Making Sure the Message Gets Through

From the legal newspaper comes a reported settlement between a deaf would-be patient and a surgeon who declined her request for a sign-language interpreter.

The would-be patient, a profoundly deaf person, scheduled an appointment for a consultation about a cosmetic procedure. With the assistance of the Greater Los Angeles Council on Deafness (GLAD), the patient explained to the receptionist that she needed the physician to provide an interpreter for the consultation. The receptionist responded that the doctor’s office did not provide interpreters, but instead would handle the communications through written notes.

The would-be patient claimed that when she sent the physician a fax and letter explaining why the note-sharing arrangement would not be satisfactory, the physician’s office did not respond to the fax and returned the letter unopened.

The would-be patient, represented by attorneys for the Center for Law in the Public Interest, filed a suit against the physician for failure to reasonably accommodate the deaf woman. The suit contended that the refusal to provide effective communication violated the California Unruh Civil Rights Act and the federal Americans with Disabilities Act.

Lew Hollman, executive director for the Center, said in a telephone interview that these laws require a physician’s office to treat those patients with disabilities the same as those without disabilities. Thus, according to Hollman, the cost for providing reasonable accommodations falls on the physician—so long as such efforts are not unduly burdensome.

Hollman explained that relying on notes between the physician and patient is rarely sufficient.

What even many physicians don’t know, said Hollman, is that a person who is deaf from birth will likely not have developed effective reading and writing skills, despite having high intelligence. Even for those deaf patients who read effectively, said Hollman, a balancing act must be considered. “If it’s the flu, writing notes might not violate the law, but anyone contemplating surgery or a major procedure should have an interpreter for proper informed consent.”

The current average rate for interpreters is $50 per hour with a two-hour minimum. A physician writing notes with a patient may be a false economy: Communicating with a deaf person through writing takes five to six times longer than using a sign language interpreter. “It is cumbersome, always limited in content, and often results in misunderstanding,” said Jo Ann Madden, director of the Lifesigns interpreter-referral program at GLAD. “Written communication is effective only when the communication is brief and simple.”

Madden said that Medi-Cal has recently begun reimbursing physicians for a good portion of an interpreter’s hourly rate. She also said her program is open to finding cost-effective arrangements for physicians with special needs. Not well known is that some HMOs also cover the costs of interpreters if arranged through the physician’s office.

Without admitting liability, the surgeon ended up settling the dispute by paying the would-be patient $5,000 in damages and paying the attorneys $37,000 in fees. The physician also agreed to change his office policy on providing interpreters to deaf patients and to train his staff on the issue.

For more information on arranging for a sign-language interpreter, contact LIFESIGNS at (323) 550-4210 or consult the GLAD website at www.gladinc.org.

Gordon Ownby is CAP-MPT’s general counsel. Comments on Case of the Month may be directed to
gownby@cap-mpt.com.