Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Dr. William Sledge


The Limited English Proficiency (LEP) population in the United States requires interpreters in order to receive appropriate medical care. However, interpreters are not used consistently in clinical encounters. This study aims to identify the barriers that interfere with providing this service, as well as to propose some possible ways of overcoming these barriers. A systematic review of the literature was conducted using Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Twenty articles that presented barriers to interpreter use were identified. These barriers referred to either professional interpreters or ad hoc interpreters, or were general barriers. The barriers to professional interpreter use most frequently identified related to cost. Most of the cost-related barrier citations were found in studies conducted in the U.S. The barriers to ad hoc interpreter use most frequently identified related to concern about the interpreters ability to interpret. I determined that appropriate provision of interpreters to the LEP community would require four elements: 1) The consistent use of professional interpreters, and the elimination of ad hoc interpreter use. 2) Research into the possible financial benefits that may arise from increased interpreter use, and how the cost of providing interpreters may be offset by the widespread benefits of using them. 3) Professionalization of interpreter services, with quality assurance and standardized training and evaluation of interpreters. 4) Increased education and training for patients and providers about the language services that are available and how to access them, and about how to work with an interpreter efficiently and effectively. One possible solution that would allow the implementation of all of the above elements is a national interpretation service.