Although the importance of having well-trained medical interpreters is widely recognized, there are few national standards of practice. With support from the Fund and the California Endowment, the National Council on Interpreting in Health Care has laid the groundwork for creation of such standards.⁽¹⁰⁾ In a Council report reviewing interpreting standards in the United States and around the world, Marjory Bancroft, founder and director of CrossCultural Communications, found that conference, legal, and sign-language interpreting are far more developed than community or health care interpreting.

Health care providers who would like to offer translation services to their LEP patients must find qualified interpreters and secure resources to pay for their services. This can be particularly challenging in solo or small group practices, in which nearly 60 percent of physicians practice. The Fund provided support to the National Health Law Program to identify promising models for providing language services in small group settings.⁽¹¹⁾ The innovative practices identified include designating a staff member to direct language access planning; determining language needs at first point of contact with patients; and hiring bilingual mid-level practitioners or dedicated staff interpreters.

The Underserved Populations program is also supporting the dissemination of the National Quality Forum's safe practice regarding informed consent, whereby patients are asked to "teach back" their comprehension of a surgical procedure and its risks.⁽¹²⁾ So far, a number of hospitals have implemented this practice among patients with limited English proficiency or low health literacy.

Good patient-provider communication is an important component of health care providers' "cultural competency," but there is more to it than that. Cultural competency involves responsiveness to all aspects of a patient's culture, enabling providers to promote greater engagement of patients in managing their medical conditions.