocodone. In 15 years I
           | only once asked to increase the dose, and it was only from
           | two pills per day to three to help me get through the
           | afternoon/evening better. A minuscule dose.
           | 
           | After doing "new patient" appointments (which by the way were
           | like $200 to $300 _each_ ) and not having a doc willing to
           | take me on as a patient unless I dropped the opioids, and
           | making several calls (who refused to tell me over the phone
           | whether the doctor was even _open_ to controlled substances
           | without that $300  "new patient" appointment) I gave up.
           | Since coming off the opioids my quality of life has plunged.
           | I struggle with depression and thoughts of suicide now,
           | especially when I'm unable to leave the house or my bed. I
           | went from stable and productive and what doctors used to say
           | is the model patient, to being miserable. Every doc has
           | offered to give me additional antidepressants or crank up the
           | doses of those, but none are willing to treat the pain that
           | is exacerbating it.
           | 
           | I absolutely believe that what the medical establishment is
           | doing to people like us (withholding treatment that we know
           | works) is cruel and borders on torture. It is the epitome of
           | taking macro-level stats and explanations and applying them
           | broadly on the micro-level, regardless of the harm caused.
           | 
           | I believe Hippocrates would be rolling over in his grave to
           | hear that these people took an oath to "do no harm."
           | 
           | For the record. I mostly don't blame the doctors. They are
           | protecting their medical licenses, which the DEA and FDA have
           | proven they are willing to revoke over the slightest anomaly.
           | When the feds started throwing pain specialists in federal
           | prison because some tiny percent of their patients were
           | abusers, it really drove home that individual doctors are not
           | allowed to think anymore. You implement government policy, or
           | you risk financial ruin and even jail time. I don't blame
           | them for being cowards. I probably wouldn't risk imprisonment
           | on a stranger either.
        
             | atdrummond wrote:
             | I don't blame the doctors either. My pain doctor was a
             | rural boy from my hometown who made good, graduated from
             | Berkeley and finished medical school and finished desirable
             | postdocs at Harvard. He simply straight up quit pain
             | management as a specialty rather than be forced to provide
             | his patients with what he considered subpar care. The loss
             | of doctors like him hurts particularly badly, as it leaves
             | us with pain specialists who either knowingly ignore the
             | decades of successfully treated patients who used opioids
             | or the remaining (and they do still exist) pill mill
             | operations, who have simply gotten more sophisticated in
             | their execution. Regardless of which doctor archetype
             | chronic pain patients end up with, they're going to suffer.
        
             | google234123 wrote:
             | We also now know that those treatments kill people and
             | users gain dependence and tolerance to opioids. It's more
             | than just protecting their medical license.
        
               | atdrummond wrote:
               | The proportion of patients who become addicted from
               | properly prescribed opioids is extremely small. The
               | majority of addicts created were provided with opioids
               | that were not appropriate for their particular medical
               | situation, in doses that were too high, and on a regimen
               | that exceeded in length what was supported by the medical
               | evidence. The proportion of new cancer patients who go on
               | to receive palliative care that includes opioids who end
               | up becoming addicted has always been, and remains, in the
               | low single digits. For patients with a genuine need and
               | who are properly inducted and maintained on them, opioids
               | are a powerful and useful medical tool.
               | 
               | Further, the bulk of use in illegal opioids stateside,
               | such as fentanyl and its analogues, is not (at least
               | today) driven by the conversion of the legal opioid user
               | to an illegal drug user. Fentanyl is now commonly found
               | in drugs that never previously would have contained an
               | opioid, such as counterfeit benzos and MDMA. Further, the
               | majority of fentanyl users on the street arrive at its
               | use after consuming other illegal/street drugs. For those
               | who started on other opioids, their first opioid will
               | tend to be the illegally diverted pills or liquid cough
               | treatments containing codeine/hydrocodone called "lean".
               | Very few new users of fentanyl and fentanyl analogues
               | come from legal opioid users, mainly because very few new
               | users are now inducted on reckless prescriptions such as
               | an immediate script for 180 Oxycontin and 240
               | benzodiazepene pills a month. Your narrative is about a
               | decade out of date at this point.
               | 
               | Thomas Kline is a superb resource if you want to take a
               | deeper dive into the actual statistics and how the
               | narrative of a crisis was used to systematically deny law
               | abiding patients the pain treatment they should receive.
               | https://twitter.com/thomasklinemd
        
               | google234123 wrote:
               | A meta study of 38 studies from 7 years ago on patients
               | using opioids for chronic pain found that 21-29% of the
               | patients misuse the drugs and 8-12% of the patients are
               | addicted to them. That doesn't seem "extremely small"
               | like you said, though maybe it's better now. I think
               | there are reasons why opioids are no longer recommended
               | for the treatment of most patients with chronic pain that
               | you aren't fairly acknowledging.
               | 
               | https://journals.lww.com/pain/Abstract/2015/04000/Rates_o
               | f_o...
        
               | atdrummond wrote:
               | https://www.nejm.org/doi/full/10.1056/NEJMra1507771
               | Volkow is a mainstream researcher, using data from the
               | peak of the crisis, and cites the rate at just under 8%.
               | It is not at all unreasonable to assume that with proper
               | prescribing (unlike what happened in the 90s and 2000s)
               | that chronic pain patients can have opioid misuse and
               | addiction numbers near or matching that of palliative
               | care patients, where addiction rates are closer to 1%
               | than 10%.
        
               | exolymph wrote:
               | Who fucking cares? This wouldn't be nearly as huge of a
               | problem if people with a physical dependency -- inclusive
               | of addicts, but by NO MEANS exclusively addicts -- could
               | reliably access safe, reliably dosed opioids instead of
               | getting pushed to street drugs.
        
               | google234123 wrote:
               | If these people have access to a doctor/health care then
               | there they definitely have options to treat their
               | addition. Any family physician would be happy to discuss
               | treatment options.
               | 
               | The problem of people without health care is a bigger and
               | separate issue.
        
             | fvv wrote:
             | Sorry if i sound blatantly stupid with my question, maybe
             | In your case this could not be a sufficient solution for
             | pain but did you ever tried with something like Marijuana
             | and if it's illegal in you state considered migrating where
             | it's legal? Or even considered to relocate to somewhere
             | where you can get access to proper medication ?
        
             | dijonman2 wrote:
             | You can buy oxy on the street. Super expensive. $1/mg.
        
             | throwaway42124 wrote:
             | I'm sorry you're in this situation.
             | 
             | Consider buying your medicine from the dark web as a
             | possible workaround.
        
           | Gatsky wrote:
           | Sorry to hear you have this problem. Chronic pain
           | understanding and management is medieval, and seemingly
           | getting worse rather than better over time.
        
             | atdrummond wrote:
             | I really appreciate your kind thoughts. Thankfully
             | Vipassana meditation has helped keep me sane in spite of
             | the inane restrictions my doctors have been put under and
             | also just so happens to help reduce the pain to a somewhat
             | more manageable level. It's funny that a lot of the
             | patients most aggressively hurt by simplistic one-size-
             | fits-all reforms like the 90 MME cap are the patients most
             | likely to support, and already be utilizing, integrative
             | medicine. Such patients have been dealing with pain for
             | years, decades often - they're not going to turn down any
             | potential solutions that might help. All they ask is for
             | their doctors to be given the autonomy necessary to
             | prescribe legal, needed medications when called for.
        
       | LAC-Tech wrote:
       | Is no one going to address the elephant in the room? If you're in
       | a country where the lingua franca is X, you need to be able to
       | speak X or life will be difficult. I'm not sure why the onus is
       | on every hospital to become a kind of mini united nations here.
        
         | umeshunni wrote:
         | Many hospitals advertise internationally and rely on medical
         | tourism of various sorts. You can't expect a 70 year old heart
         | patient flown in from Taiwan to Phoenix to learn English for
         | their surgery.
        
           | thaumasiotes wrote:
           | I think if you're advertising internationally for
           | international patients, it becomes reasonable to expect you
           | to have translators on staff.
        
         | paxys wrote:
         | Tourism (including medical tourism) is a thing, as is
         | telemedicine. In general, doctors and hospitals aren't in the
         | business of turning away people just because they speak the
         | "wrong" language.
        
           | google234123 wrote:
           | To be fair, most the people only speaking Spanish in the US
           | aren't here for tourism.
        
         | jka wrote:
         | People travel recreationally, for business, and sometimes out
         | of necessity to places where they don't speak the local
         | language - perhaps you, friends, or family have, or will in
         | future, experience those kinds of travel.
         | 
         | Medical emergencies (or, to be honest, routine medical care)
         | can be required for anyone, anywhere, for no particular reason.
         | Care workers are no doubt familiar with that.
         | 
         | For people to want to improve the situation for hospitals
         | doesn't seem bad if it's possible. Do you think that we cannot
         | achieve better?
        
           | LAC-Tech wrote:
           | _People travel recreationally, for business, and sometimes
           | out of necessity to places where they don 't speak the local
           | language - perhaps you, friends, or family have, or will in
           | future, experience those kinds of travel._
           | 
           | Sure, my wifes English is very good but not perfect. I
           | accompany her so I can give quick translations to medical
           | terms she might not know.
           | 
           | If we ever bring her parents here to live, guess whose job
           | it's going to be to make sure they understand doctors? Well,
           | mostly hers... but you get my point. The onus is on us.
           | 
           | I have no expectation that every hospital should be able to
           | communicate in every language on earth.
        
             | [deleted]
        
             | jka wrote:
             | Thanks - that all makes sense, and I agree that generally
             | it makes sense to navigate life with realistic
             | expectations.
             | 
             | Having optimism, and deciding to challenge existing
             | limitations can both be useful too, though.
             | 
             | > I have no expectation that every hospital should be able
             | to communicate in every language on earth.
             | 
             | I like the way you stated that. At first it made me think
             | about how to improve translations. Now it's making me
             | wonder whether there is a more universal common medical
             | language (in many situations, I think that human care for
             | each other doesn't require much communication at all).
        
         | jspash wrote:
         | I recently went to Poland for a quick 2 day holiday. Felt great
         | before I left. Felt great while I was there. Tested positive
         | for covid the morning I was supposed to fly home. Fast forward
         | a bit and I'm in the back of an ambulance while my partner was
         | on the plane back home.
         | 
         | They put me up in a hotel for 10 days. Fed me 3 times a day.
         | Checked on me twice a day. And on day 10, opened the door and I
         | was on my own.
         | 
         | How I could have managed that without Google translate, I don't
         | know. None of the doctors or nurses spoke more than a few words
         | of English. And I could barely say hello, goodbye or thank you.
         | (I can now!)
         | 
         | As you say, life would have been difficult. It was difficult
         | even _with_ google translate. But it made the interactions much
         | easier on both parties involved.
         | 
         | I would hope that if someone was visiting my country on
         | holiday, or to visit their relatives, and happened to get sick,
         | that the hospital would do all they could to communicate with
         | them and not treat them like they shouldn't even be there.
        
           | LAC-Tech wrote:
           | Right, but if you decided to move to Poland - you'd realise
           | you probably need to speak Polish, right?
        
       | slackfan wrote:
       | There has been a better option for a long time, called on-staff
       | Medical Interpreters. In fact, my spouse worked as one for
       | approximately seven years. Unfortunately due to hospitals
       | consolidating into medical networks and cutting costs wherever
       | they could, this went from on-staff interpreters, to contract
       | interpreters, to on-call phone interpreters (works incredibly
       | poorly), to google translate.
       | 
       | Blame the beurocrats running your hospital. The systems were in
       | place, just have been absolutely gutted.
        
         | standardUser wrote:
         | Having multiple full-time paid translators on hand 24/7 at
         | every hospital in the country would be nice, but probably not
         | realistic.
        
         | not2b wrote:
         | That approach is best for cases where it works, for example in
         | areas where there is a large minority of speakers of a given
         | language (Spanish in the US, for example). But if the patient
         | speaks a language that is unusual for the area, finding an
         | interpreter is going to be more difficult, or maybe not
         | possible in some cases.
        
           | pseingatl wrote:
           | You have a similar problem with respect to criminal trials of
           | defendants who speak minority languages. You can find a Khmer
           | interpreter easily enough in Los Angeles, but good luck in
           | Miami.
        
             | sokoloff wrote:
             | Criminal trials are at least scheduled, permitting travel
             | or other advance arrangements.
        
         | munk-a wrote:
         | My SO had to seek medical attention in rural southern France
         | (we were visiting Carcassone) - she initially sought care at
         | the local emerg where there was not a translator available, she
         | speaks high-school french but most of the conversation was
         | carried out through miming and charades. A few days later, as
         | instructed, she followed up with a local clinic where she
         | prepared a written version of her condition and brought it in
         | to show the doctor, they consulted that and again went through
         | a song and dance to try and mime out the response.
         | 
         | I think it'd probably be nice if there was an english fluent
         | person on staff at the emerg but I think it's unreasonable to
         | expect local clinics to have support for translating especially
         | when English is a rather unlikely language to be spoken in that
         | area - having someone German and Italian literate would be nice
         | and having someone Spanish literate (and, ideally, Basque
         | literate) would be much more important.
         | 
         | If you're running a hospital in Vancouver you better have a
         | French[1], Punjabi and Mandarin translator on staff - outside
         | of those I think it's reasonable to rely on tools like Google
         | Translate, it sucks but full language coverage isn't
         | reasonable.
         | 
         | 1. I think a French translator might be legally required due to
         | the bilingual nature of Canada but it's honestly much less
         | common on the west coast compared to Punjabi and Mandarin.
        
           | ipaddr wrote:
           | Usually your staff comes from the local population which
           | gives you staff members who speak the languages you would
           | need.
        
             | missblit wrote:
             | Unless a recent immigrant or tourist has a medical
             | emergency right?
             | 
             | Or even a longer-term immigrant who never quite learned
             | much medical vocabulary.
        
             | djrogers wrote:
             | There are relatively few native French speakers in
             | Vancouver..
        
           | throwawayboise wrote:
           | > I think it's reasonable to rely on tools like Google
           | Translate, it sucks but full language coverage isn't
           | reasonable.
           | 
           | Far better than what was possible before, when as a tourist
           | you maybe had a phrasebook or something similar.
           | 
           | This is part of the risk of travel into an area where you
           | don't know the language.
           | 
           | Also if you are going to permanently move to such a place,
           | it's incumbent on _you_ to become functionally fluent in the
           | local language. Nobody there owes you a special accomodation.
        
             | munk-a wrote:
             | > Also if you are going to permanently move to such a
             | place, it's incumbent on you to become functionally fluent
             | in the local language. Nobody there owes you a special
             | accomodation.
             | 
             | Functional fluency doesn't really cover hospital
             | interactions though, right? I can live for decades in Paris
             | without knowing what the word for chest pains or sprained
             | ankle are.
        
               | AmericanChopper wrote:
               | I've lived in a foreign country where I learned the local
               | language and was hospitalised twice during the time I
               | lived there. My vocabulary certainly didn't contain very
               | much medical vocabulary, and it wasn't an issue at all.
               | At worst you're Google translating one or two words, or
               | explaining things in a slightly odd way.
               | 
               | I could certainly say "chest pain" though.
        
               | Talanes wrote:
               | I've spoken English my whole life and still struggle to
               | express the exact sensation I'm feeling to a doctor.
        
               | djrogers wrote:
               | No, I doubt you could - 'pain' and it's synonyms, as well
               | as basic body parts like 'chest' are pretty basic words
               | for someone who's spent decades immersed in a language...
        
           | Cd00d wrote:
           | I had experience with the charades act. Got food poisoning or
           | a stomach bug in Sofia, Bulgaria and had to act out vomiting
           | and diarrhea at the chemists desk. Eventually they got the
           | drift, opened a box of pills and gave me a sheet of them with
           | no further instruction.
           | 
           | I think I could have been successful if I knew some French,
           | but alas, I opted for Spanish in high school. At the time it
           | seemed Bulgarians over a certain age had French for their
           | second (or third) language, and the younger folks had
           | English.
        
             | Xenoamorphous wrote:
             | > At the time it seemed Bulgarians over a certain age had
             | French for their second (or third) language, and the
             | younger folks had English.
             | 
             | Yes this happens in Spain too. People over 50 or 55 or so
             | were taught French at school but younger people were taught
             | English.
             | 
             | However don't expect most of them to speak much of it.
        
         | brianwawok wrote:
         | > By 2028, it is expected that health care spending in the U.S.
         | will reach nearly one fifth of the nation's gross domestic
         | product
         | 
         | It is a balance of features vs price. Right now, we need to do
         | absolutely everything we can to keep the price of medical care
         | as low as possible.
         | 
         | In the US it might make sense for most hospitals to have people
         | on staff for Spanish. I don't think we as a country can afford
         | 270 other languages of full time staff. We should use tech in
         | any way possible to cut this cost.
        
           | w-j-w wrote:
        
           | slackfan wrote:
           | Bluntly speaking, this is not a problem that tech can solve.
           | Because nothing, no video calls, no vr, no phone calls, can
           | replace an on-site professional. There are approximately top
           | 10 languages you want to have staff for, and then the rest
           | can be handled by contractors. But you have to remember that
           | most "staff" are actually 1099 contractors now because they
           | can be paid submarket wages that way.
           | 
           | Thanks, monopolies.
        
         | nradov wrote:
         | Medicare and most private insurers will pay for medical
         | translation or interpretation services when necessary. It's
         | HCPCS billing code T1013. Generally hospitals would make a
         | small gross profit on it, so I'm puzzled why they would
         | eliminate those positions if there is enough demand to keep
         | them busy.
        
         | kvathupo wrote:
         | What are countries with more functional healthcare systems
         | doing differently?
         | 
         | When it comes to comparisons with other countries, much of the
         | dialogue in the US is centered on insurance coverage. That
         | said, I'm curious if other countries have found better
         | solutions to similarly fundamental issues, such as doctors
         | working long hours, doctors being forced to maximize the number
         | of patients, continued medical education, and patient education
         | about the doctor-patient relationship.
        
           | wswope wrote:
           | Career healthtech worker; opinions are my own; focusing only
           | on the provider-specific questions you're asking:
           | 
           | Biggest problem (w.r.t. provider overwork and availability)
           | is regulatory capture by AMA and hospital groups. The AMA has
           | for decades induced an artificial shortage of MDs by limiting
           | the number of available residency slots. In particular,
           | there's an acute shortage of slots for primary care providers
           | (gen practice, family med, internal medicine, OBGYN) - which
           | combined with financial incentive, leads to an oversupply of
           | specialists.
           | 
           | AMA is also very assertive about keeping alternative
           | providers (e.g. nurse practitioners) from having the rights
           | to perform certain procedures - again as a form of financial
           | protectionism. I'm picking the worst possible example,
           | because it goes wrong _all the time_ , but in many LatAm
           | countries for example, routine x-rays and ultrasounds are
           | often read by technologists rather than radiologists. Broadly
           | speaking, there's a chilling effect of provider liability, in
           | that your PCP may not be a dermatologist, so instead of doing
           | a mole screen themselves during your annual office visit,
           | they send you for a specialist visit instead of doing it in
           | house (to avoid the unlikely chance they miss something
           | subtle the derm might've caught) - costing more money,
           | fueling the oversupply of specialty care, and letting the
           | "general" skills of GPs atrophy even further.
           | 
           | TLDR: The American Medical Association kills people.
        
             | kvathupo wrote:
             | I initially thought this was a fringe comment, but I was
             | surprised to learn that your criticisms have basis, with
             | adherents like Milton Friedman [1]. It certainly toppled my
             | presumptive association of the AMA with putting patient
             | care first.
             | 
             | P.S. I found this tidbit on tobacco particularly
             | troublesome [2].
             | 
             | [1] - https://en.wikipedia.org/wiki/American_Medical_Associ
             | ation#C...
             | 
             | [2] - https://www.sourcewatch.org/index.php/American_Medica
             | l_Assoc...
        
           | oblvious-earth wrote:
           | Aaron Carroll did a Youtube Series back in 2014 on the topic,
           | even if you don't want to watch the videos there's a lot of
           | good links in the description of each one:
           | https://www.youtube.com/watch?v=yN-
           | MkRcOJjY&list=PLkfBg8ML-g...
           | 
           | From what I remember: Insurance is one reason, Hospitals not
           | engaging in collective bargaining (e.g. vs. NHS in England
           | which makes decisions about what to spend money on and makes
           | companies bid on contracts for the whole country), wasteful
           | premium care that adds little to patient outcomes (e.g. vs
           | Singapore which has a privatised tiered healthcare system but
           | heavily regulates healthcare so this doesn't happen), and
           | simply paying Doctors far more money.
        
       | scotty79 wrote:
       | Why is Google translate still so bad?
       | 
       | I remember that when it was introduced many years ago it was
       | horribly bad but it's badness was a hope that things will improve
       | quickly.
       | 
       | And after so many years and so much data available to google it's
       | still that bad.
        
       | nitwit005 wrote:
       | I'm sure it's possible to make their discharge instruction
       | template, but it seems inevitable they're hand out instructions
       | to people who won't understand them.
       | 
       | Even with native speakers, medical instructions can be difficult.
       | You can find lists of commonly confused English medical terms:
       | https://www.antidote.me/blog/medical-terms-a-to-z-common-and...
       | https://www.2ascribe.com/articles/health-wellness/40-words-t...
       | 
       | And, of course, there are still plenty of illiterate people.
        
       | abortionlover69 wrote:
        
       | [deleted]
        
       | jquery wrote:
       | Deepl is a better option. It feels several years ahead of Google
       | Translate in quality. I know enough Japanese to hurt myself, and
       | Deepl is definitely giving the superior translations, by far,
       | which is great for my studies. As an analogy, it's like going
       | from 144p to 360p (a good human translation ranges from 720p to
       | 4k+). Yeah 360p video is still blurry but it's in a different
       | league than 144p.
        
         | anon_123g987 wrote:
         | The problem with machine translation is not the obvious general
         | mediocrity, but the occasional undetected catastrophic failure,
         | especially in medical context. I don't think DeepL (or any
         | other fully automated system) is any more reliable in this
         | sense.
        
           | potatoman22 wrote:
           | Can any automated solution be reliable enough? I don't think
           | so unless you can prove it does less harm than a professional
           | medical translator.
        
       | atdrummond wrote:
       | For those who know better than I - does this article, when saying
       | Taiwanese, refer to Taiwanese Mandarin or the language also known
       | as Taigi/Taigu?
        
         | rahimnathwani wrote:
         | When speaking: probably not Mandarin, as in that case they
         | would have no difficulty finding an interpreter.
         | 
         | When writing: not a relevant question, as Google Translate is
         | for the written form, not spoken dialects.
        
         | LAC-Tech wrote:
         | Considering they were using google translate, I assume they
         | meant Taiwanese Mandarin. Though usually when I hear taiwanese
         | as a language in english it's tai-gi.
        
           | atdrummond wrote:
           | I was doing some research on Hokkien in general the other day
           | and that's when I noticed some using the endonym Taigu
           | instead. I'm not sure what the difference, if any, is.
        
             | rahimnathwani wrote:
             | Taigu is a Taiwanese-specific dialect of Hokkien.
             | 
             | Hokkien is spoken outside Taiwan (e.g. Fujian).
        
               | atdrummond wrote:
               | I'm aware of that, so apologies if that wasn't clear. I
               | was referring to the Taigu/Taigi distinction as the
               | source of my uncertainty.
        
               | thaumasiotes wrote:
               | > Hokkien is spoken outside Taiwan (e.g. Fujian).
               | 
               | It would be pretty shocking if that wasn't the case,
               | since Hokkien is spelled Fu Jian .
        
               | LAC-Tech wrote:
               | Right, but when people say "Hokkien" in English they
               | generally mean Min Nan Yu  - though I've also heard the
               | term "Southern Min" used.
        
             | LAC-Tech wrote:
             | I've only heard 'gi', but it looks like alternate
             | pronunciations[0].
             | 
             | I've only really dabbled in the language, but I quickly got
             | the impression it's not exactly standardised. Even
             | something as simple as 'I' seems to have two pronunciations
             | (gua and wa).
             | 
             | [0] https://www.mkdict.net/results?query=%E8%AA%9E+&page=1&
             | q_typ...
        
               | atdrummond wrote:
               | Ah, now that you've highlighted the specific
               | pronunciation divergence the two separate
               | transliterations now make sense. I really appreciate the
               | reply, given the relatively low stakes here.
        
       | aaron695 wrote:
        
       | pseingatl wrote:
       | Telemedicine is now a "thing," it is not that difficult to find a
       | medical professional in another country who is fluent in English
       | as well as the target language. Just as X-Rays are now commonly
       | sent overseas to be read, you can set up a Zoom call with a
       | medical colleague who is bilingual.
       | 
       | On the other hand, if you are complaining about the quality of
       | Google Translate, that is another matter. Deepl.com's
       | translations are better, but they support fewer languages. Google
       | Translate works on the amount of source material available in the
       | foreign language and what kind of source material. Mandarin can
       | be quite good. Legal Arabic isn't that bad either, after a United
       | Nations project to translate all Iraqi laws into English. There's
       | not that much Burmese; Thai translations are uniformly horrible
       | and as for Mizo? Forget it.
        
         | 1986 wrote:
         | As with anything in US healthcare, it's never that simple, e.g.
         | Telehealth providers outside of the US can't bill Medicare
         | (https://mhealthintelligence.com/news/doctors-outside-us-
         | cann...) which covers about 1/5 of the population.
        
       | [deleted]
        
       | atdrummond wrote:
       | I and some others in the healthcare/healthcare tech spaces
       | volunteered to create a discharge templating system for many of
       | the top non-English and non-Spanish languages used in the United
       | States - specifically the top languages in the Northwest to
       | start. Our offering utilized data from, and would have been
       | integrated with, an EMR whose name means "particularly
       | impressive" even if their response was anything but. After openly
       | communicating our plans with this firm for many, many months
       | (over two years for some of us) we were informed right before our
       | intended trial that we would be denied from providing our
       | services to the patients (and their providers) who truly needed
       | it. We were never given a reason and I've not seen any product
       | released by this firm in the interim to make me think we were
       | potential competition to any part of their EMR suite.
       | 
       | It was a truly perplexing and depressing outcome. Worse, as some
       | of our team hadn't yet had their sense of possibility and belief
       | in the US medical system destroyed, I saw first hand a number of
       | talented persons simply walk away from doing any work in health
       | or healthcare tech. It was a double blow that went beyond just
       | the loss of the software that was being created; people who
       | otherwise would have dedicated their lives to improving patient
       | outcomes instead went elsewhere with their careers or
       | volunteering lives.
        
         | nojito wrote:
         | Doubt your company is large enough to partner with them.
         | 
         | The issue with discharge templating is that EVERY single client
         | under that company gets customized support from them until you
         | are able to guarantee providing that level of custom support
         | you don't have a shot in partnering with them.
         | 
         | There's a reason why Caregility is the solution instead.
         | 
         | https://www.healthcareitnews.com/news/mount-sinai-eases-tran...
         | 
         | Touching the templates themselves is never going to scale.
        
           | atdrummond wrote:
           | It wasn't a company - there was zero profit motive here - and
           | we had received very helpful advice from them and strong
           | support until we got close to starting a trial, at which
           | point communication suddenly ceased and it became clear
           | something had changed with regards to our relationship with
           | them.
        
             | lotsofpulp wrote:
             | Perhaps when they actually got serious, they escalated it
             | to legal, and the lawyers shot it down due to your entity
             | not being able to take enough liability off of their hands
             | (conjecture). I can see the execution side stringing you
             | along but no one having actually done the legal due
             | diligence first, who may have shot it down early enough to
             | prevent you wasting your time.
        
         | pythko wrote:
         | I'm curious for more details on what your templating system was
         | and how it worked. If you're up for sharing, I'd love to hear
         | about it.
         | 
         | I know the aforementioned EMR puts a lot of emphasis on their
         | After Visit Summaries, which sounds somewhat similar to what
         | you describe.
        
           | atdrummond wrote:
           | Feel free to email me. I'm dealing with a death close to me
           | and some estate related issues so I may take some time to get
           | back to you but I will.
           | 
           | For what it is worth, we never saw ourselves as a replacement
           | for the After Visit Summaries but rather an adjunct that
           | ensured said Summaries could be understood and utilized by
           | non-speakers or ESL patients who perhaps are not as confident
           | in their skills.
        
         | sjtindell wrote:
         | My partner has used an EMR called Epic in her work and it, like
         | all EMRs it seems, is trash. Government protections and a moat
         | of network effects, they're untouchable.
        
           | potatoman22 wrote:
           | It's hard to design software that's both flexible and
           | reliable enough to meet the needs of these medical users. In
           | an ideal world imo, hospitals could plug in various modules
           | into an overarching health IT framework -- that way they
           | could pick and choose what works the best for them. However,
           | that would mean they're now working with dozens of
           | systems/companies instead of just one.
        
           | bena wrote:
           | EMR software, like all medical software, suffers from a
           | variation of the Dead Sea Effect.
           | 
           | Those who are truly invested in EMR software are not
           | developers and developers are not invested in EMR software.
           | So, as a developer, it's a job you take because you need a
           | job. And if you're competent, you can get a job elsewhere
           | eventually. If you're not, well, it's not like medical
           | software has a deep talent pool to draw from. You can coast
           | for a long time.
           | 
           | Combined with that, you have to work with doctors and nurses.
           | Doctors especially operate under the belief that demonstrated
           | competence in one area correlates to expertise in all areas.
           | No one bikesheds harder than a doctor. Except a doctor who
           | fancies himself a programmer as well.
        
             | potatoman22 wrote:
             | Besides pay, is there any reason a dev would be more
             | invested in any other B2B app? A few people I know work in
             | medical software, and a lot of them think it's meaningful
             | work.
        
       | analog31 wrote:
       | A relative of mine is deaf, and relies on Google voice
       | recognition in order to comprehend her doctors. The doctors are
       | all amazed that such a thing exists.
        
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